For a fulfilling sexual relationship, women particularly need to feel love and to have energy without fatigue, a hormonal balance that allows peaceful emotions, and some level of relaxation with a good sex drive. Men need good circulation to create a penile erection, physical vitality, and good hormone function. Lust often encourages more passionate sex. This is most common early in a relationship, when fantasy and sensuality arouse the sexual desires of both sexes. But for a longer run and repeat performances, some other qualities must be present in the relationship.

A big obstacle to a longer-range satisfying sexual relationship is boredom or complacency. Becoming used to each other, along with the little day-to-day irritations or conflicts, can easily interfere with the sexual energy of either or both partners, and soon, sex may be a rare occurrence, decreasing in frequency from daily or weekly to monthly or even less often. Bringing a feeling of freshness, fantasy, romance, and new energy into the relationship and bedroom will often revive the sex life. Creativity in a relationship is important.

There is no reason why sexual activity has to decrease in later years, though for most people, it usually does become less frequent. The changes that come with age still allow sexual function; realistically, however, it is not the same as it is in a young person. Women have lower hormone levels later in life unless they go on hormone replacement, but they can still maintain sexual vitality and drive, with or without hormones. Men usually have less decrease or a less distinct cutoff in hormone levels, which are more necessary for their sexual function. As long as there is good circulation and cardiovascular health, both sexes can maintain a good sex life. Obesity, poor diet, mental and emotional stress, and cardiovascular disease are some common conditions that can interfere with sexual vitality.

The Chinese have a concept about the frequency of ejaculation and orgasm for men and women that is described in the fascinating book The Tao of Sex and Loving by Jolan Chang. According to this theory, men are meant to have frequent erections, lots of sex, and only rare orgasms. Regular ejaculations drain the kidney/adrenal chi (energy) and possibly lead to fatigue, decreased vitality, or lower back weakness in men. When the adrenals are weakened, there is also lower ability to handle stress. Men can learn to have more complete orgasms without ejaculation with special techniques described in the book. Women are meant to have as many orgasms as they wish, which are energizing to them. And if the man is not releasing all the time, he will have more sexual vitality to satisfy his partner. Sound intriguing?

Many other factors seem to affect sexual desire and performance. Alcohol, nicotine, coffee, marijuana, and sugar are some of the pleasure drugs that may reduce sexual vitality, as can many pharmaceuticals, such as tranquilizers, antihypertensives, particularly beta-blockers, and birth control pills or hormones. Other factors that may influence sexuality include genetics, childhood upbringing, personal attitudes, and basic hormone levels. For example, men with higher testosterone levels and better adrenal function usually will have more sex drive.

As mentioned earlier, stress levels also can interfere directly with sexual function and drive. Often, underlying worries about money, job, and so on take our minds off sex. A recent study revealed that men who received raises or promotions at work increased their sexual frequency; the reverse happened to those who were demoted or whose pay was decreased. (For more understanding of stress aspects, see the Anti-Stress program. Further discussion of sexuality is found in the programs for Adult Men, Adult Women, and The Elderly.)