Sex Matters 6/5/02: Louanne Cole Weston, PhD

Everything you've ever wanted to know about sex but were afraid to type. WebMD's Sex Matters? expert, Louanne Cole Weston, PhD, joined us for this live event to discuss our members' intimate questions and concerns. The following discussion took place on June 5th, 2002.

By Louanne Cole Weston
WebMD Live Events Transcript

The opinions expressed in this transcript are those of the health professional and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician.

Moderator: Hello, Louanne. Welcome back to WebMD Live. We have several questions from our members. Let's get started.

Member: I am a 51-year-old woman who had a hysterectomy in October (one ovary was left). Ever since surgery and healing, I could have sex all day long. Is this hormonal, psychological, or what? I am not complaining about this heightened libido, just wondering.

Weston: Sometimes, people have a history of painful menstrual periods or chronic pain in the pelvis throughout the month. These types of symptoms are not very conducive to having enjoyable sex. So when a hysterectomy takes those problems away it is not uncommon for a woman to have a sexual rejuvenation and her desire can really increase. So if by any chance you were having pain associated with having a uterus prior to your hysterectomy, then probably my explanation would make sense.

Member: My wife is 50 and postmenopausal. I am 54. While my need and desire for sex is not at all what it was even 10 years ago, my wife has seemed to just "turn off" completely. She shows absolutely no interest at all, period! She doesn't tell me, "no," she just doesn't participate, which makes me feel like I'm taking something from her, almost as if I'm raping her. It is a horrible feeling. She will do everything she can to avoid having sex. She was not this way before menopause. Please educate me; she will not talk about it.

Weston: It would be important to encourage your wife to have her hormone levels checked by her doctor. She may be operating with a deficiency of estrogen and/or testosterone. Menopause often does cause a decrease in estrogen levels and without it, many women don't feel very womanly or sexually interested. I can understand your discomfort in experiencing sex with her the way you have described, no one who respects his or herself would want to have sex in this manner.

After your wife has a blood test to check her hormones, the next step would be finding a sex therapist with whom both of you feel comfortable talking and see if together some shared understanding could be created between you and your wife. I know that she does not want to talk about it, but I would recommend that she, out of love for you, agree to attend three sessions and give up having sex with you in the manner you have described where she doesn't seem to really be there. It would not be a bad trade-off in my mind. Let your wife know that you care for her and you are interested in her happiness. Ask her if she is willing to spend a little time being interested in a portion of your happiness. Attending a few therapy sessions would be a sign of that.

Member: I know that there are extremes on both ends with a question like this, but in your experience, what have you found the average amount of sex a married couple would have in a week? I am 23 and we have sex three or four nights a week. Just wondering what you thought.

Weston: Questionnaires that ask about frequency of sexual contact per week cannot always be relied upon, because people sometimes increase or decrease their answer for a number of reasons. Sometimes they hope to impress the researcher, sometimes they fear shocking the researcher, sometimes they have read other statistics and they want to be like all the others and sometimes they just plain forget. I've often found in my therapy practice that I've asked the question how often do you have sex, per week or per month, and two people will give me rather different answers sitting there together in the same room. So I don't rely heavily on studies that ask that question. My tendency is to say does the frequency you have feel good to you and your partner? Are you two happy with each other? So giving you some kind of number right now wouldn't be very useful, sorry to disappoint.

Member: I recently had a blood test to check my testosterone level. The result was 430. My doctor said it was OK, but he didn't seem sure. Do you know?

Weston: Four hundred thirty probably was a test for total testosterone and while it is meaningful, it is not the complete story. What may be more meaningful would be measuring your free testosterone. That is because the free testosterone is what provides you, as a man, with your sexual drive. You might have a high number of total testosterone, but a bunch of it could be bound with other molecules and therefore not free to give you sexual drive. So knowing the 430 is a good start and it is a good number, but if you are feeling low sexual drive, a return trip to measure your free testosterone would be the next step.