Updated

The two of you are having sex, but only one is climaxing. And it’s probably not her.

The number one "Dear Doc" question I get has to do with "lack of desire," "lower libido," or "inability to achieve orgasm" for women, and it can be caused by a number of physical and psychological factors.

Once the kids are out of earshot, read the following out loud to her and see if she’s shaking her head in agreement, then make the necessary adjustments to make "Oh, no.." turn into "Oh, yes!"

1. Distractions

In order to be able to achieve orgasm, women need to be able to focus. Everyday distractions ("Did I leave the oven on?," "Is that a door I heard slam?") can make the relaxing and concentrating that are needed, impossible. It’s neurological — women are just rigged that way.

2. Bad Technique

It’s not really a guy’s fault — he probably learned his moves way back when from a videotape that was produced by a man, staged to entertain men, then passed around among his friends until someone left it in the family VCR and it was confiscated. However, he is responsible for updating his technique: asking and listening to what she says she needs in order to see the fireworks.

3. Breaks and Lube

A big deal breaker: inadequate foreplay. The "man in the boat" isn’t just a passenger, he’s the damn captain, and don’t you forget it. Seventy percent of women cannot climax with intercourse alone! "Lube," like KY Jelly, Astroglide or any other "personal lubricant," should be stocked in the closet with the importance of candles, batteries and the freeze-dried food in your survival kit.

4. Fear of Babies

Research shows that fear of pregnancy can make relaxing enough to "let go" impossible. Fear of STDs is another.

5. Zzzs vs. Os

Fatigue or sleep deprivation is a well-known libido-killer. If you find yourself hesitating between "nookie" and "snooze-button," you are at high-risk.

6. Self-Image Problems

Sure, guys can pat their gut and call it winter fat and still get as aroused as when they had visible six packs 10 years ago, but women aren’t so lucky. Those 10, 20 or 30 pounds you’ve gained not only put you at risk for diabetes and heart disease, but they can take a hit on your sexual self-esteem like nothing else. So don’t just wear that favorite gym T-shirt, actually go there and work out.

7. Mommy Brain

It makes for fantastic mothering. Bionic hearing, incredible intuition, stamina and rage of a mother lion when the baby is in question. Add to that a healing episiotomy or Caesarean, discomfort of blocked lactation ducts and some of #6 above … can you blame her when she’s "not in the mood?"

8. A New Day

A woman’s hormones change every day, every month – and then factor in childbirth, postpartum depression and peri- and post-menopause. Finally hormones are getting the attention they deserve, along with brain neurotransmitters. What does this all mean? The female brain and body make up a complicated machine, with no one-size-fits-all manual for it.

9. Guilt

Religious guilt, relationship guilt, or just plain old run-of-the- mill guilt can get in the way of being aroused. Shyness or embarrassment about asking for whatever type of stimulation works best can also cause a roadblock. Negative attitudes toward sex (usually learned in childhood or adolescence) can make it hard to enjoy sex as an adult.

10. Not That Into You

Slow degradation of sexual interest in long relationships, lack of emotional involvement, boredom and monotony in sexual activity = lower or no libido.

Dear Doc,

Any book recommendations for parents who want to be lovers again?

— Fred and Gail

Dear Fred and Gail,

Try "Love in the Time of Colic: The New Parent’s Guide to Getting It On Again," by Ian Kerner.

You’ll love it!

— Dr. B

Dr. Belisa Vranich is a psychologist and sex expert. She is the author of four books, including her latest "He's Got Potential," which is in stores now. Do you have a "Dear Doc" question? E-mail Dr. Vranich at DrBelisa@gmail.com and check out her Web site at www.drbelisa.com.