Help

I have been married to the same wonderful man for 27 years.  I have never had a voracious appetite for sex, but it has gotten worse and I am afraid that it is affecting my marriage.  Let me first state, that I am 49 in menopause, I have had a mastectomy and I am taking antidepressants.  I suffer from general anxiety disorder and require sleeping pills to sleep.  My husband has been wonderful through the whole breast cancer thing, but he is really depressed that I am not "jumping his bones."  I rarely turn him down for sex whenever he wants it, but he wants me to always initiate it.  His idea of solving this problem is to never come to bed while I am awake and not getting close to me. I know he loves me and I love him more than ever, but my sex drive just isn't there.  I don't think that hormones are an option due to the breast cancer. He is fifty and his sex drive is stronger than ever.  Once is never enough.  What can we do?

[Janice M Epp, PhD]

Hi Sue.

There are several issues here--many very complex.

Illness and injury can greatly affect our sexuality. After cancer surgery, some women experience depression and many worry that their partner will no longer find them attractive. Body image is very important to women’s sense of themselves. In addition, during recuperation from mastectomy, there is a period of pain as well as reduced sensation, which can also interfere with your ability to get turned on.

Health issues can definitely affect your desire, as can anti-depressants. Some people who have taken anti-depressants report a period of 6 months with low desire before their sexual interest and desire return. However, many of these medications can permanently inhibit desire and orgasm. The good news is that there are several other anti-depressants which don’t have such a strong effect on desire. Ask your psychiatrist if you might not try one—or else a combination of your usual medication in the evening and Wellbutrin in the morning (a very successful combination for many because Wellbutrin seems to have an energizing effect for them).

You state that you’re anxious. If you’re feeling anxious or unsure of yourself, your desire for sex will be affected. Or perhaps you have conflicting feelings about being sexual, based on earlier issues in your life? Or you may actually FEEL desire, but suppress it, due to feeling conflicted. Are you aware of any reasons you may have for avoiding sex? These are areas for you to explore with yourself.

In the meantime, you can certainly begin doing things that stimulate you sexually, How about exploring books and/or explicit images that might turn you on? Perhaps you haven’t come across anything that turns you on at this point in your life. That’s understandable. We often go through periods where our desires may take a break.

And, of course, many other factors can influence desire. You might also examine what else has been happening in your life that may have affected you. Are you content with yourself, with your life, with your relationships? Do you feel like it’s your JOB to have sex with your husband? If so, that can cause resentment. Are you feeling pressured? Again, this can cause problems. It’s fruitless for me to speculate because there are a zillion reasons why your sexual desire might diminish—way too many to list here. You need to take an inventory of yourself and your life situation because only you know the answer.

Sexual desire is a very tenuous thing: it can come and go many times. Perhaps you’re bored, but don’t know how to express yourself, or you’re holding back for fear of hurting his feelings (fairly common among women).

Other reasons you might not be turned on: If you’re worried about pleasing him, rather than just enjoying pleasure, this can be a turn-off. The other message that many of us receive is that sex is somehow dirty and wrong, unless you’re doing it for reproductive purposes. Sometimes this can creep into our unconscious thoughts and sabotage any pleasure.

And, of course, there’s the whole issue of husband’s attitudes and behaviors and whether any of those are affecting your desire. Is sex mostly about HIS pleasure rather than yours?

You’ll also need to talk with your husband. The most helpful attitude is “what can we do TOGETHER to make this work for both of us?” This process involves problem-solving as a team. If you put your heads together, you might be able to work out a creative solution. If your sexual energy is low, how about asking to hold and stroke him while he self-pleasures? This can be a good beginning to rebuilding your sex life together. If this isn’t an option you care to pursue, are there other things the two of you can do that will bring you together? Think of this as a fun way to get to know each other better, and it won’t seem so daunting.

Remember not to put pressure on yourself. I’m wondering what YOU think is contributing to this. You’ve probably got more insight than you realize. Hopefully, the two of you will decide to see a therapist trained to help people talk about their sexual issues. That would be a constructive next step. Best of luck to you. Dr. J