He couldn't resist the temptation to cheat five times in three months. Hardly an affair. She'd asked him how he was. He succumbed. That's all it took for this God-fearing man.

They'd watched my TEDx talk on the No Sex Marriage: Masturbation, Loneliness, Cheating and Shame. She wanted me to be an expert witness in his divorce trial.

He admitted to the indiscretion. Regardless, the division of assets lay in the hands of twelve southern jurors, not one with a high school diploma.

The deposition read like War and Peace, sans peace. 1000 pages, the cheating paled by comparison to the lesbian liaisons, limousine lovers, parental alienation, drinking, hateful women and murder.

Cheating is the ultimate betrayal but so is imposing fidelity in a sexless marriage.

In late winter, I flew to Georgia.

We met for dinner, the lawyer, her client and me. His lawyer wasn't sure if the best strategy was to bring attention to his indiscretion. The jury was impatient. This trial had been going on for weeks.

His ex-wife subpoenaed sixty friends. Besides, the lawyer felt the jury empathized with him.

A recess for Christmas. The trial played out into the New Year.

The assets were divided unfairly……in his estimation. His legal bill was $300,000.

Betrayal all around. He believed she never loved him. He didn't want the marriage to end.

The real sadness is that this couple never had the right help. Sexless marriage is a thing. There is help.

Maureen McGrath hosts the Sunday Night Health Show on CKNW, CHQR, CHED and CJOB. She is a registered nurse , executive director of the Women’s Health Initiative Network, and in clinical practice in North Vancouver. She also does telehealth consults for people and couples all around the world. A TEDx speaker, she is author of Sex & Health: Why One Can’t Come Without the Other. Her radio show is a free download on iTunes. Sextalk

Her website is: Back To The Bedroom

To book an appointment email Maureen at: [email protected]

For those of you who are new readers (and for those who may have just missed a few articles) I wanted to showcase the top 10 most read articles so far! As always, feel free to leave me a comment or write me an email if you have any sexual-health related questions – my door is always open!

TOP 10 MOST READ ARTICLES

(1) Replens® vs RepaGyn®: What's the Difference?

Given the variety of personal moisturizers available, it is so important that a woman chooses the right product for the right reasons. Knowing the ingredients and how it works is also one important aspect of optimizing treatment. Meredith had tried Replens® for vaginal dryness but was still experiencing pain with intercourse and wondered if RepaGyn® might be a better choice for her. Read about my recommendation for Meredith >

(2) 5 Tips for a Better Sex Life

Is your sex life in a slump? If you have stopped fantasizing about sex or have no interest, and this cannot be better accounted for by a medical condition, you may have low sexual desire.  Fatigue is the number one cause of low sexual desire but there are a number of other root causes that could be at play. Time is a hot commodity these days and lack thereof may result in less spent in the bedroom. View my 5 tips for sprucing up your sex life >

(3) Doctor, It is Dry Down There

I ask every patient of mine if they experience vaginal dryness, because I know they won’t tell me on their own. Most often, women will answer by saying, “I am not sexually active.” One does not need to be sexually active to experience vaginal dryness; women associate the vagina with sex but it is time we associated the vagina with health! Learn what you can do about vaginal dryness right now >

(4) Caught Red-Handed... You Won't Believe the 'Now What'

Joanna, married for 17 years entered my clinic after discovering that her husband had been communicating sexually online with another woman. Admittedly, life had become hectic and sex was infrequent. The couple had not discussed their arid sex life or her dwindling sexual desire; she assumed that Caleb was not bothered, but she now had evidence to the contrary and felt that she needed to talk action... Read about how Joanna took control >

(5) A Fish Named Wanda

50 year-old Wanda told me, during a routine visit, that she and her husband were not sexually active. In the past month, they only had sex once and he had difficulty attaining and maintaining an erection (the textbook definition of erectile dysfunction). She also suspected that he was communicating with other women. It would be important for Wanda to talk to her husband about how his recent activities were negatively impacting their relationship. Wanda might have to release her fish as he needed to help himself and accept responsibility for his actions. Read more about Wanda's story  >

(6) My Angry Vagina

47 year-old Susanne told me that she and her vagina were both angry. She had a vibrant sex life in her twenties and thirties but more recently had the unfortunate circumstance of requiring chemotherapy for breast cancer. It was at this time that sex became extremely painful and her sexual desire plummeted. As if her sexual desire wasn’t already low (due to peri-menopause) this made things worse. Read more >

(7) Can a Lack of Sex Lead to Divorce?

