Sex therapist Ian Kerner shares the secrets to talking about sex

Ladies, think twice before you decide to hold back your sexual frustrations from your partner. It’s not only bad for your relationship, it could also be harmful to your health, according to recent studies.

Last week, the “New York Times” reported that it’s not what we fight about that makes the difference, but rather how we fight, and how those ways of arguing affect men and women differently. The way you fight can have just as big a toll on your health as other factors such as diet, exercise and cholesterol.

Confrontation naturally triggers the brain’s “fight or flight response.” Many men respond by fighting, and it’s been shown that this confrontational approach to arguing raises heart rate, increases blood pressure and plays a role in stress and heart disease. But, interestingly, the opposite reaction, flight, can be just as harmful, if not worse, to women: It leads to self-silencing, and this bottling-up of emotions leads to stress, anxiety, depression and a cascade of unhealthy behaviors.

Not surprisingly, sex is one of the main reasons people argue, often above money, housework and other common sources of conflict. Sex is also one of those subjects that women tend to keep bottled up because they’re afraid of an angry reaction. You can be lying in bed next to someone and feel a million miles apart from them. But self-silencing and bottling up emotions around sex leads to severe depression, anxiety and often infidelity.

So women, don’t go to sleep on a sex issue. Talk about it. I know that’s easier said than done. Just recently a female patient of mine recounted the harrowing experience of trying to talk to her boyfriend about his lovemaking skills: “It was like a scene out of ‘Taxi Driver.’ He gave me this Robert De Niro ‘you talking to me’ look, and then pointed his finger in my face. I swear I thought he was going to off me!”

How to talk about sex with your man
When it comes to communicating about sex, there’s often a gap between what we want to say and how we end up saying it, and even the gentlest of words can come off as confrontational. Criticism, expressed or perceived harshly, is the sexual kiss of death. So if you can, try to express your desires as a positive turn-on rather than a negative turn-off. Instead of telling him, “You don’t know anything about foreplay or how to please a woman,” tell him that you had a sexy dream about him last night — trust me, he’ll want to know more — and then describe the foreplay you’d like as though it was something he was doing in your dream.

Also, anthropologists have long observed that women are “face-to-face” communicators, while men do so “side-by-side.” This means that women are much more comfortable with direct eye contact, which probably has a lot to do with the female history of nursing, cuddling and generally fawning over their infants all the while staring lovingly into those big baby eyes.

Men, on the other hand, find direct eye contact extremely confrontational. As Helen Fisher wrote in her remarkable book, “Why We Love,” “this response probably stems from men’s ancestry. For many millennia men faced their enemies; they sat or walked sat by side as they hunted game with their friends.” So unless you want your words to send him into battle, use evolution to your advantage and have a sex talk while taking a walk or drive, or shopping or watching TV.

But if you’ve ever sent a guy out on even the simplest of errands, you know that words are not enough. Not only do you need to tell him (if you’re shy about vocalizing, try telling him one morning that you had a sexy dream about him and then describe what you want him to do as though it happened in the dream), but you also need to show him, like by placing your hand over his and letting your fingers do the walking — you need to reinforce it with positive feedback.

The main thing is not to go to bed on that sex issue. It’s not good for your relationship, or your health!

Ian Kerner is the author of several books, including “She Comes First: The Thinking Man’s Guide to Pleasuring a Woman.” Learn more at IanKerner.com.