But I did and do have fears and insecurities about the so-called LBD. You know, on one level, I think that the myth of LBD has to do with the ways that society conceives of and configures female sexuality. It’s assumed that two dickless women couldn’t possibly sustain the passion without falling into a pleasantly platonic, non-erotic relationship. It comes from the patriarchal desire to see women as non-autonomously-erotic beings. I think it’s important to consider the ways in which our insecurities and fears of LBD can involve, to a greater or lesser degree, some internalization of this myth.

I have also found it helpful to focus on the value of quality over quantity. Like you, I was seized with fears about there not being enough passion to sustain us in the long haul. Often, this type of fear becomes a self-fulfilling prophecy, as our fears tend to get in the way of our arousal and ability to communicate. I’ve also found it really helpful to be patient with myself and my lover, and to not be so hard on ourselves. There is no magic number of times that you need to have sex to maintain the love. The key is to create a situation where both partners feel loved and accepted and free to express their desire without negative consequences. If one of us is turned on and the other is too tired, we try to go for a quickie with a vibrator while telling each other fantasies or just holding each other and kissing. The Hitachi Magic Wand is always there to give you an orgasm, and the tired partner can be intimately involved without exerting herself.

Now, to answer your specific questions:

A. Keep following up with the doctor, but go easy on yourself. Feeling bad about being tired will only drain your energy more. It’s perfectly understandable that you’re tired, and it need not affect your relationship in more than superficial ways if both of you feel accepting of your limitations.

B. I think it’s really important to take the pressure off. Sometimes just mutual masturbation with the Hitachi Magic Wand, some great sexy story-telling and cuddling afterwards can go a long way towards relieving horniness and fostering intimacy without tiring you out like marathon sex. I’ve also been meaning to try those intimacy exercises for couples, which involve taking sex off the table completely for a few days and just focusing on non-genital massage initially, working up to taking off clothes in a few days and touching all parts, but with no penetration or clitoral stimulation until the culmination. You can take a week or longer. I’m sure you learned about this technique during your M.A. There are different schedules on the internet, most designed within a heteronormative framework, but you can easily adapt a schedule for your own needs. Finally, scheduling can be helpful for some people, though not all. Figure out whether you like to schedule sex at a convenient time or if it just adds to the pressure. Scheduling morning sex works for some people, although if you’re totally not a morning person like me, don’t bother trying. I do enjoy scheduling a sex retreat for days when we both have several free hours.

C. Like I said above, Q should explore the cultural myth of LBD and the ways it might be informing her fears. I’m sure you’ve been as reassuring as possible that you still desire her and want to have sex with her. And, besides the fact that LBD is a cultural myth with major implications following from that, all sexual relationships have ebbs and flows. Sometimes there are periods of more sex, sometimes it slows to a trickle. Once or twice a week is more than enough to sustain intimacy. Feeling inadequate because you’re not meeting an imaginary quota is draining and definitely not arousing. Focus on the present, and quality over quantity. Why are sexual acrobatics more meaningful than physical affection in terms of intimacy–unless you’re afraid of losing intimacy? And, look, I know there’s nothing quite like coming with your lover’s brilliant hand inside of you, but we all have plenty of toys to give us physical gratification when we feel the need.

D. Yes, communication is key. But after a certain point, Q’s insecurities are her own, and you shouldn’t feel guilty because you’re not responsible. I have a hard time accepting it when I’m all revved up and my lover is not or is falling asleep. I’ve done a lot of work myself in terms of accepting her as a separate person with different needs and desires. It’s not her responsibility to help me with this after she’s reassured me that she loves me and wants me. It’s her right to not be turned on right when I am, or to be exhausted when I’m excited.

E. There are so many ways to explore our passion for each other without having strenuous, energetic sex. I have become quite an accomplished story-teller, for example. Once you both get your individual anxieties and guilty feelings out of the way, you’ll be able to communicate more effectively and come up with inventive ways to keep up the erotic gratification and intimacy.

As far as your sex/relationship problem, I would go the extra mile to make sure Q knows how much you care about her and how much you still want her. I’m a romantic, so I’d go as far as having flowers delivered to her, sending cards, writing letters, buying jewelry, baking cupcakes with messages written in icing, whatever it takes.

Buena suerte!

a) Talk to your doctor. Also… all those things that they say? Keep going to bed at the same time each night, avoid caffeine, etc? Do them. They suck, but do them. I have to keep a new schedule over a MONTH before it clicks, but eventually it will click.

b) Carnivelsq was spot on for this one. Find a time that you are both around, but before bedtime. Instead of cooking dinner together, grab takeout and eat after sex. Look at your life and find the thing you need the least. Because sex obviously is one you don’t want to give up.

Maybe shower together? That would save time… ;)

c) I like the answer “communication”. But also… sex. Honestly. Even if it isn’t as often, the sex is still great, right? So remind her, once in a while, that you still find her absolutely stunning.

d) Continuing up with the medical end of it might help this a lot. Maybe even let her in on the meetings with the doctor, if you are to that point. Let her see that you are trying to figure it out, and are not complacent.

e) Carnivelsq is right, again. Communication.

a) sorry to say it, honey, but i think you answered this one already. congrats on having a fullish time job, but it really is kind of hard to work and do a lot else (especially be sick).
b) this one’s hard, because to some extent you probably shouldn’t push yourself too hard, so that you don’t get even more burnout. but for me, i’ve found that no matter how tired, if she starts something i never want to say no. the hard part there is that she feels like she’s being pushy/inconsiderate/something.
c) keep it up. that is, even if it’s down to once a week, if it’s consistently at least that often (or whatever frequency you find sustainable with everything else), then at some point i think it becomes clear that this isn’t a downhill spiral towards *no sex!* – it’s just a single step into a different rhythm.
d) god, this one’s hard. insecurity is rough, and as hard for you because there’s so little you can do. as carnivalesq said, keep saying it. and keep being affectionate, even when you know there’s no chance for “more”. neither of those things feel like much consolation as they happen, but it adds up, and it does help. also, amazing sex. even if it’s less often, if the sex is still as awesome (or awesomer), it does wonders to banish insecurity =)
e) all of the above, and, of course, communication.

anyhow, that was a little long, and it’s kind of based on what i’ve been doing/dealing with/thinking about recently. i don’t know how well it relates to you, but i hope it helps a little.

It’s tough, sometimes it doesn’t really help to hear “it’s not you,” but just keep saying it. I feel like you can make it work somehow, or weather it out.