Severe Sexual Apathy in Women: Causes and Solutions

Severe cold sensation

Hello Dr.
Lin, I would like to ask you a question.
My wife is 44 years old and has three children.
She has been experiencing severe sexual dysfunction since she was about 36 years old (it can't be menopause at 36, right?).
No matter how long the foreplay is or whether we use any sex toys (like vibrators, KY lubricant, massage wands, G-spot stimulators, etc.), nothing seems to work; she just feels no sensation.
As soon as penetration occurs, she complains of dryness and pain, often giving me a cold shoulder.
Have you ever seen a couple with no interaction at all? I try to hug and kiss her, but she always has a bunch of excuses to refuse.
In summer, she says it's too hot even with the air conditioning, and in winter, she claims it's too cold.
We can only have intercourse once every six days.
I feel like I’m complaining a bit, so I apologize! Is there any hope for her given her lack of sensation? I have read online that some vaginal rejuvenation procedures can improve vaginal lubrication and even alleviate constipation.
Is this true? If we seek medical help, does health insurance cover treatments for sexual dysfunction? How long does the treatment usually take? Based on your experience, do you think there is still hope for my wife? If not, I am considering divorce, as my life feels no different from that of a monk.
Even the current frequency of once every six days is too much for her; I’m going crazy! PS: My size is normal, and even oral sex provides her with no sensation!

David, 40~49 year old female. Ask Date: 2012/08/03

Dr. Lin Wenbin reply Obstetrics and Gynecology

The lack of sexual harmony between couples can stem from psychological factors in addition to physiological ones.
It is essential for both partners to seek joint consultation at a sexual dysfunction clinic to thoroughly address the issue.
When there is a lack of sexual coordination, it is crucial not to impose one's own preferences onto the other.
For instance, the use of sex toys like vibrators may not be something the female partner is comfortable with; just because she does not express her discomfort does not mean she enjoys such toys.
Therefore, open communication is vital! Without sufficient discussion, forcing the use of sexual aids may backfire, leading the female partner to associate unpleasant experiences with intimacy, making genuine connection even more difficult.
Vaginal rejuvenation is not a panacea.
Surgery should only be considered if there is a genuine medical need after a doctor's evaluation; otherwise, it may only increase discomfort for women.
Moreover, the enjoyment of sexual activity does not depend on the size of the male partner's genitalia but rather on communication skills.
Not all tall men excel at basketball, and many women believe that size is not as important as the mindset during intimacy.
Sexual activity should not be approached as a routine; doing so can diminish desire.
Just like enjoying delicious food, one should not indulge excessively at once to maintain its appeal.
I suggest that you have an open conversation with your wife and lower your defenses.
Both partners' perspectives are important.
Additionally, if you are only intimate once every six days, I recommend that for the other five days, you both dress appropriately and spend 30 minutes engaging in conversation and gentle affection (discussing how you fell in love, for example), without intercourse.
This gradual nurturing of intimacy can increase the frequency of sexual activity.
Many couples have found this approach effective in clinical settings.
Using divorce as a bargaining chip is not a constructive strategy.
If the male partner is resistant to mutual communication, even finding a new sexual partner may only lead to temporary satisfaction, ultimately resulting in similar issues.
I wish both of you lasting love and a long life together.

Reply Date: 2012/08/03

More Info

Understanding severe sexual apathy in women can be a complex issue that encompasses both physiological and psychological factors. In your wife's case, her experience of sexual dysfunction, particularly her lack of sexual desire and discomfort during intercourse, is not uncommon, especially in women who have gone through significant life changes such as childbirth and the responsibilities that come with raising children.
Firstly, it is important to recognize that sexual desire can be influenced by a variety of factors, including hormonal changes, psychological stress, relationship dynamics, and physical health. At the age of 44, your wife may be experiencing hormonal fluctuations that can affect her libido. While menopause typically occurs around the age of 51, perimenopause can begin years earlier and may lead to symptoms such as vaginal dryness, hot flashes, and mood swings, all of which can contribute to a decrease in sexual desire.

In addition to hormonal changes, psychological factors such as stress, anxiety, and depression can significantly impact sexual desire. The demands of motherhood, work, and other responsibilities can lead to emotional exhaustion, which may manifest as a lack of interest in sexual activity. Furthermore, if there are unresolved issues in the relationship, such as communication problems or feelings of resentment, these can also contribute to sexual apathy.

From a medical perspective, it is crucial for your wife to undergo a thorough evaluation by a healthcare professional, preferably a gynecologist or a sexual health specialist. They can assess her hormonal levels, rule out any underlying medical conditions, and discuss potential treatment options. Treatments may include hormone replacement therapy (HRT) if hormonal imbalances are identified, as well as topical treatments for vaginal dryness, such as estrogen creams or lubricants.

In terms of psychological support, couples therapy or sex therapy can be beneficial. A trained therapist can help both of you address underlying issues in your relationship, improve communication, and explore ways to enhance intimacy. It is essential to approach this situation with empathy and understanding, as your wife's experience of sexual apathy may be distressing for her as well.

Regarding the idea of vaginal rejuvenation procedures, while some women report improvements in sexual function and satisfaction after such treatments, the evidence is mixed, and these procedures may not address the root causes of sexual dysfunction. It is essential to have realistic expectations and to discuss these options with a qualified healthcare provider.

As for insurance coverage, this can vary widely depending on your location and the specific insurance plan. Many insurance plans do not cover treatments for sexual dysfunction unless there is a clear medical diagnosis. It is advisable to check with your insurance provider for specific details.

In conclusion, there is hope for improvement in your wife's sexual health and overall relationship satisfaction. However, it will require a collaborative approach involving medical evaluation, psychological support, and open communication between both partners. It is important to approach this situation with patience and understanding, as both of you navigate these challenges together.

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