American Medical Association Family Medical Guide - American Medical Association [262]
I told my gynecologist about the problem and she surprised me by saying that a lack of desire for sex happens to a lot of women after childbirth. She suggested that Pete and I see a sex therapist.
During sex therapy, we did a lot of soul-searching as we completed each stage of the therapy. I found the guided imagery—using my imagination to go through each part of my body—especially helpful because it helped me realize that part of my problem was that I had a lot of anxiety about getting pregnant again. We want only two children, and the more anxious I became about a possible third pregnancy, the less I wanted to have sex with Pete.
Pete felt terrible when I told him my fears. Being so emotional made me realize how much I love him and how badly I had been treating him. Little by little, I began to feel desire for my husband again. We’re having sex two or three times a month now. That may not seem like much, but with all of our pressing responsibilities, it feels like a honeymoon. My gynecologist recommended a very effective method of birth control, so my pregnancy worries have diminished. It’s wonderful to have resolved our problem so we can have a healthy relationship again—both physically and emotionally.
Little by little, I began to feel desire for my husband again.
Differences in Sex Drive
People have different levels of sexual desire. Many—if not most—couples experience a difference in their sex drives. When misunderstood, these differences can cause friction and resentment in a relationship. Often, couples do not need counseling or treatment to find a solution to their problem—they simply negotiate their differences. For example, if your partner wants to have sex more often than you do, you can suggest having intercourse the same number of times each week and adding oral stimulation once or twice a week. If this type of negotiation is not possible, you may benefit from seeing a qualified therapist or counselor.
If you think that a physical problem—such as genital pain, extreme fatigue, or a hormonal imbalance—may be lowering your or your partner’s desire for sex, see your doctor for a physical examination. Other medical conditions that can affect sexual desire include depression (see page 709) and anxiety (see page 718). Drinking too much alcohol, taking sleeping pills or tranquilizers, or using illegal drugs can lower sexual desire. Some prescription drugs, such as those used for treating seizures and high blood pressure, also can have a dampening effect on sex drive. Talk to your doctor if your interest in sex has declined so much that it is causing problems in your relationship.
Vaginismus
Vaginismus is the involuntary spasm of the muscles in the lower third of a woman’s vagina. This condition prevents intercourse because the muscles around the opening of the vagina tighten so much that the penis cannot penetrate. Women who have vaginismus may not even be able to insert a tampon into their vagina. The inability to reach orgasm (see page 489) often accompanies this disorder.
Vaginismus is an exaggeration of a natural protective vaginal reflex, similar to the action of closing your eyes in a dust storm. The most common causes of vaginismus are emotional factors such as shame, guilt, or anxiety over a possible pregnancy, or the anticipation of painful intercourse. Inadequate education or misinformation about sexuality can produce fear that results in the disorder.
Temporary vaginismus sometimes occurs when a woman has a physical problem that affects the genitals, such as an abscess or severe inflammation