Under the Hood

Episode 40: “Arousal Non-Concordance” — When Your Mind & Your Body Don't Match Up

• Season 1 • Episode 40

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0:00 | 15:51

Content note: this episode includes brief references to sexual assault.

"Arousal non-concordance" is the nerdy, clinical term for when your physical arousal signs (like blood flow, lubrication, or erections) don't line up with what you're actually desiring. In real life, that can look like feeling super turned on mentally while your body shows zero physical signs of it...OR your body reacting physically to something you have absolutely no interest in.

This mismatch is fairly common and affects people of all ages and gender expressions, but that doesn’t make it any less confusing or distressing for those going through it

In this episode, sex & relationship therapist Dr. Rebecca Howard Eudy and pelvic floor physical therapist Dr. Alex DiGrado explain why this physical-mental disconnect pops up during key life transitions in particular; that it’s not a reflection of true attraction to your partner; and how to stay deeply connected even when your physical hardware isn't cooperating like you had hoped.


What You'll Learn:

  • Lube begets lube: How using a high-quality lubricant (like Slippery Stuff or Uberlube) can break the anxiety-pain cycle.
  • Navigating trauma and bodily responses: How the body can respond with signs of arousal during a non-consensual encounter, which may leave SA survivors feeling ashamed and embarrassed.
  • Healthier communication: The key difference between checking in using a "yes, no, maybe" approach versus anxious second-guessing.
  • Pre-planning for non-concordance: How agreeing on a game plan before intimacy lowers anxiety and takes the pressure off both partners.
  • Redefining intimacy: The power of expanding what "counts" as intimacy way beyond just penetration.


Tune in if you've ever thought:

  • "I usually have no problem getting turned on - why is this happening to me now?"
  • "Does this mean I'm just not attracted to my partner anymore?"
  • "How do I bring this up to my partner without it turning into a whole ordeal?”
  • “Why did I still get hard, even though I said no? Does that mean some part of me wanted it?”


Helpful Resources:


Connect with us:

Dr. Rebecca Howard Eudy
Website: rebeccaeudy.com
Instagram: @rebeccahowardeudy
Newsletter: Parents in Love Substack


Dr. Alexandra DiGrado
Website: bostonpelvicpt.com
Instagram: @bostonpelvicpt
Newsletter: Under the Hood


Under the Hood Podcast
Instagram: @underthehooddocs
Website: underthehoodpod.com

YouTube: @underthehooddocs

SPEAKER_01

Welcome to Under the Hood. I'm Dr. Alex DeGrotto, your pelvic floor physical therapist. And I'm Dr. Rebecca Howard Uti, your sex and relationship therapist.

SPEAKER_00

Hello, hello. I hi, I've been practicing this term because I keep getting it wrong. So this is a term that actually comes up quite frequently in my clinic, but I didn't realize that there was an official term for it. And thankfully, Dr. Rebecca is all over this. And this is arousal nonconcordance. It's a fancy, it's a big term. It's a big fancy term. And can you tell us what it is?

SPEAKER_01

Yeah, yeah, absolutely. So this is like the clinical sex therapy term for when the desire, which desire is wanting something that you don't have. And you know, we can have desire for all kinds of things, but in sex therapy, we mostly talk about desire for sex. Yep. And so being desirous of having a sexual encounter is desire. And arousal is the body's physical response to sexual desire to a sexual interaction. So erection, lubrication, those are signs, physical signs of arousal. Blood flow, yeah. Blood flow, exactly. And so when we have arousal nonconcordance, which is extremely common. Yes, it is. What that means is that someone may the desire and the arousal are not in alignment with each other. So when desire and arousal are in alignment with each other, we have desire for the sexual interaction that we're having, and our bodies respond with the appropriate arousal. I'm using appropriate sort of quotation marks, but what we would deem to be the appropriate physical arousal. Yeah. Which our partner, if we're having partnered sex, would look at and say, oh, they're aroused. So for someone with a penis, that would be an erection. For someone with a vulva, it might be, you know, increased lubrication, increased blood flow to the area, increased sensitivity. Yeah. And so when arousal nonconcordance happens, what that means is that you could be very desirous of having a sexual encounter with your partner or solo, and the actual physical arousal, the symptoms of physical arousal are not showing up. Matching it up. Matching it up physiological. Yeah, that's so interesting. Exactly. Because the physiological symptoms of arousal are separate from desire. These are two different things. And another place that this, you know, comes up a lot is it can go the other way as well, is that someone who is non-consenting in a sexual interaction can have arousal. So they may have an erection, they may have an orgasm, even during a rape or a sexual assault. It's so confusing and it can cause a lot of shame. But it is actually the body's way of protecting itself. It's uh the physiological, exactly. Physiological, exactly. So the the arousal is not under our conscious control. That's the body's response. And so it's perfectly reasonable that these two do not always go together. And so it can be deeply confusing.

SPEAKER_00

Yeah, absolutely.

