His and Her Health

I am in desperate need of help!! I am 26 years old in a very loving relationship with my boyfriend for the last 4 and a half years. I feel that I am a close to losing a wonderful man. He has been so patient with me through all of this but I think he maybe running out of patience very soon. <P>I have tried many methods to find the source of my problems. I have seen a Psychiatrist, a Sex Therapist, my Gynecologist, a Urologist, etc. No one has been able to help me define or solve this problem. <P>I feel as though I am facing a brick wall with no hope in sight. This is not fair to my boyfriend or me.<P>Somebody please help!!!!<P>

I don't have much time, but is low libido something you've had all your life or only in this relationship? Did you have an interest in sex before you were ever sexually active.<P>Are you on any medications like birth control pills, antidepressants, antianxiety, or any other forms of meds?<P>Do you know of any ailements you may have like diabetes, hypoglycemic, hyper or hypo thyroid etc.,<P>Is there any history of sexual abuse or was your upbringing one where sex was never talked about or seen as dirty?<P>Also, when you do have sex do you still get aroused and turned on from it, if not again, was that the way its always been or just recent. If so, do you think the lack of arousal may be connected to lack of libido.<P>You've come to the right place there are many people here who are much more learned and well read on this topic than I am you are willing to help you!

My current partner is the only sexual partner I've ever had. I had an interest in sex before we were sexually active, and I did for a while after that. Then slowly but surely I lost my interest in sex all together. I think part of the problem is, is that I never derived any pleasure from sex, in fact during intercourse I feel nothing. Which is so frustrating, it makes me feel like I'm not a woman.<P>I started taking Allesse before I was secually active, then eventually stopped because I thought that might be the problem. When I did not feel any interest return, I tried a testosterone topical cream which did nothing. I eventually started the pill again, but this time I am taking Ovcon. For a few months I took the anti-depressant Wellbutrin, but I realized this wouldn't help, because the source of my depression is my lack of a sex drive not anything else.<P>I don't have any ailments, I've had my hormone levels checked (they're fine). I've had a gynecologist and urologist give me a full check to see if my problem was medical. There is no history of sexual abuse in my past. Sex is not something my family necessarily talked about, but I would hardly say it was something to be viewed as, as dirty.<P>I haven't had sex in about 2 years, so you can imagine my boyfriend is starting to get a little annoyed and frustrated. And by sex I should really elaborate and say there hasn't been any sexual activity in 2 years. I am never turned on or "in the mood."<P>Please help

Does your partner try to pleasure you in ways other than intercourse? Have you ever had an orgasm with him? Does he kiss you, caress you, stimulate your body, engage in lots of foreplay? Many women don't feel much during intercourse, so that should in no way make you feel like you're not a woman.

<BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR><font face="Verdana, Arial" size="2"><BR>I've had my hormone levels checked (they're fine). I've had a gynecologist and urologist give me a full check to see if my problem was medical.</font><HR></BLOCKQUOTE><P>Do you mind telling us what was done?<P>What tests were run, and what were the results. (I can't tell you how often I've seen errors in this testing. Tests not done that were needed, the results read wrong, test that were inappropriate in type etc, so I'm just wanting to get a feel for what you've had done.)<P>I see you talk about a topical testosterone. Was this something your doctor prescribed for you? Can you tell us what strength it was, how much you used, where and how often? How did the doctor know how much was enough, or too much? (i.e. Did he test levels after you started using it, and when?)<P>Do you know what you want from sex? Or is sex, virtually all sex pretty "blah" for you. (I'll assume your partner tries to make sex good for you, takes time to touch you etc... If this isn't the case, please let us know. i.e. Your lack of interest isn't because your lover isn't because he doesn't take time and effort to stimulate you the way you like.)<P>I'll also assume that the health of the relationship is decent, other than the sexual tensions. Again, if I'm wrong, please say.<P>Have you seen a specialist in FSD, or have these other providers simply been standard urologists and GYN and Sex Therapists? If you haven't seen a FSD specalist, I'd strongly recommend it.<P>(I see your profile lists NY as your location. If that's true, there are some excellent providers in NYC and NJ. You can email me for a list if you like. Or, see the website listed in my profile. We have a "Find a doctor" page. I can't recommend them here, so you'll have to do one of the above.)<P>Follow up with some answers, and we'll see what we can do.<P>Thanks and best of luck in your search for a solution. I know it can be very frustrating. <P>Best wishes,<BR>Greg<P>------------------<BR>My profile has my email address and website. Click on the icon at the top of this post that looks like a head with a question mark.<P>Also note, I am *not* a doctor, and this is not intended as medical advice - Please talk to your doctor about your concerns.

