I have no desire to be sexual. None at all. I’m 41 years old, I’m not old or
menopausal so I am really confused about this situation as I remember
really loving sex. But in the last 2 years, I feel dead to sex.

My husband is getting tenser and tenser with me. He is frustrated
and I don’t blame him. After all, it is my fault. Whenever he approaches
me for sex, I make excuses and when I do give in, it is “duty sex”. He
gets nasty, says harsh words to me, and then completely ignores me for
days . he has always treated me like this when he is angry. I hate it.

Just to give you some background that might be useful. The last couple of
years have been difficult for me. I’ve lost family members to covid-19
and one of my children was in a motorbike accident and has struggled
with orthopedic problems since then. There have been a few times when
we thought she may be disabled. And she is still not fully recovered.
Also one of my other children left home to study overseas and I miss her
so much.
Do you have anything to give me to get my sexual desire back?? Oh, by
the way, I have noticed that now I have so much pain with penetration.
Nona

DR EVE ANSWERS:
Dear Nona,
Women love sex .. until other parts of their bodies. minds, hearts get
hurt and then desire disappears.
Hold on to the fact that you loved being sexual. Hold that close to your
heart, like a precious gift to yourself, a reminder that under correct
conditions, you are a healthy sexual woman.
By “healthy sexual woman “ I mean a woman who feels safe and secure
in her own sexuality and in different consensual sexual situations. Also, it

means a woman who has no sexual dysfunctions, as pathologized in the
DSM5.
The DSM5 says that if a woman consistently has a sexual interest,
fantasizes, and desires to be sexual, she has no low sexual desire
disorder; if a woman naturally becomes engorged and lubricated then
she has no problem with arousal, and that if a woman is orgasmic, she
is sexually healthy.

Nona, you’re being hurt with ‘sex” . By this I mean, your brain now
anticipates that sex = pain. Not only physical pain but emotional and
relational pain. And your smart brain says to you: ”no sex” to help you
avoid the pain. But the conundrum you have is that if you don’t have the
sex your husband wants, you circle back into more emotional,
psychological pain as he withdraws from you and hurts you with his words
and abandonment.
So you have duty sex when you have no desire hormones to make you
feel excited, no lubrication or engorgement and yes, the pain will happen with
penetration. And orgasms may not happen at all.

Messy, right ??
So I ask you Nona- do you think that you have a “sex problem “ of low
desire ?! Or do you have a PTSD problem that gets you to respond to sex
in this very typical PTSD way?

Why do I say PTSD?
PTSD happens in response to trauma, maybe multiple traumas. Either
childhood traumas, or, as in your case, adult event traumas.

Symptoms of PTSD include :
 Sleep disturbances
 Change of appetite
 Anxiety and fear

 Irritable, agitated, angry
 Hyperalert /hypervigilant
 No energy/feeling tired
 Depressed, sad, tearful
 Isolating
 Loss of concentration
 Disturbing memories
 LOSS OF SEXUAL DESIRE

Look at your life, your last few years specifically. I see a few traumas:
illness, death, uncertainty, loss of your child to another country
/adulthood and a tense marriage. Pretty threatening life, right?

Your brain has put you into Survival mode, giving you hormones, and
energy to just survive what you are telling it, feels traumatic for you. And
when one is in survival mode, there is no turn-on in the brain to sexual
pleasure.

Nona, find ways to manage your PTSD. Turn to a professional who can
take you through a healing process of self-regulation, self care, self
compassion. In that regulated state, you feel more able to think clearly,
make good decisions, feel in control of yourself .. and watch how you will
once again seek and be responsive to kind, thoughtful pain-free sexual
pleasure!