Tell Giselle: Getting one’s desire to stay sparked

“My husband and I are struggling over sex. Now that we are older we have it less frequently. That is not the issue. What is wrong is that I don’t have any desire for sex, and his less than obvious desire for me doesn’t help. We are not yet retired. When is it time to give up on sex?”

G: I would like for the answer to your question to be never, but I realize that is not living in reality.

I’ll cut to the chase and ask you to focus not directly on sex, but on what you think is the reason it has lost its appeal. Then ask yourself why you think he desires you less than he once did.

Your answers may or may not be related.

Even women who are youthful may find their need or interest in physical intimacy will diminish dramatically. This may be in part because they are exhausted by their higher educational path, career and/or the unrelenting work of raising children well. It can also be a result of an undiagnosed health condition, like an underactive thyroid, other hormonal imbalances, or inadequate diet and sleep.

These factors are not exclusive to women, but I do hear of this decreased desire for sex more often from women than I do from men.

If you and your husband want an improved sex life, a good place to start is with an honest conversation about what you are feeling about the change in intimacy. If you do not find a way to discuss this, there is the likelihood that you will both drift into a state of sexlessness with one another long before that is healthy or even necessary.

To avoid this, if that is what you truly want to do, it is time to stop tip toeing around your disinterest and dissatisfaction, and consider whether or not you and your husband still have enough left to invest in your marriage, and are willing to seek way more than my input.

And while you consider that, I’d want you to schedule a physical exam to see if there are any hormonal or other health issues, including anxiety or depression, that are contributing to this situation. The same goes for him. His less than enthusiastic response to you may be driven by his own health status.

Diminished sex drives are frequently related to certain medications such as those that treat hypertension, metabolic syndrome and depression. Other hormonal changes, not just low testosterone, can be the culprit. As can the use of recreational drugs such as cannabis and alcohol.

I once counseled a woman who was shocked to discover her husband was using his laptop not just for his work, but for taking pleasure in the images of others in the act. What she had

assumed was just a heavier work load turned out to be an addiction that destroyed not only trust but their future as a couple.

I have counseled other women who gave up on physical affection because it became painful. I told them to see their doctor to rule out serious health issues that can cause this, and to inquire about a prescription for lidocaine, a topical gel. In addition, there may be the need for estrogen cream to improve tissue health, and to help prevent UTIs (urinary tract infections) which are not uncommon, especially in older women. Using a water-based product (I recommend Good Clean Love) can help to moisturize.

Make the decision to regain what is being lost by aging and as a result of decreased activity. The saying “Use it or lose it” does have direct implications for our most personal tissues.

But back to the starting point which is about communication and the point of this column. It all begins there. It’s not going to be any good if you just talk to me and then employ the tools for yourself that I’ve offered. Without understanding what is going on with your husband, there is no amount of healthy tissue or hormonal balance in yourself that is going to correct his diminished desire or behavior toward you.

So how to begin the conversation? Find a time when neither of you are stressed, tired or distracted. If you say that is never, then you have way bigger problems than intimacy or romance.

Let’s be honest and blunt: If affection with your husband is truly a priority for you, then make your choices reflect that.

If it is not such a priority, and you are just concerned that one or both of you will stray from faithfulness because your desire for one another has been flatlining, then you need to begin the conversation with what it is you fear or hope to prevent.

There are many therapists who can help you formulate the conversation so you become closer rather than add to the problem by stumbling at the start. You might pull up the podcast “DOAC” by Steven Bartlett and listen to the episode with psychosexologist and couples therapist Dr. Karen Gurney https://www.youtube.com/watch?v=E5swtIjpxxA .

For those who are raising a family and are wanting to improve their romantic life, she has a new book coming out in April that fits the bill: “How Not to Let Having Kids Ruin Your Sex Life: Navigating the Parenting Years with Your Relationship Intact.”