Recently I had received some criticism for saying, “if couples are not having enough sex, then men may cheat to meet their sexual needs.” Understanding that men’s sexual drives are driven by strong urges and cravings, I saw this simply as a risk factor for infidelity, a public service announcement of sorts. Other women did not see it this way and perceived this as blaming women for men’s bad behavior. Learn how I enlightened Valerie >

(8) Understanding and Managing Vaginal Dryness (Video)

I am extremely passionate about empowering women through teaching them about taboo subjects such as vaginal health. To that end, I was delighted to be invited by Canadian Health & Family (Better Living TV) to discuss vaginal dryness, a common but not often discussed condition, which affects many women.! Watch the 4-minute video now >

(9) Aligning the Stars

Elsa asked me about a new sexual desire gel she heard about on the radio, called V-Love. Divorced for over two years, she had always been hesitant to delve into the online dating world because she’d been living with low sexual desire due to vaginal dryness. Although she was interested in meeting someone to spend time with, she was hesitant because of her low sexual desire (which she did not realize stemmed from her vaginal dryness). Learn how Elsa was able to get back into the dating world, comfortably >

(10) Ladies are Fooling Themselves: Men Need Sex

As a rule, men cannot go without intimate sexual relations when in a relationship unless they are having sex with someone else. That may sound drastic but believe me, the men in sexless marriages come to my clinical practice and tell me about their intimate experiences with other women from friends, to women seeking sex online, to prostitutes. Ladies, if you don’t think it's important to seek treatment when your relationship is good and you stop having sex, think again. Shutting the door on your sex life may have other consequences. Learn how to face your situation >

Well, there you have it - the top 10 most read articles (so far). I hope these articles have helped you get back to the bedroom!

“Life is short, have an affair” is the company slogan. This lures people in much like a seductive mistress in a den of iniquity.  Quite the tag line for an imperfect world where (in part) because of the internet, entitlement is the order of the day. Having our needs and secret fantasies met privately, of course, is a right.

I am surprised at the responses to the realization that extramarital affairs are common. With some of the statistics like 37,000,000 members to the 880,000 citizens in Ottawa, it seems that fidelity is an unrealistic dream. The nightmare of the alleged breach and exposure of people on Parliament makes it seem like affairs of the heart trump affairs of state. Perhaps we need to bring "the Donald" to Parliament Hill.

Many of my patients have confessed memberships in a club that boasts privacy in penetralia. They may have cheated for a plethora of reasons but the one common denominator is that they are all panicked. And so they should be, their right to privacy has been breached.  But what about their partners?

What has surprised me above all else is the reaction to the cheating spouses because many people find this behaviour repugnant, forgetting their own foibles. So many people are irrationally angry with cheaters. Many people who have expressed this sentiment to me have been targets of discrimination and hatred themselves. We can say it is human nature to judge others... it makes one feel better about themselves.

People in relationships and marriages cheat for a multitude of reasons and they stem from cultural, educational, psychological, emotional, to relational. Many couples stop having sex for medical reasons and at the risk of hurting their partner may have chosen what they thought of as the most secretive spot to have their sexual needs and biological urges met. "Too bad for those men, they’re cheating dirt bags, and deserve no such discretion,” the hackers wrote in an online manifesto... “Too bad for Ashley Madison, you promised secrecy and didn’t deliver.”

Well as karma would have it, the trusted cannot be trusted. Those who cheated on their partners, those who breached their own marital vows and agreements with their husbands, wives and other life mates have been betrayed as well.  What goes around comes around comes to mind.

That said, my faith in humankind will be lost if the sexual desires, fantasies, nude photos, and clandestine affairs of private citizens are splattered across the internet, like a modern day Scarlet letter on steroids. Yet it is human nature to judge others. Perhaps on one level, it builds one's self esteem, makes us feel better about ourselves and our choices. "Well I may have smoked pot, run a red light, and beaten my wife, but at least I never cheated on her."  Do we get some satisfaction knowing someone was worse off than we were? Who is to judge?

It seems to me that 37,000,000 people have been betrayed in this marital minefield from those who have been cheated on, to those who have cheated, to those who encouraged cheating. Betrayal is one of the most damaging emotions as it cuts to the core of trust the cornerstone of any relationship.

Before we judge a person, we must walk in their shoes, walk their path traveled, live their fears, sorrow, pains and joys. We all have a story and only the truth is interesting. This is a sad story and all of the players deserve empathy and understanding. One can only judge if they live another’s life.

She said that their sex life had dwindled down to barely palpable. In other words, they barely touched each other any longer. Before children their sex life was robust and fun! The problem she faced, in addition to the daily fatigue as a mom who was not sleeping through the night, was that sex was painful.

She knew she avoided her husband because after a full day of three little ones tugging on everything all day, the last thing she wanted when she fell into bed was to be touched. She did not have time either to address her vaginal dryness either and she had never mentioned this to her husband because she was embarrassed. This was a tremendous worry. Not only was she trying to raise her children and excel at that, she now had to deal with betrayal, betrayal she knew happened due to her neglect of her health issues... she neglected her husband.

