"You mean, just tell her ‘honey, your feet are freezing – please put on socks while we make love’? Oh, I could never say that!"

This is what patients tell me all the time. They can take off their clothes, entwine their body with someone else’s, try to create a new life or risk catching a disease – but they can’t simply talk about the most basic, real-life stuff surrounding sex. The reasons are familiar – embarrassment, fear of judgment or rejection, lack of self-acceptance, anxiety about ruining the mood. And yet that sense of inhibition, combined with the lack of practical information, can cripple sex with even the most exciting, desirable, or beloved partner.

Here are a few of the things my patients would really like to tell their partners.

* "Lube, please"
Not because we need it, or because someone is old or dried out, but because it makes sex feel better. Over lunch sometime, encourage your partner to think of it as "we use lube" rather than "you use lube."

* "Clean up your act"
This could be the hardest thing for people to say in bed – requesting that a partner shower, brush his/her teeth, shave (face, legs, or a stubbly pubic mound), maybe clip their toenails. But no matter how spiritual or cerebral the sex, you’re still doing it with someone’s body, so compatibility of personal hygiene is essential. You’re not nagging (or being nagged), you’re creating the environment for good sex. And while we’re at it, if you’re going to put your fingers inside someone – vagina, anus, mouth – please wash your hands before getting into bed. You shouldn’t have to tell someone more than twice.

* "Look at me! Talk to me!"
Many people want to feel more connected with their partner during sex, but feel this either happens magically, or not at all. Ironically, many people would indicate that they’re present if they felt that their partner – you – were interested. So say so.

* "Stop"
Sex is not an express train, which you have to ride to the end once you begin. Rather, it’s a local – you can exit anytime you like, getting on another train a few minutes later, or leaving the station altogether. There are lots of reasons someone might want to stop – you have to pee, sex hurts, you lose the mood, you simply change your mind. Maybe your partner calls you the wrong name, or you realize you’re not with Brad Pitt after all (darn those light-rum mojitos and dark tavern lights). In any case, you do not need a good reason, or a complicated vocabulary. "Um, I wanna stop" should do it. "Please stop now" should definitely do it.

* "Spank me, bite me, get a little rough with me"
Yes, a "normal"-seeming person like you may want to be held down, or bitten, maybe even spanked or tossed around. Heavy equipment isn’t necessary to make you swoon – a strong eye and a look of "do it this way, and now" can be magical if you’re in the mood for it. If you occasionally are, talk about your pleasures and your limits when you’re out of bed. Then a simple phrase ("You’re getting none of this tonite") or submissive glance will invite the game.

So how do you talk about those sexual topics you just can’t talk about? Text messaging? Not the best way. Many people find it easier to talk cooperatively about sex outside the bedroom, when everything feels less complicated. Others like talking in the moment ("I’d like that even better if you slowed down"). Either way, just do it. It gets much, much, much easier after the first time. And the reward of (probably) getting what you want will make you look forward to the second time.