Depression and Desire

QUESTION: I lost my mother a couple of years ago, and fell into a depression. This impacted my overall relationship with my husband as well as our sex life.

While I'm getting better emotionally and our marriage has improved, our sex life hasn't bounced back. I just don't feel much desire. It's very hard for me to get turned on, and it's hard for me to do anything sexual for my husband or to enjoy what he does to me.

I've asked my gynecologist about it and she says that I'm fine, but I don't know if she's right. Is there anything I can do to get my old feelings back, or could all this just be trapped in my little brain?

ANSWER: Are you taking antidepressant medication? If you are, that might explain your sexual problems. In women, most antidepressants -- notably the Prozac family of drugs that also includes Paxil, Zoloft, Celexa and Luvox -- may cause libido loss and difficulties with arousal and sexual function.

If you're taking an antidepressant, we would suggest asking your doctor about switching to different type of antidepressant such as Wellbutrin. This antidepressant is as effective as the other medications we've listed, but much less likely to cause sexual side effects. Wellbutrin is not absolutely free of sexual side effects, but the risk is much lower than it is with other drugs.

If you're not taking antidepressant medication, things become more complicated. Libido and arousal are tricky emotions. We wish there were some magic way to boost your libido, arousal and sexual enjoyment, but unfortunately, there isn't. Nonetheless, here are a couple of suggestions:

First, consider what you mean by "turned on." Most people assume that for sex to be any good, you have to feel lusty desire before you begin, and hot arousal as soon as you get naked. That's often the case with men. But Rosemary Basson, clinical professor of psychiatry at the University of British Columbia, Canada, has a different idea about women's sexuality, one that challenges the conventional wisdom about "sex drive." Her research suggests that for quite a few women, desire is the not the cause of sex, but rather the result. Many women begin making love feeling rather neutral about it, but as things heat up, so do they. We're not suggesting that you acquiesce to sex when you are truly not in the mood. But if you feel neutral, there's nothing wrong with becoming sexual without feeling lust beforehand. You may feel desire as things develop.

I also suggest that you and your husband consult a sex therapist. Your situation has a long history, which may mean sexual resentments and other relationship issues that affect your sexuality. No sex therapist can guarantee resolution of your situation, but many couples share your problem, so any sex therapist you consult is bound to have considerable experience dealing with your situation. In a 1997 report published in the Journal of Sex and Marital Therapy, researchers at University of Pennsylvania School of Medicine in Philadelphia tracked 365 married couples who sought sex therapy for a variety of problems, including issues like yours. In two-thirds of them (65 percent), sex therapy resolved the problem. The researchers concluded, "Sex therapy is effective in the real world." To find a sex therapist near you, contact either or both of these organizations: The American Association of Sexuality Educators, Counselors and Therapists (AASECT) at (804) 644-3288, or on the Web at www.aasect.org; or the Society for the Scientific Study of Sexuality (SSSS), (610) 530-2483, or www.sexscience.org.

MyPleasure is dedicated to improving people's lives by providing them access to the best toys and sexual enhancement products available.