His and Her Health

I am 34 and have been married to a really fabulous guy for 10 years. We have two kids. I do not know where to turn anymore. I have no desire sexually and cannot remember ever having any in my entire life! My husband always has to initiate sex and most of the time I turn him down. I feel like a monster. How I could let the person I love the most feel so unwanted, desirable is a terrible thing. I keep telling myself that I am just lazy but I am not a lazy person in any other aspect of my life. I went to a doctor who specializes in sexual dysfunction. After doing all sorts of tests, nothing really showed up and they said my testosterone level was fine. I need help! Why dont I ever get horny? I want to be a passionate person! Someone - please respond.<P>Thanks.<BR>

MassachusettsMom,<P>Before you were married, had you ever been sexually attracted to a man? Had you ever felt little butterflies in your stomach (and elsewhere) when you saw or interacted with a particular man? Had you had much dating experience before you married?

The reason I ask is there are many women, and men, who never really develop that side of themselves. Can someone who is not a passionate person now become a passionate person? Can someone who was once passionate with their husband become passionate again? I do think most of us have it in us. It's a matter of focusing on those parts of yourself that makes you feel like a sexual being. It's very much a LEARNED process. Despite what some here would have you believe, it's usually not a matter of rubbing some testosterone gel on your shoulders. It takes conscious effort to re-shape your thought process and your image of yourself and how you relate to those around you. I will say the simple act of rubbing testosterone gel on your shoulders is a great way to begin the process of self-discovery, because it helps put you in that frame of mind. But it can't end there. You have to work on that part of yourself mentally.

<B> MassachusettsMom</B><P>Can you fill us in on what things you’ve had done, which areas have been examined?<P>I can tell you with certainty that I’ve heard “Your hormones are fineâ€

Hi. I do not know my testosterone level - only that it was fine and the next step was to try DHEA. That did absolutely nothing for me. I have a great relationship with my husband other than this issue. I have not had any surgeries, sex is comfortable, I'm 34 so I don't believe i'm pre menopause. I take birth control pills and yes, I do take Celexa but I can tell you that this problem has been around for years and years. <BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR><font face="Verdana, Arial" size="2">Originally posted by distressed_12345:<BR><B>[b] MassachusettsMom</B><P>Can you fill us in on what things you’ve had done, which areas have been examined?<P>I can tell you with certainty that I’ve heard “Your hormones are fineâ€

<BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR><font face="Verdana, Arial" size="2"><BR>Hi. I do not know my testosterone level - only that it was fine and the next step was to try DHEA. That did absolutely nothing for me. <P>...<P>I take birth control pills and yes, I do take Celexa but I can tell you that this problem has been around for years and years. <BR></font><HR></BLOCKQUOTE><P>A few thoughts.<P>DHEA is only useful as it creates more downstream hormones - namely testosterone. It has no real action *itself* that we know of.<P>So, I'm puzzled why if your FSD Specialist checked your T and found it adequate, why then supplement DHEA? (There are other issues that would need checking too, such as: <UL TYPE=SQUARE><LI>Checking DHEA levels prior to use - to confirm low levels<LI>Checking DHEA levels post use to make sure they have risen. (To make sure the DHEA product taken actually raises DHEA)<LI>Checking T values post treatment start to make sure increased DHEA does increase T. (Some people seem to have a conversion problem, and thus, higher DHEA levels may not result in higher downstream hormone levels.)<BR></UL><P>(BTW, I have a diagram of the conversion of all the hormones - starting with cholesterol and going down through estrogens, testosterone and DHA. If you want it, just let me know and I'll make sure you get it.)<P>Second thought…<P>Hormonal BC (especially orally administered) raise Sex Hormone Binding Globulen (SHBG). As you age, T levels decline. Over time, OC’s appear to raise SHBG cumulatively. Thus, the result can be a marked decline in Free Testosterone. (Free T is in essence, Total T – SHBG bound T) Since the increase in SHBG appears to be cumulative, this can be a double whammy. Lower T levels, and higher binding of the already lower T levels may mean much lower Free T levels.<P>Getting blood values of SHBG would be valuable to know if this was an issue or not. (This is something your FSD provider should have already done. If not, I’d be suspect of the skill and knowledge of the provider.)<P>You don’t state if the provider did a Free T test. Total T is almost meaningless, especially without SHBG values. If your provider didn’t test for many of the things listed in my first post, then your physical review, IMHO was not complete and I think you ought to consider starting again with a better provider.<P>Last. How long did you take the DHEA, and how much, how often? DHEA can take a very long time to bring about results – much longer than T. So, since T can take 3-12 months, or even longer, one should consider taking DHEA for a minimum of 6 months, IMHO. Less than this, simply is not enough time for the process to work.<P>Finally. Celexa is an SSRI anti-depressant. Just because you’ve had the problem for years, doesn’t mean that the SSRI won’t cause problems – or that it isn’t exacerbating your problem further. T and DHEA seem to often have reduced effectiveness when one is taking SSRI class drugs. Thus, I’d discuss with your provider whether you need an SSRI class drug. One alternative is Wellbutrin. It can still have negative effects on sexual function, but much less often is it a problem. (Of all the SSRI class drugs, on average the whole class causes some sort of sexual function problem in around 80% of all users. As you can see, this is extraordinarily high.)<P>One final thought on this subject. Low testosterone and estrogen can both cause mood disturbances. Again, if the blood assay’s described above have not all been done, I think they might be helpful in looking at your situation in a more complete manner.<P>We might be able to direct you to some resources for finding a new provider if you want. We can’t do that here, as it’s against the rules. If you want, please look at my profile, and email me. The alternative, is to let me know and I’ll email you – just make sure your email is listed in your profile here.<P>Let me know. I’m glad to help in any way I can. I understand how frustrating and difficult this whole thing can be, and I know there are solutions.<P>Best wishes,<BR>Greg<BR><P>------------------<BR>See the icons at the top of this post for my profile and more information.<BR>Also note, I am *not* a doctor, and this is not intended as medical advice - Please talk to your doctor about your concerns.