Just to let you know, we are virtually on the same boat. I have had only one sexual partner and we've been together 3 years and I'm 24 now. Like you I had an interest in sex before I was ever sexually active, (in fact, I think I more of a sexual person then than I am now). In the begining of our relationship I was probably seen as the more sexually adventourous one, wanting to try new positons, doing things in semi-public, phone sex etc.,. All of these things turned me on mentally but never physically. Sex has so far been a very underwhelming experience. My relationship has suffered as well, I can't say its been two years since I've had sex but sexual activity occurs only about 2-3 times a month and we live together.<P>Like the previous posters stated how much foreplay are you receiving? Most woman don't climax from intercourse alone. Does your b/f perform oral sex or try to stimulate you manually.<P>Also, what has been your experience with masturbation? Have you ever tried it? Did you orgasm from it? Have you had any experience with vibrators?<P><p>[This message has been edited by Serena (edited 13 July 2003).]

Thank you all for your wonderful responses, I appreciate all your help...<P>My boyfriend is very wonderful and caring, he is willing to do whatever is necessary to please me, he is very giving. He has in the past brought me to orgasm through clitoral stimulation and I have used vibrators, both have worked. However, with intercourse there is nothing, no sensation whatsoever, nothing good or bad.<P>In regards to the tests that I've had done. I went to see a Urologist that was recommended by Drs. Laura and Jennifer Berman, who is doing something similar in NY as what the Drs are doing in California. He was the one who administered the test on my hormone levels and determined that they were fine. I don't have the results to check exactly what they are. <P>My gynecologist is the one who prescribed the topical cream, again, unfortunately I do not remember the dosage but it was used daily and applied directly on my clitoris. <P>All sex for me is what I describe as nothing. I know that foreplay is important, but I no longer have any interest in it. The whole point is for it to lead to sex, and I feel like that is something that I cannot participate in right now. What I'm trying to say is that if I can't have sex then I don't want anything. My relationship with my boyfriend is wonderful, I would even go so far as to say perfect (except for this one issue of course). We're very much partners, best friends, etc. We love each other dearly and would like to get married some day soon. But I fully understand his reservations, sex is something that is very important to him. He cannot continue going without it.<P>I have seen a sex therapist who is affiliated with the urologist recommended by the Drs. Berman. She bascially came to the conclusion that there was nothing she could do to help me, and it's been about a year since I've met with any doctors in regards to this issue.<P>Thank you, I look forward to your responses.

If your able to climax through clitoral stimulation then I think it's safe to say that physically everything is fine. As for vaginal stimulation most women don't climax from penetration alone there are methods and techniques that you could try if vaginal orgasm are important to you, but by all means your are normal!<P>Your lack of libido could be from testosterone defiency but your Dr's who were recommended by the Berman's say they were normal so I guess we can say that's true.<P>I'm curious, did you tell the MD's and therapists you could climax from clitoral stimulation? If you did they still feel that something medically/psychologically could be done? Also, is lack of vaginal sensation the only problem or is there some pain too?<p>[This message has been edited by Serena (edited 15 July 2003).]

<BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR><font face="Verdana, Arial" size="2"><BR>If your able to climax through clitoral stimulation then I think it's safe to say that physically everything is fine.</font><HR></BLOCKQUOTE><P>(I'd cautiously agree, but testosterone or other hormonal issues could still be a problem.)<P><B>jgk1118</B><BR>I'm not sure what to think. I'd like to believe that the Bermans sent/recommended you to someone who really knew what they were doing. However, I'm surprised that if the T levels were good, why the GYN prescribed T. Further, I'd like to know for sure that the T levels were good. (I'd just like to verify if possible, that the urologist was headed down the right track.) <P>Do you think it would be possible to get copies of all the blood work you have had done? I'm interested in what tests they did run, and what the results of those tests were. Both of those things may tell us a bunch.<P>Do you mind naming the urologist they recommended?<P>From a psychologcial perspective, what did the sex therapist and psychiatrist have to say? What was their explaination on your lack of desire? (Perhaps they didn't have one, but I'd like to know exactly what they thought.)<P>I want to summarize what you have said, and make sure I understand correctly. <P>Sexual intimacy or sexual play is simply not very pleasureable. It doesn't matter if it is penetration, foreplay, oral sex, using a vibrator alone or with a partner, etc - none of it is high on your list of great things to do. You can orgasm. <P>I'd have to say, that the symptoms here sound much like ours. However, in our case, testosterone levels were very very low. Testosterone has been helpful in dealing with some of the issues, and we're yet in the middle of things - so the full jury is still out, so to speak. But enough about us...<P>A few additional questions. I'm wondering how intense sensation is from stimulation such as fingers, oral or vibrator? (This is a particularly difficult thing to judge, but I thought I'd ask.)<P>How intense is orgasm? <P>How much natrual lubrication do you have? (When aroused.)<P>Is there any pain during or after penetration? If so, please describe it.<P>Again, I'd say what you describe sounds much like our situation. Given that, I'd very much like to review the blood-work done. <P>I think that's about all I can think of for now. I hope we can be helpful.<P>Thanks,<BR>Greg<P>------------------<BR>My profile has my email address and website. Click on the icon at the top of this post that looks like a head with a question mark.<P>Also note, I am *not* a doctor, and this is not intended as medical advice - Please talk to your doctor about your concerns.<BR><p>[This message has been edited by distressed_12345 (edited 15 July 2003).]

Thank you again for your responses. I really appreciate all of the wonderful feedback.<P>Okay.... I told both the doctors and therapists that I could climax from clitoral stimulation. However, no seems to able to pinpoint what exactly my problem is. No one has been able to tell me if this is medical or psychological or why, which is I think what bothers me more than the whole low libido issue in the first place. I am of the opinion that in order to solve a problem you have to figure out the "why" before you can figure out how to solve it. Basically how things were ended with both the urologist, therapist, and psychologist was that there was nothing they could do to help me. If you would like the name of the urologist please send me an e-mail which is listed in my profile.<P>In regards to the testosterone issue I was prescribed the testosterone early on, before I even had my testosterone levels checked, so that solves that mystery. I was looking earlier for my hormone test results but I could not find them, so I'll have to get back to you on that.<P>I am able to orgasm, but the feeling is not that intense, I wouldn't say it is painful. Intercourse is certainly not painful, it is just as I like to say "blah." Nothing special. I think my lubrication is fine, I would imagine if it wasn't I would a lot more pain. Also, remember I haven't had sex in about 2 years, so I'm working from memory here.<P>In a nutshell, I am so frustrated and depressed around the whole issue....