SPEAKER_01

Either for someone who is the survivor of a sexual assault or for somebody who is really wanting to be sexual with their partner and they're struggling to achieve or maintain an erection. Or, you know, which is often the case, where, you know, uh adding a lubricant is really necessary because your body is not lubricating in the way that might make it comfortable to have any sort of penetrative intercourse or anything like that.

SPEAKER_00

Wow, the examples that are coming to mind for me that a lot of people I I found don't actually know is early postpartum, where your estrogen levels are suppressed and you don't lubricate, and you really need to use a high quality lube. And people don't realize that, and sometimes people's partners will get offended or be confused, and there's it's such a fraught time anyway, with the changes in the relationship, especially first time, that it it can people's feelings can get hurt, even though it actually has nothing to do with the desire, like you said. It's just the fact that they our our body physiologically isn't producing as much lubrication naturally because of the, especially for people that are pumping or breastfeeding, their their estrogen levels are suppressed. They haven't gotten a period back yet, all of those things. And that's mirrored again in menopause and postmenopause.

SPEAKER_01

Yeah, absolutely. And adding a lubricant can be really helpful as well because you know, the the adding that that lubricant can actually help with the physiological arousal. Because obviously, if you're trying to have intercourse and you know, there's not enough lubrication, that's not a feel yeah, and it can be pain, it can be really painful, which then suppresses arousal. Absolutely. And so adding that lubricant, even though it's not the body's natural lubricant, we just have to, you know, accept, okay, this is this is part of the way that our that our that our sex goes. And there's nothing wrong with that. And actually, it can really help with the arousal. Yes. Because it's like sort of the loop the lubrication begets lubrication because it then ends up making it feel better.

SPEAKER_00

Yeah. And also it would be important for the person's partner to understand that it really doesn't have anything to do with the desire or their attraction to them or their ability to turn you on. It's not about that. No, it's not about that. Not at all. But I don't think that's really well understood or well known.

SPEAKER_01

No, I don't think it is either. And so it can feel it can feel really confusing to the partner and it can feel really confusing to the individual.

SPEAKER_00

So true. Because I keep thinking about the partner, but even the person who's experiencing it within their own body might not recognize or know or understand the physiological processes at play. Whereas we, you know, this before when you explained to me what this arousal non-concordance meant, it was so clear. Oh, yeah, I deal with this all the time in the clinic. All the time. Yeah. And I just didn't realize this term. But it's one of those things that I talk and educate so many patients about, and people of all gender expressions experience it. You know, it's not just lubrication in the vagina. You know, we're also talking about erections.

SPEAKER_01

Yes, absolutely. Yeah. And so you can have a person with a penis who is deeply desirous of their partner, yeah, who is feeling really desirous of having a sexual encounter, can actually be feeling mentally turned on. Yeah. And their erection is not as hard or as consistent as they might like it to be. That can be caused by all kinds of different physiological and emotional things, but it the two are not, they're not connected all the time.

SPEAKER_00

And so this really plays into our recent episode on talking about sex and talking during sex, is having a vulnerable and honest conversation about what's going on, especially for whichever partner understands a little bit more about the physiological aspects at play, that that they can explain to their partner, actually, this truly has nothing to do with my desire for you. I am incredibly desirous of you. This is because of X, Y, and Z, if they happen to know the physiological reason behind it. But also I think it it really plays into expanding our view on what's possible with intimacy.

SPEAKER_01

Absolutely. Right. And so I I think it's so wonderful the way that you talk to a lot of your patients in the clinic who are struggling with these sorts of issues about making a plan, about communication.

SPEAKER_00

Tools in the toolbox and saying, hey, you know, I'm going through this period of time that I'm experiencing this. Let's get the slippery stuff, let's get the uber lube, let's get, you know, when this happens, I'm gonna focus on on pleasuring you. And that will naturally lead to, you know, my arousal for further on in the experience, or we'll take our attention off of this part of our body and focus on kissing, focus on cuddling, I'll give you a massage. That's my plan for when this happens. So then it takes the pressure off.

SPEAKER_01

It does take the pressure off. And what it also does is reduces the anxiety of what is gonna happen when I get into this situation. How is my partner gonna react? How is this gonna go between us from a rate relational standpoint? And anxiety shuts down arousal. Right. So if we can lower the anxiety normalize, this is something that happens to people all the time. This is really, really normal. And it it often lands with the partner as you're not, are you not attracted to me? Yeah. Do you not want to be with me? It causes a lot of insecurity, both in the individual who's experiencing it and also in the partner. And so lowering that anxiety, normalizing it, making a plan can really help with that.

SPEAKER_00

Wow. I think this is so great. And also expanding the repertoire, having the tools in the toolbox. And I do feel that in terms of arousal as we age, especially, there's some time at play. You know, there needs to be a little bit more time. Whereas sometimes people are used to things happening quickly. And so now it's sort of more of that lead up time and more of that kind of what you tell remind me what you call it, when you have people do that sensate focus. Yeah, yeah. Yeah. Yeah.

