Why Don’t I Want to Have Sex?

Women can have a lower sex drive than men because we have lower testosterone levels. This can affect everything from sex drive to the blood flow to sexual organs to the quality of orgasms. Simply put, this difference in levels even can affect our need to have sex.

Not Just Testosterone

Beyond testosterone, however, there are other reasons to consider.

• Taking antidepressants may be an issue. As we grow older, we may think about getting pregnant later in life or achieving certain professional goals. In general, we also may experience increased stress. As a result, many of us are prescribed antidepressants, which has a dramatic effect on libido.

• Another factor: birth control. What’s ironic is we use birth control to protect against pregnancy and then we don’t want to have sex once we’re on it (sort of an unfortunate 2-for-1 special). Oral contraceptives will reduce circulating testosterone levels, as will some prescription medications, which can affect our ability or response to arousal. I usually suggest an IUD as an alternative.

The Right Headspace

Being able to be aroused and consistently stimulated takes time and practice. Because a lot of women believe they may not ever have an orgasm, they may have no reason for even wanting to have sex. They may just be accommodating their partner.

Questions I ask my patients include:

• Is your partner arousing you?

• Is there enough of a frequency of having a climax to associate sex as a positive experience?

• Are you seeking it out as a means of pleasure, as a way to enjoy yourself?

If you went to the gym every day but were told you may not have any noticeable results, would you keep going? Women may feel the same way about sex. If it is not a guaranteed positive experience, why do it? If sex is not viewed as a stress release, it’s not pleasurable. They may lack feeling loved. 

Arousal can begin mentally. It can depend on whether we are receptive or in the mood. Stimulation is thwarted if we’re not in the right headspace.

Connect with Your Partner

If women — these nurturers, caregivers and providers — are not having sex often, they may not see it as a problem. It may be because they do not enjoy it or its overall quality. Maybe their total orgasms are declining. The truth is, sex helps you connect with your partner. Having unadulterated pleasure and drawing attention to that is important.

Uncovering what the real issues are is necessary. Is your partner doing what you need to help feel aroused and to the point of climax? Do you have concerns about your body image or a history of sexual trauma? (Overcoming the trauma of sexual abuse can be extremely challenging, but can be possible with counseling.) Is there any possibility of discord in the relationship?

Hormonal Imbalance

If everything is going well but you still don’t want to have sex, it might be because of a hormonal imbalance. In that case, being treated with testosterone can be life changing.

The results may change a couple’s entire relationship and how they connect. A lack of testosterone can be treated and effectively so. It brings you to a functioning level. And remember, testosterone treatment is not limited to your later years (menopause). You can do so far earlier when it’s warranted or necessary.

Talk It Out

We need to be more comfortable talking about sex. We need to reinforce that discussion without it being viewed as risky or rebellious. Talk about what works and what doesn’t; it adds to your quality of life. It is a tool in your box.

The more open you are, the more chances you’ll have for improving your libido.

And if your partner is not doing what you want them to do, communicate that. It ought to be as common as asking them to pass the salt or pick up a gallon of milk on the way home. Within the confines of a relationship, we should always talk about our sexual needs, wants and expectations.