February 25, 2017 Liza Colimon, MD Honoring Health Vow # 2 I Vow to Stay Connected to My Body to Hear and Feel Everything it has to Say If you ever find yourself not in the mood to have sex… Welcome to the club. If you are always in the mood, then consider yourself lucky or maybe this indicates you know secret things! I remember attending a friend’s bachelorette party and as we went around the table as she opened gifts, she received anything from underwear to sex rule books (of course my gift). I remember when she opened the whip she received from a friend and leather thong underwear. I think half of us at the table who all had children at home under the age of five were all thinking the same thoughts about the gift giver… “What is she doing right that I’m doing wrong!” Especially when she started the demonstration on how to use it…. But don’t make assumptions. Comparing yourself to others is your first mistake. Instead of feeling guilty (or not), get to the bottom of what may be taking your mind off SEX. Decreased libido (sex drive) or lack there of, is one of the most common and difficult complaints to address during an office visit. Not to mention patients always throw it in at the last minute, just when the visit about their fibroid is about to end and I’m about to get up from my seat. Don’t wait until my hand is on the door knob….Ladies, do your do diligence and make a separate appointment for this discussion because it will take time to enlighten you on all the possibilities. What’s most important is that you don’t ignore your lack of desire if this becoming a sore spot in your relationship or if it is affecting the way you feel about yourself. Recent studies show that anywhere from 5 to 14 out of 100 women have what doctors call Hypoactive Sexual Desire Disorder. This is actually a real psychiatric diagnosis classified in the Diagnostic and Statistical Manual of Mental Disorders. This doesn’t mean you are crazy. It just means that the problem has come up enough and required enough attention to be recognized by medical professionals. The diagnosis is defined as a persistent or recurrent deficiency or absence of sexual desire or receptivity to sexual activity that causes distress or interpersonal difficulty in your relationship. In other words, you either feel minimal or no response to your partners attempts at sex or you have very little desire to have sex at all, which is causing problems between you and your partner. Studies show Hypoactive Sexual Desire Disorder is more common in women aged 40-60, likely due to declining estrogen and testosterone levels, in women taking birth control pills, and in women who have had their ovaries surgically removed prior to menopause. But often times, we find no reason to explain drastic decreases in desire. Decreased desire is also highly linked to depression and use of certain medications and antidepressants. From a practical standpoint I challenge all women to consider why their desire has changed. Ask yourself the difficult questions…. Are you still attracted to your partner? Are you involved in a healthy, abuse free relationship? Do you and your partner get along well? Do you have intimacy with your partner when you’re not in the bedroom? Yes, I’m talking about emotional intimacy, a connection often deeper than sexual intimacy especially if you are in a long-term committed relationship. Or, perhaps your mind is off wondering about your work emails, where all the sock mates have disappeared to, if the bills will get paid this month, and about the five loads of laundry that have been piling up in the corner since last week? Maybe you and your partner stopped talking to each other. Was your last date months or years ago? Or is it all about the kids? Has trust or infidelity become an issue in your relationship? Now this diagnosis does not apply to you if you daydream about having sex with someone else other than your current partner, or you are having sex with another partner simultaneously. If so, this leads to an entirely new discussion. Bottom line is don’t be afraid to discuss your concerns with your gynecologist. Find time other than the last 30 seconds of your visit.