How can I get back my mojo?

April 21, 2017 7:07 AM

I'm a 39-year-old woman in a long-term (16 years) heterosexual relationship, and in the past year or so I've had a big unexplained drop in libido. I've had my hormone levels checked, which was the only test my doctor did in response to the problem, and they're normal. One big problem is that, suddenly, sex is often painful.

My sex drive has not been as high as my partner's for many years, but in the past year or so it's gotten much worse (i.e., I want it much less and he wants it much more). Lubrication has become a serious issue, and recently water-based lubes have been ineffective. I switched to a silicone-based lube, which meant I had to stop using my silicone-based diaphragm and we've gone back to condoms. I don't want to take hormonal birth control.

I love my partner very much, we are close and we have a child. We've had issues in our relationship that he is actively working to resolve, mostly related to his tendency towards unhappiness/depression and self-isolation. He has been working on this a lot, though, and I'm happy about it. We have made a major move in the last few years and have not made many friends in our new place. We both feel pretty isolated socially and I have also been dealing with some chronic pain issues, through which he has been incredibly supportive. He is in therapy and I did a few sessions, and I'll start again next week. I've mostly been focusing on finding things to do that I enjoy even without lots of friends like art classes, mindfulness meditation, exercise, etc. I don't know whether the problem is biological or emotional or some combination of the two. I've asked myself whether I feel like I've outgrown this relationship or something but I really really do love him and I just wish that my libido were more in line with my feelings.

I've sort of run out of ideas lately and I'm tired of feeling guilty about not being able to respond to his advances. We try to have sex once a week and we're usually "successful" but it takes a couple of hours to come around and sometimes it's so painful when we start to have sex that we have to stop. We do manual stimulation and oral stimulation and stuff, but I'm not as into this as I (normally) am to good ole PIV sex. I'd like to find a way to make sex as easy as it once was (i.e., sometimes required lubrication, almost never painful, didn't take a couple hours to get it done). I welcome any and all suggestions.*

*Other possibly relevant information: I don't masturbate much, he does a lot. Neither one of us are particularly into porn. He's an extremely attentive lover. We're both in decent shape physically. I do find him attractive, I just don't have much desire for sex.

posted by anonymous to Human Relations (11 answers total)

Have you gone to your gynecologist recently and been checked out? (you say you want to the doctor but did not specify if you went to a gynecologist). You mention various issues, but pain with sex would definitely discourage me from wanting sex. There are various options to help with lack of lubrication and painful sex, but seeing a good gynecologist is a first step. (If you were in the Washington, D.C. area I would recommend James Simon; his office might be able to suggest someone in your area).
posted by gudrun at 7:38 AM on April 21, 2017 [1 favorite]

Do you feel attractive?
posted by Guinevere at 7:59 AM on April 21, 2017

Maybe it'd be nice to explore sex outside of piv sex sometimes: he comes on you, for example, or oral, or mutual masturbation. There are many kinds of sex, and you can still feel sexy and loving and close to each other.
posted by sacchan at 8:10 AM on April 21, 2017

Yes, it seems to me that you're treating the pain as a function of your lowered libido, when in fact it seems likely to be the other way around (or, possibly, to be co-"morbid"). Did you discuss the pain with your doctor? Merely checking hormone levels is not an appropriate response to that symptom, so, if so, I suggest you try to find a doctor (probably a gynecologist) who will take the problem seriously.
posted by praemunire at 8:14 AM on April 21, 2017 [6 favorites]

I have also been dealing with some chronic pain issues,

This will put a serious damper on things. If all your attention is going to pain and managing pain, there's not going to be a lot left for other stuff. It's hard to experience your body as something capable of pleasure if it's mostly giving you the opposite. If your pain's not under control, advocate to get it under control. (Although... some of the medications they give for chronic pain, like the SSRI/SNRIs, are not always great for libido... maybe look into alternatives, e.g. medical marijuana, if that's possible where you live/for your condition.)

