Why Don't I Want To Have Sex?

Sex is complex.

Historically, people with vulvas have been told that their pleasure experiences should be just like those who have penises. The expectation is spontaneous arousal, light petting, penetration, orgasm. And for some people that works. Sometimes it works for a period of time. Sometimes it works with a specific person.Sometimes it works until you have a baby, or encounter stress at work, fight with your partner, hit menopause, or feel depressed. Sometimes it never works.

None of that is wrong or bad or means there’s anything wrong with you.

It means you need a new strategy.

I had a patient who had been sent to the doctor by her husband, she told me that things had progressively gotten less sexy through subsequent pregnancies. She told me that she didn’t orgasm anymore, and that she faked it a lot, that she did feel pleasure, but by the time she felt like it might go anywhere, her husband had climaxed and the experience was over.

There are lots of possible treatments for sexual dysfunction. For this patient, we checked her pelvic floor and had a lot of weakness that we worked on. We made it easier for her to access an orgasm (a big contraction and then relaxation).

Pelvic floor strength and time and attention helped her have an orgasm, but pelvic floor strength didn’t make it so she could have an orgasm with her husband.