“Dear Dr. Eve, 

I have no sexual desire at all. I am 36 years old and should be having the sexiest time of my life. I am married, and objectively still find my husband attractive. In the beginning, I used to want sex with him and in fact, I’ve always enjoyed sex with other people. 

I’ve been to a therapist who told me that I should try harder, make date nights and watch porn.  She also suggested I see my doctor as it may be hormonal. None of this has got me keen to have sex with him. I should mention that I have never had an orgasm with my husband. 

Perhaps you can help me



Dear Lila

We live in a society that says that if you don’t have sexual desire, especially for your beloved, then there is something wrong with you….mentally wrong with you.  Seriously. SEXUAL DESIRE/AROUSAL  DYSFUNCTION, known as Hypoactive Desire Disorder,  is in the DSM5 Manual as a “mental disorder”. This is the manual that guides all health care workers into classifying and treating mental illnesses. HYPOACTIVE DESIRE/AROUSAL  DISORDER is defined by two criteria: A-“persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity” and B-“marked distress or interpersonal difficulty.” This must be present for at least 6 months. 

 Focus on Point B: It recognizes that only if your lack of desire causes you “personal distress “is it a problem. So I guess, Lila, that you have a mental disorder as you fulfill these 2 criteria. 

As your therapist has done, the “treatment “ is: get this woman horny, using whatever is at your professional disposal. This may include medication (none of which has robust outcomes ), and /or sex therapy.  

 My approach is somewhat different:  if there are no medical factors, medications, chronic illnesses that directly affect sexual desire, then  I am curious about your lack of sexual interest.

 I ask “what purpose does your lack of sexual interest have for you?” 

If there is a lack of orgasm, bad sex, lack of intimacy and connection during sex, then the purpose of your lack of desire is clever: it is protecting you from FEELINGS .. feelings of frustration, rejection, loneliness, disappointment, regret, fear, anger, etc. Your reaction is wise: no sex means no pain. 

Hence I urge you to stop medicalizing and pathologizing your low sexual interest. Rather be curious, spend time going inward and honestly, compassionately, and kindly talk to what is really going on in your heart.”