Brynn decided it was time to speak to someone about her vaginal health and her relationship. She heard me, on the CKNW Sunday Night Sex Show, say that I was the “vagina whisperer" as well as a "sexpert." She wondered if there were any treatments for vaginal dryness that may help her to resume sex with her husband.

I explained that a personal moisturizer would probably be the best treatment option for her given the chronicity of her problem. Lubricants are a short term solution only and typically used during sexual activity to reduce friction. Personal moisturizers provide longer-term relief. For example, RepaGyn® is an ovule inserted into the vagina once daily for eight days as a treatment period and then twice weekly (or as needed) as a maintenance period. After two months, Brynn should be feeling better.

Brynn felt betrayed but knew in order to save her marriage she would need to confront her husband, Jack about the affair. She hoped the affair with his co-worker was about sex, not love. Intellectually, Brynn could understand why her husband cheated on her and she knew they had to work together to save the marriage. She hoped that Jack would want to work things out but only time will tell. It is always important to look after one’s health especially your sexual health and/or vaginal health as it can greatly impact your relationship. Attending to your sexual health will help you get back to the bedroom.

First, I asked her how long it had been since she and Josh had sex. She said it had been about five years mainly because of vaginal dryness; she said it had become increasingly difficult for her to have sex with her husband due to the associated discomfort of pain during sex (dyspareunia) and boredom in the bedroom.

Josh, an attorney himself, was 10 years older and Thelma thought (had hoped, really) that by the age of 62 he would no longer have an interest in sex. Boy, was she wrong. At 52 she was no longer interested in sex and wondered when it might end for him. Quite possibly never, I told her.

From cradle to grave, we are all sexual beings and there is no magic age when sex stops. There are, however, circumstances which may alter a person’s ability to engage in sexual intercourse; medications, medical conditions and injuries to name a few. Men in particular though have sexual urges and cravings that are different from most women due to biological need and socialization.

Thelma felt betrayed by both her friend and her husband. Her immediate response, after learning about the affair, was to end her marriage and run away. She told her husband that he had 2 weeks to move out of the home they shared and then she left on a road trip to visit her parents, her best friend, and her sister in an effort to process her pain.

Thelma realized that her vaginal dryness had so many consequences on her personal life as she grieved the loss of her marriage and her best friend. I explained to her that vaginal dryness could also affect her physical health. Estrogen receptors decrease in the vaginal walls during peri-menopause (the years leading up to menopause), which leads to vaginal dryness.

Lubricants and personal moisturizers like RepaGyn® (hormone free) vaginal suppositories will help her to get relief from her vaginal dryness. If vaginal dryness is left untreated it may advance into vaginal atrophy, a condition associated with additional symptoms such as urgency, leakage of urine and recurrent urinary tract infections. Vaginal atrophy may require low dose localized estrogen treatment.

Thelma decided to carry on with her plans to divorce Josh and I could not help but think that had she dealt with her vaginal dryness early on, she may be headed back to the bedroom with a bag of tricks to spice things up instead of to the courthouse to split things up.

Enter Valerie (not her real name), a fifty-something divorcé, who presented to my office after having had her marriage break up (seven years prior) due to infidelity. She presented to my office because she decided she did not want to be alone for the rest of her life but she knew she needed to address her vaginal health. After menopause, which occurred at age 47 for Valerie, she experienced low sexual desire due to vaginal dryness. Because of this, her sex life with her husband, Bob (not his real name either), dwindled to a few times a year and it was painful each time. She had no idea where to turn... but he did.

He turned to other women, a few other women. Valerie was heartbroken when she received a phone call from a woman who had been sleeping with her husband. The woman called to tell Valerie that her husband was sleeping with someone new effectively cheating on both of them. Valerie’s husband felt tremendously guilty about his indiscretion (which is not uncommon). They tried to work it out and Valerie said she had sex with her husband three times per week, whether she wanted to or not, enduring pain the entire time, but she no longer felt the same about him; the betrayal was too much for her to bear and she could not get over it. So they parted ways.

Valerie had not been sexually active since her divorce and still had vaginal dryness and could not imagine having sex with anyone. When I examined Valerie, I saw that her vulva and vaginal tissues were pale and dry. She had no other vaginal symptoms. Since her sole symptom was vaginal dryness, in my mind, she was a perfect candidate for RepaGyn® (hormone free) vaginal suppositories to assist her in getting relief from her vaginal dryness. I recommended that she take RepaGyn® daily for two months, then twice weekly and informed her that this was lifelong therapy.

Valerie thanked me and said she wished I had been around seven years earlier as she thinks treating her vaginal dryness may have helped to  increase her sexual desire and her marriage might have been saved. She said that couples were lucky to have me help them address their vaginal health issues and resultant low sexual desire so that their marriages don’t suffer the same fate. She was certain that I am saving many marriages through education! I told Valerie that although her marriage could not be saved, getting her vagina healthy and treating her dryness, I was sure, would help her get back to the bedroom with someone new.

