Natalie Morales: Willer, thank you. This morning on Today's Woman you've heard the expression 'No sex please. We're married.' Well, it's an old joke. But for millions of husbands and wives, keeping the flames of passion burning is no laughing matter. Apart from the benefits, experts say, that a healthy sex life can also be an important sign of a relationship's overall happiness. Today, contributor Dr. Judith Reichman is the author of I'M NOT IN THE MOOD and the relationship expert Michelle Wiener Davis is the author of The Sex Starved Marriage. Good morning to both of you, thanks for being here.

Both: Good morning.

Natalie Morales: Such an important topic, obviously for our healthy relationships. And Michelle, let me start with you. How do you define a sexless marriage? And is it more of a widespread problem than we even know of?

Michelle Wiener Davis: Well, the research is telling us that if couples are having sex fewer times than ten a year, uh..that it is really a sex starved marriage. But I tend to look at it in a slightly different way. Because unlike vitamins, there are no daily minimum requirements for a healthy sex life. uhm, what, so, what happens so often in the couples in my practice is that one spouse is desperately yearning for more physical touch , more closeness, more sex and the other one is just figuring "uh, it's just sex.

Natalie Morales: Is that one spouse more of men wanting it more often than women, or does it go both ways?

Michelle Wiener Davis: I'm so glad that you're asking that question, because we always hear about women not being in the mood and it's true that...

Natalie Morales: Right! I got a headache.

Michelle Wiener Davis: Right! Exactly. And it's true that more women than men complain about that. But I am convinced that low sexual desire in men is America's best-kept secret. And when I talk to my colleagues, they do sex there will be, they all agree that men feel so much shame about admitting that they're just not in the mood, because virility and you know...

Natalie Morales: Equated with their manliness.

Michelle: Absolutely, absolutely.

Natalie: So how much of it is would you say physical versus mental, the psychological factors that are involved?

Michelle: Well. It's definitely inseparable, I mean that all the issues that I'm sure you've got to hear are overlapped.

Judith: I mean, as a person who takes care of these physical problems and talks to couples and women about their actual medical issues, I would say that 75% of the time it is psychological, and only 25% of the time, especially in the younger couples do I find that there's something medical going on.

Natalie: Let's talk about what's happening, because children obviously a huge factor, once you have children, well, priority shift, right? What is happening in that case? Are we seeing more of a change or transition in the relationship? And Michelle, can you start to rekindle the flame?

Michelle: Well, clearly, children are a big issue, we become such a child-focus culture that our chil.., we're running our kids to lessons and all sorts of activities, and the marriage gets put on the backburner. I always tell couples that the very best thing that you can do for you rela.., for you children is to put your marriage first. But there are lots of other relationship issues. So many people tell me when there are underline resentments and anger; it really stands in the way of feeling close and therefore wanting to be physically close.

Natalie: Such feeling seems to happen to the wife that "I am doing enough around the house,(absolutely) you can kinna take that out on the others, on this house".(Absolutely.)

Judith: But even if having babies, I mean there are some physical changes that women go through. For example, when a woman is breastfeeding,(Sure.) and a couple of weeks ago, we talked about how really important it was to breastfeed, hopefully for a year, during that period of time, there's an increase in the production of something called prolactin, and that's the hormone that lets the milk down. And that actually prevents ovulation, decreases hormones, so here are these young active women mothers and they're having thinning and dryness in the vaginal area that actually leads to a, we call it Atrophic Vaginitis and sex hurts, or something hurts, you don't wanna do it. (Sure.) So often the complaint from women who had babies is "I don't wanna do it, it hurts." And then they remember that hurt even after they stop breastfeeding, it continues to become a habit. And voila, this couple is no longer having satisfactory sexual relationships.

Natalie: And what about older couples? I imagine there are more medical issues as well.

Judith: Absolutely! As we go through peri-menopause and menopause(Sure.),there are these fluctuating hormones, and let's face it, they affected our brain, our body, our genital organs, and if you have less estrogen, there's less moisture, there's less blood flow into the vaginas. So arousal is affected and then many people talk about testosterone and that too may go down. And it's not just total testosterone, it's someone we call free testosterone, that which is unbound like Sampson. And basically we probably need that too for sexual response. That can change in peri-menopause and menopause. And we sometimes talk about how we can address this and what kind of hormones we can possibly use.

Natalie: And when I get into that and a woman, she just..

Judith: Yeah! But if a woman comes in and says to me: Oh, you know, sex is no good, I'm not having relationships, my marriage sexes, test me.

Natalie: Right!

Judith: And I'll say something like: "Well! Does it become OK when you go away on a vacation and you have a romantic evening?" And she says, "Yes."Then I'll say "You're wasting your money, we might as well not test. It's not hormone normal."

Natalie: Ok