SPEAKER_01

We can talk about that another time. For sure, that's a really good sex therapy technique that can really help to reduce anxiety, to increase pleasure, to have, you know, increased communication, all of the things that go into having a satisfying and and overall connecting sexual experience. Because that's one of the things that's the most important, the connection. Absolutely. And so another thing that's really important to pay attention to is consent. Yes. So being consenting, of course, if we're talking a non-consensual situation, then that's that's different, right? The body may respond because arousal is not under our conscious control. It's not something that we can control whether it happens or not. So that may happen, even in a non-consenting situation. But in a consensual sexual situation, in the context of a relationship, in the context of a wanted partnered sexual experience, it's really important to know and to trust your partner's consent.

SPEAKER_00

Yeah.

SPEAKER_01

So if they are, you know, say if if a person with a penis does lose their erection, their partner asking, are you okay? Do you want to continue? That's perfectly fine. That's checking in on consent. Yeah, totally. You know, if if it seems like your partner is wanting to be in the in the interaction, but arousal is taking a little bit of time, you're noticing that things feel a little bit different. Checking in, are you okay? Is there something on your mind? You know, it's it's okay to ask, are you attracted to me? Are you, but that's anxiety. Right. That's that's anxiety coming into play as opposed to really just checking in on that consent. And also the individual when they become aware of it, right? So someone who who has a penis, if they are aware that they may sometimes lose an erection, or the, you know, the hardness of their erection may fluctuate over the course of sexual encounter. Or for somebody who's postpartum or going through perimetopause, or they just know their body and they know that they need to add lubrication ahead of time, saying this, this, like we just talked about, this could happen. It doesn't mean that I don't want to be here. I do want to be here. I am attracted to you. And so just really reiterating that consent can be incredibly helpful to keep both people connected, even when our bodies don't show up exactly as we might like them to.

SPEAKER_00

This is reminding me a lot of people with vaginismus, which we have talked about. And that is that involuntary muscle spasm that almost just shuts the whole thing down and pushes it out. And so I do feel that for folks who are experiencing that, it's it can feel really personal, you know, for the partner. And it's so wonderful to have this language that it's physiological and it truly isn't something that they're doing on purpose. And so that I think is even incredibly valuable for those folks as well to understand that this isn't anything to do necessarily with the partner at hand and everything to do with the vaginis itself and working through that.

SPEAKER_01

Yeah, yeah, absolutely. And for folks with vaginismus, there's all kinds of different techniques and ways to be sexual without having intercourse. Yes. You know, when that those muscle spasms shut down the vagina, it makes it really impossible a lot of times for anything to be able to be inserted, even something like a tampon. Yeah, slowing it down, focusing on regulation, focusing on sensation. It doesn't mean that they're not consenting of being in the situation. It doesn't, it may mean that. They may say, I need to take a break.

SPEAKER_00

Totally.

SPEAKER_01

And that's also fine.

SPEAKER_00

Yeah, and I love that yes, no, maybe list. Sometimes for my people with vaginismus, we're doing dilator training and other things on the side, but we'll we'll put on the no list penetrative intercourse for for now. No for the now. Yeah, because if it hurts, then it's exactly and pain begets pain, you know. So we're not trying to perpetuate that pain cycle. And but that doesn't mean you can't be intimate. Yeah, you know. So I do feel that that that and it really expands the repertoire for people, which is wonderful.

SPEAKER_01

Yeah. And I think similarly for people who are struggling with like an erection erectile dysfunction situation, you know, intercourse where there's penis being inserted in, you know, vagina or anus or whatever that the the intercourse may be on the no list as well for just pure physiological reasons, but that doesn't mean that being sexual is on the note list. Right. There's many, many, many other things that, like you said, expanding the repertoire can be, you know, really help people to stay connected, to have other options where they can be be there with their partner. And can feel so satisfying too. Yeah, it can feel so satisfying. But part of that is destigmatizing, understanding that this is normal, that it's okay, that it doesn't mean something other than just your body's physiological arousal is just not cooperating at the moment. And isn't that so often the case? I mean, our bodies refuse to cooperate in all kinds of things all the time. Yes. And so somehow we sort of panic when it's a sexual sensation. Because it's so vulnerable. Because it's so vulnerable. But there's many times that our bodies, you know, we have more fatigue than we'd like, or we have to say, Oh, you know, I I'm not gonna do that today. Being realistic about where we're at and what our body wants or doesn't want without it being a crisis or, you know, a a bigger meaning.

SPEAKER_00

And yes, exactly like you said, personal to the other person. No, it's it's the desire is separate from the arousal. Completely separate. Thank you so much. Thank you. Thank you for listening to Under the Hood. If you liked this episode, please take a minute and leave us a review. And we'd love to hear from you. If you have any ideas for future episodes, please let us know.