Dang - I just managed to loose my whole post, and it wasn't short.<P>I'll make it shorter.<P>Here's some advice I give on blood-work.<P>===<BR>First thing. <P>Call every doc who has run *any* blood work on you for the last couple of years. Request that they either mail, fax, carrier pidgeon, etc *FULL* copies of all results to you. This is really important, and something that you should ask for in the future. <P>(Don't accept *only* a "reading" over the phone, though I'd take careful notes if they offer. Then ask for them to mail or fax. If they refuse, politely inform them that you are legally entitled to full copies of your medical records, and that they need to get with the program.)<P>Post those results here, along with the ranges they give as "Normal."<P><BR>Probably the most important test(s) in relation to desire disorder/ low libido, arousal disorder and sensation issues are:<P><UL TYPE=SQUARE><LI>Total and Free T by equilibrium dialysis if possible (see an explaination of this in the blood-work section of the website listed in my profile.)<LI>Thyroid Function Tests (TSH, Thyroxine/T4)<LI>Prolactin / PRL (A blood test that measures the amount of the hormone prolactin.)<LI>LH / ICSH (Luteinizing hormone) <LI>FSH (Follicle Stimulating Hormone)<LI>Estradiol<LI>SHBG (Sex Hormone Binding Globulin)<LI>DHEA and DHEAS</UL><BR>===<P>Basically, I don't see much hope down the psychological road for you, though I could be wrong.<P>I think you will need to re-examine the physical assessment you were given, and determine if there's enough hope/possibility down that road to revisit it.<P>I personally think, given what you've said, that there is a good possibility that your physical assessment was not good enough. A key piece to trying to assess that is looking at the only tangible piece - the blood-work.<P>Other than recommending yet another provider, I can't give much more help. So, would you please get the blood work and post the results and ranges here. (Or alternately, if you would rather not post them for the world to see, I'd be glad to give them an amateur look.) Your provider is *obligated* to give you that information, so don't let them give you a no answer. (You may have to do so in writing though.)<P>Perhaps others have additional thoughts, but I'd like to look at the blood-work data.<P>Best wishes,<BR>Greg<P>------------------<BR>My profile has my email address and website. Click on the icon at the top of this post that looks like a head with a question mark.<P>Also note, I am *not* a doctor, and this is not intended as medical advice - Please talk to your doctor about your concerns.

If the clitoral orgasms you do receive aren't that intense then I can defintley relate to that. The "arousal" and "orgasms" I feel are very muffled and insignificant. It seems I skip the entire sexual build up and excitment and just feel some mild tension and a release that's over just as it's starting.<P>The only thing I can think of is pelvic injury. From horse back riding, falling on a balance beam, a lot of cycling, etc. Did the urologist test for bloodflow and neural sensitivity?

You're forgetting an entire large piece to the puzzle that is FSD. We women are poor judges of our own genital blood flow. We can be physically aroused but not mentally aroused and therefore have blunted orgasms. This is where it can become a mental thing.

Amen, WREN. What you describe is the biggest obstacle in FSD research, the disconnect between the physical and the mental.

jgk1118 said<BR> <BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR><font face="Verdana, Arial" size="2"><BR>I have seen a Psychiatrist, a Sex Therapist, my Gynecologist, a Urologist, etc. No one has been able to help me define or solve this problem. <P>...<P>I have seen a sex therapist who is affiliated with the urologist recommended by the Drs. Berman. She basically came to the conclusion that there was nothing she could do to help me, and it's been about a year since I've met with any doctors in regards to this issue.<BR></font><HR></BLOCKQUOTE><P>Wren says<BR> <BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR><font face="Verdana, Arial" size="2"><BR>You're forgetting an entire large piece to the puzzle that is FSD. We women are poor judges of our own genital blood flow. We can be physically aroused but not mentally aroused and therefore have blunted orgasms. This is where it can become a mental thing. <BR></font><HR></BLOCKQUOTE><P>Perhaps, though I doubt it. Would you have us believe that the Psychiatrist and Sex Therapist completely ignored these issues? (Subjective arousal vs physical arousal and how women relate to them is an issue I've read about. Extending that to blunted orgasms I have not. Do you have a citation?)<P>Rather than attacking my process for giving a solution, a problem that seems in epidemic proportions lately, how about laying out exactly how jgk1118 might go about solving her issue. (You did remember, didn't you, that we’re here on this thread to solve *her* problems, not have theoretical arguments about these issues. This is someone who is hurting and needs some direction.)<P>I *personally* think the most likely productive avenue is to carefully re-examine her physical assessment. This area is the one where knowledge and skill seems the hardest to come by, and thus the most likely to have been done incorrectly. If you disagree however, layout some real possibilities and avenues for treatment, and let the poster decide. Putting arrows in my back may be easy sport, but it doesn’t help jgk1118.<P>Cheers,<BR>Greg<P><BR>------------------<BR>My profile has my email address and website. Click on the icon at the top of this post that looks like a head with a question mark.<P>Also note, I am *not* a doctor, and this is not intended as medical advice - Please talk to your doctor about your concerns.<p>[This message has been edited by distressed_12345 (edited 16 July 2003).]