Sounds like the relationship issues might be a big part of it though, too. It's hard to be depressed, of course, but it can be really hard to be around a depressed person.
posted by cotton dress sock at 8:14 AM on April 21, 2017 [7 favorites]

Talk with your gynecologist about this. Something like a topical estrogen cream may help. It sorta plumps up the lady bits and makes things less painful.
posted by joan_holloway at 8:32 AM on April 21, 2017 [1 favorite]

I will n-th the advice to check in with a gynecologist if the original investigation was done by a PCP, but in addition: it might be useful to check out the book "Come As You Are." I found it really enlightening and guilt-relieving and helpful when I was struggling to come back from a loooooong postpartum drop in libido. In particular, a better understanding of how female libido/desire actually works was helpful in pinpointing how we might be able to jump-start things again - the common understanding that libido is there or not, that it's kind of a free-standing phenomenon, is based on how (some) men experience sexual desire and doesn't transport over to (most) women very well, and can create problems around being frustrated about libido being gone without knowing how to effectively address it.

I also agree with others that it's likely that the pain and unsatisfying sex are causing the lower libido rather than the reverse. Anecdotally that was very much my experience with pregnancy/postpartum (which was obviously just the hormonal changes), and then it took a bit of time after my hormones returned to their previous levels to remind my brain that sex felt good and was something to look forward to or to seek out. However, re-setting my brain to respond with desire in the face of potential sexy-time only worked once the hormone issues were fixed in a way that meant that sex wasn't painful and also could (semi-reliably) result in an orgasm that felt pleasurable.
posted by iminurmefi at 10:45 AM on April 21, 2017 [3 favorites]

I considered posting this anonymously but I want you to know there's no shame in it. There are a lot of different things that can cause pain during sex and none of them are your fault. I have vaginismus and for a long time I had vulvar vestibulodynia. Sometimes these things just happen, sometimes they're caused by something (like childbirth). That doesn't mean that's what your issue is, just to say a lot of things can go wrong and the longer they go without treatment, the harder they are to resolve. When you go to a gynecologist, if they blow you off (a lot of gynos are more interested in reproduction and less interested in sexual health), ask if they know a gynecologist that specializes in pelvic pain. For me, I had to go to physical therapy and also therapy therapy because I was young and had some weird assumptions about sex. Everyone that helped me was kind and not judgemental and I'm relieved I got help. Because it hasn't been mentioned yet, this book is awesome.
posted by Bistyfrass at 11:03 AM on April 21, 2017 [3 favorites]

Because no one has mentioned it yet, I'll suggest that you may be starting to go into perimenopause, when libido and lubrication levels can dive, or fluctuate a lot. A simple one-time hormone (FSH) test won't tell you this (e.g., http://www.theperimenopauseblog.com/are-lab-tests-accurate-in-testing-for-perimenopause/). If you're on Facebook, you can check out the perimenopause groups there; I've noticed lots of women in their mid- to late-30s reporting that they experience the same low-sex drive and pain-during-sex symptoms, and women who experienced this in their 30s and became menopausal by their mid-40s. It might not be your case at all, but worth considering, I think.
posted by mmw at 11:51 AM on April 21, 2017 [5 favorites]

Just coming in to suggest the book Come As You Are - it's a really engaging read and it goes into detail about the science of how desire works for different people. There are case studies of women who are struggling with similar things to you. It talks about variations in libido, and how some people experience desire responsively rather than spontaneously, and it talks in detail about what to do when you want to have sex (or, *want to* want to have sex) but your body and brain aren't quite cooperating. It also talks about the difficult relationship dynamics that can result from a mismatch in libido. I found it really illuminating and I think you might too.
posted by escapepod at 6:22 PM on April 21, 2017 [1 favorite]

Yes, as mmw said, it's fairly likely this is perimenopause. And if so, it's hormonal, i.e. purely physical. A friend of mine who went into menopause early and didn't realise it wasted years worrying and feeling bad about not wanting to have sex with her partner. Her symptoms were low libido and general low energy, plus sex was painful because her vagina had stopped naturally producing lubrication.

As mmw said, a single test won't tell you much because hormone levels fluctuate a lot, even during a single day. Also, this is one of those areas where there's huge variability in doctors. My friend told me hers had been giving her a bunch of 1950s-style lifestyle advice ("drink a glass of wine!" "try a bubble bath!"); then later she switched and the new doctor knew instantly what was going on, and how to handle it. She was prescribed estrogen and testosterone cream, and says her libido and energy levels were back to normal within a few days.

Good luck!
posted by Susan PG at 6:37 PM on April 21, 2017 [1 favorite]