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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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my wife has lost interest in sex. we have not had sex on a

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my wife has lost interest in sex. we have not had sex on a regular basis for almost 5 years. we talked about this recently and she said that she just doesn't think about it or want it anymore. she really does not seem to think she is missing anything, but we are in our 30's and i don't think this is normal.
Submitted: 4 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 4 years ago.

Hi! I believe I can be of help with this issue.

First, let me say I can imagine how difficult and disheartening this situation must be for you. You feel healthy and want to want sex. Your wife has none of this desire.

The question of normal or abnormal is not productive here. You are right that it is normal in your 30s for the husband and wife to both have sexual desire. In the sense that normal means most couples. But to tell your wife she's not normal is not going to inspire her to want to do more than feel depressed.

And that's the number one concern here. Loss of sexual desire is a depressive symptom. Now, I am imagining that the two of you had an active sex life early on in your relationship, that it didn't start out this way. Therefore, the first worry is depression. So making her feel bad doesn't seem useful.

Another problem is that she may not know what has happened to her sex drive. Or that she never had a strong sex drive to begin with but early on wanted to please you more because the relationship was new. We don't have hard statistics because there is no current research and the older research on sex which got a lot of attention was not very reliable. But we do in the psychology field have a good idea of what is going on:

We believe that a large minority of women do not experience an orgasm most of the time. That it's a rare experience for them. We don't know if it's 25% or 33% or even more. But that it is significant numbers of women we are sure. And another significant group does not experience orgasm through intercourse accept rarely. And that's at least 33% to perhaps 45%. So together, you've got more than half of women who don't usually have an orgasm with their husband at the same time. Pretty amazing, isn't it!? That can diminish her sex drive.

Does that mean that at least half of women are doomed to being unhappy and not being able to make their husbands happy and having awful marriages and lives because of this? Well, we psychologists certainly don't think so and my goal is for you and her NOT to think so as well.

You would want to seek an experienced sex therapist. By that I mean a psychologist or psychotherapist who is certified by either the AASECT ( or the American Board of Sexology ( You would both want to go this therapy and work on whether there is a sexual problem in the marriage that needs to be addressed or if there is depression or if there is something else going on.

Now let's talk about what the two of you can do on your own as well. Let me address this part to her and you two read it together:

Sex is meant to be part of the emotional closeness of a couple. One way to express emotional closeness in a couple is through intimacy of touch and feeling, but this is only one way. Why do I bring all this up?

To take the pressure off of you as we explore the options out there for you. Remember: the more pressure you put on yourself, the less you will have desire. Why is a great big psychological question we don't have room for here. But it is a truth. Relaxing is a big key here.

But first let's discuss some technical matters. There are some pharmacological options for your to explore with your gynecologist. One is Testosterone treatment. There is a testosterone skin patch available that has been clinically shown to offer improvement. Don't try Viagra just because it's on the internet being marketed now also for women. No evidence at all.

Next is exercise. If you're not getting regular moderate to full exertion exercise, start. An exercise class is a good way to start. Exercise regularly at least 4-5 times a week and become knowledgeable about it. If you prefer videos at home, go to and look at all the videos available. That site lets you preview them and has the leading instructors. Exercise will help you with the emotional closeness work below.

Next is Kegel exercises. That's to strengthen your vaginal muscles. That may help with sensation during intercourse (if you tend to be dry a simple lubricating cream or gel might help). Here's the Mayo Clinic entry on the exercises:

Now for toys: suction vibrators can help. Any vibrator can also be useful. Have your partner play with it on you as well. Then, the internet is full of toys and supplements and creams. It is a question of money. None of them have ever been shown to do anything consistently effective. To me, they are diversions from reality into pure hope. So it's up to you. Vibrators are the only toy I've seen any evidence for.

Okay. Now let's get to the heart of the matter:

There's the question of pleasure. Giving pleasure to your partner is also a pleasure. If you are emotionally intimate with your partner, discussing what pleasure is and expanding its meaning to include that you want more than just the orgasm but touching and stroking and extended foreplay to get you more involved in the sexuality, even if it means he has already had an orgasm and you don't is fine. Even if it means he touches you at first for a few seconds before you want him to move on to massaging your legs, fine. The idea is to reawaken pleasure, not necessarily reawaken orgasms. So if after a while you enjoy him touching you sexually for a few minutes or using a vibrator with you and you have an orgasm manually from his touching you or other means, that's great. Or no orgasm.

So I want you to reorient your thinking about sex. The two of you have been thinking in this way: no libido, therefore no sex. This is not even true for men, and is certainly not true for women. I recommend you allowing yourself to feel pleasure. PLEASURE. It doesn't have to be more than that.

So, the key: his initiating sex is an act of giving love to you. That has to be your understanding. And if you initiate sex, it has to be for the same reason, the desire to give love and express emotional connection and communication. NOT that you are seeking an orgasm. Both of you need to accept this premise. His purpose in being involved is to show his love, care, and consideration for you along with his natural sexual desire and urge and intensity. And his sexual desire is good and fine and important. For you it is the secondary part almost always; for him the sexual intensity is primary almost always. This is fine. You both have to agree to treat sex as an act of GIVING, an act of showing love and caring for each other, each according to what gives you pleasure.

You will want to touch him as well for the sake of giving him pleasure even if it is not for the sake of you feeling sexual intensity like it is for him. That will enhance your pleasure. And when it stops being pleasurable, when he's tired of it, that's when he's had enough. End of story until he feels like having pleasure again. If that means he changes focus to your pleasure, fine. If that means the two of you watch a movie and then go to sleep or have some more pleasure, fine. If it means just him coming during intercourse or a different way and you can relax while he strokes your back, fine. Do you both see the picture? Do not get too focused on this stereotype of our culture of the mutual orgasm. You need to get out of that box right now because you're not there. But HE has to begin to think of being a GIVER, of giving to you in other ways than just orgasms alone. He has pleasure and enjoyment his way and you your way. You can give him enjoyment his way. And he will be giving you pleasure as well. It's the mutual giving that counts in the self help technique.

So, these are the options I can help you with. I wish you the very best!

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