PART 2: I Never Want to Have Sex Again - Kamm McKenzie OBGYN

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PART 2: I Never Want to Have Sex Again

Again… thank you Laurie Watson for this informative information. Please see “Part 1” of this post before continuing with this read.   

Dr. B


5)      Body issues:      

  • What mood problems might be affecting sex?  Are you depressed or anxious?  Is the medication used to treat the mood disorder (like an SSRI) one that dampens sex?  Any other medication or illness that might impact sex? 
  • Are you on birth control pills? BCPs are notorious at lowering libido and developing vaginal dryness or pain. 
  • How did pregnancy and delivery change your body and vagina?  Did you suffer post-partum depression?  Do you allow yourself to be a sexy mama?  Have both you and your husband started focusing exclusively on the needs of the children?
  • Are you menopausal and adequately treated for any sexually associated changes? Many menopausal women experience symptoms that interrupt sex: night sweats that leave them tired, reduction of testosterone and estrogen production that changes their craving-sex feelings, vaginal dryness and atrophy, etc.  Women report more distress over their low libido in this age group of 45-60.2
  • Are you a breast cancer or gynecological cancer survivor?  Is your self-image damaged due to the loss of a breast (the most highly visible and culturally esteemed symbol of femininity.) What cancer treatment was used and how is it affecting your sexual recovery? Were you even told that your treatment (chemotherapy, drug therapy, radiation) would impact your sexual life?
  • Is her husband a survivor of prostate cancer?  Does he suffer any other physiological sexual dysfunction?

6)      Eroticism: Is sex sexy?  Do you have fun in bed once you get going?  Or has sex devolved to getting ready, turning down the sheets, doing it, cleaning up, getting back in bed, going to sleep?  Has sex become BORING?  Are either you creative enough to inspire a thrill? I ask about her partner’s technique.  How long does the whole thing last?  How long does he touch her clitoris?  Have you been more erotic in previous relationships?  Does your partner have poor technique?  How much courage have you exercised in talking about what you really need to get excited and reach orgasm?  Are the partners tactful and kind when they discuss their needs in bed?

7)      Frequency: How many times a week do you have sex?  A month?  A year? In listening to the reply I still am thinking about the quality of their bond – does she give one answer to this question and does he give another? A low libido woman might say it happens every week. Her husband will reply, “No, not on the week of your period and last month we didn’t do it the week your mother was visiting either.”  If they can’t agree on how often it happens, this tells me that their relationship is fairly disrupted.  Often partners want me to know that it is not simply a matter of getting more sex, but a matter of having sex where she is an involved, desirous partner.  But very low frequency is an indicator of trouble in bed.  Sometimes her partner has unreasonable expectations for frequency; her normal libido has been labeled dysfunctional because of the mismatch.  Feeling sexually starved or sexually drowned cannot be resolved by simply finding the mid-point.  Each partner must have empathy and deep understanding for the needs of the other when it comes to quantity.

8)      Sexual History: What was your first sex experience like? Was it with someone you cared about and who was tender?  Did you just get rid of your virginity like it was a burden?  Did you masturbate in childhood and was it acceptable in your family?  Did a parent tell you the facts of life?  What were the teenage rules about acceptable sexual expression in your family?  Does any particular genital or body part of yourself or your partner cause you to shudder when looking, touching, or talking about it? Did religion and faith play a role in the formation of your erotic self; was the message about sex a blessing or an evil? What was the romantic triumph or tragedy of your parent’s marriage? Was there alcoholism, adultery, addiction, anger in your family of origin?  Is there a history of trauma, molestation, date rape, or violent rape?

While these questions do not cover every possible origin of low libido, they often start an important conversation about when it started and what area might be the place to begin solving it.

Link for more help from Laurie Watson with SexTherapy in Raleigh, Cary, Greensboro and Chapel Hill, NC. Laurie’s book Wanting Sex Again is available on Amazon!  She often sees couples for 12 hour intensives over the weekend.

Follow Laurie on Twitter or YouTube.

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