Felicia asked me, “Do women cheat because they are bored and men because they are under appreciated?” I explained that both of those reasons are common for men and/or women, but extramarital affairs are complex and often have a number of reasons that belie them. For example, a man with a high sex drive might be married to a woman with a low or decreased sex drive because she is working outside of the home at a very stressful job. She may be taking care of children or elderly parents and, as a result, may be very tired,  (which is the number one reason for low sexual desire). A married man may meet someone at work that he is attracted to and who pays him some attention. It might all start out innocently but can quickly move from attraction to an emotional affair and then to a physical one. Emotional affairs are dangerous because 50% progress to a sexual relationship, a potential disaster for a marriage. However, it was what Felicia mentioned next that was of grave concern to me...

Felicia said that she and the man she has been involved with had been "sexting" each other, which can be very arousing. She said her lover asks her to send nude photos of herself during those sexting sessions and she obliges. She was genuinely shocked when I pointed out the potential risk to her reputation at having sent provocative pictures of herself to her part-time lover. Believe me, I am not giving instructions on how to have an affair but the chances of getting caught are greatly increased with the addition of nude photos to sexting. In addition to that, what if the relationship soured? In that case, her lover may instigate a campaign of 'revenge porn' against her.

Revenge porn is sexually explicit pictures/media that is publicly shared online without the consent of the pictured individual. Felicia was so attracted to this man that she never denied his requests regarding rough sex, bondage or sexting. Admittedly, she had not thought out the consequences of her behavior as she was quite caught up in the excitement. I explained that it is NEVER okay to send illicit photographs and that (perhaps) if she did not meet his every demand the relationship may end (although I doubted this), but her soul would be saved and ultimately he would pay her more respect.

I suggested to Felicia that she ask her lover to delete any and all photographs of her from his phone. This was no guarantee they would not turn up elsewhere on the internet, but at least her lover’s wife likely would not see them. I must say, Felicia was very grateful for this advice. Having a “No Pictures Please!” policy – whether you get back to the bedroom or when sexting – is the only way to protect yourself during those times you choose iniquity.

Join me Sunday Night at 8pm on the CKNW Sunday Night Sex Show , when Thomas Panuzio (a National Security Expert) joins me to discuss revenge porn!

Alex was a friend of a friend (Jane), and when Lucinda laid eyes on him she felt an instant attraction. Alex joined the ladies after dinner for a few drinks and that is when the heat really turned up on this chance meeting of two would-be lovers. Lucinda found Alex funny and fascinating. He had a mop of dirty blonde curls atop his head, downcast green eyes, and a crooked smile. He wasn’t really in that great of physical shape. She could not account for this intense physical attraction.

When her friends went to bed, Lucinda and Alex stayed up chatting until they hit the hot tub.  In the hot tub, the chatter turned to caressing, then kissing, then the release of the wonderful endorphins associated with making passionate love. Lucinda was forever changed. Since the ill-fated ski trip, she had conversed via text with Alex a few times, but could not seem to get him out of her mind. When Lucinda presented to my office she was a menagerie of emotion. Confused, nervous, and heartbroken she could not believe the result of her tryst. A romantic at heart but practical too, I could palpate her pain.

When women make love, the hormone oxytocin is released and the bonding hormone fuels the desire to cuddle after lovemaking. When men orgasm the key hormone released is dopamine, which accounts for a surge of pleasure for them. I could not help but think of these two hormonal differences when men and women make love, and I was not surprised that Lucinda would be the one hurt in this situation. I then thought of Alex and wondered if he could not get Lucinda off of his mind. Biologically speaking, I had my doubts.

Lucinda had much to consider, one of which was her betrayal towards John (who she seemed to have forgotten in light of the recent events). Lucinda would need to assess her current relationship and assess what was missing. Did Alex feel that same way? If she had Alex on her mind, she would be checking out of her relationship with John.  Lucinda chose to end her relationship and pursue Alex but, as it turns out, Alex had different ideas after all.  Although he said he was very attracted to Lucinda and thoroughly enjoyed their night of iniquity, he was well on his way to building a life with his girlfriend, Veronica, a medical student who he was very much in love with. Needless to say, Lucinda was heartbroken.

Women and men cheat for different reasons and both Lucinda and Alex were textbook cases. Women often cheat because they are bored, whereas men cheat because they are emotionally dissatisfied and underappreciated. Understanding neurochemistry and biology may have prevented Lucinda’s heartbreak. Perhaps she should be the one to go to medical school to learn how to avoid a broken heart and get her mind, heart and body back to the bedroom.