Doctor's Advice: No desire for sex

Q I am a 21-year-old woman. I don't have any sexual desire. No matter how I try, I just can't get turned on. When I'm having sex, I don't have that wild desire that I'm supposed to feel. My clitoris doesn't respond to touch, nor do my breasts. My boyfriend is very romantic. But he is not aware of my situation. I'm tired of pretending. Can you help me?

I am sorry to her about your situation, which is commoner than you might think. Quite a few young women feel no interest in sex. One of them said to me recently: "I just don't see what all the fuss is about!"

In fact, a lot of these young ladies do learn to like sex as they get older and find out more about their bodies. And that might happen to you.

But should you now seek medical help from a doctor, or have some blood tests? I think that at the moment, there would be very little point in that. You see, it is most unlikely that you have any anatomical or hormonal abnormality.

However, it would be worth seeing an experienced counsellor or therapist. She could help you to explore what is going on in your mind by getting you to talk about your emotions and your thoughts regarding sex.

Two things would be of particular interest to her:

1. Were you by any chance brought up in a family where sex was considered as something dirty or nasty? Sometimes this is the reason why a woman cannot bring herself to regard sexual activity as exciting or fun.

2. Were you ever sexually abused when you were a child? Again and again, I have seen females whose sex difficulties related to abuse during childhood.

Anyway, I am sure that the counsellor or therapist could help you. She might well suggest that you bring your boyfriend along to your consultation sessions with her.

And what should you do now about him? Well, continuing to pretend to him that you are turned on does not seem a good idea to me. It is not really fair to him, nor to you.

I feel it is time that you talk frankly with him about some of your sexual problems. Emphasise that it is not his fault!

I hope that he will be very understanding, and that he will want to help you. I suggest that you ask him to give you a break from sexual activity for a few weeks. Instead, he should give you plenty of hugging and cuddling and kissing so that you feel affirmed and loved.

I wish you both well.

Q I am a 22-year-old male virgin. Doctor, when I masturbate, I ejaculate in under one minute. Does this mean that I would not last long during real sex? If so, how can I get help?

Your story does suggest that you somewhat 'explosively triggered'. In other words, it does not take much to make you orgasm.

No one can forecast what will happen when you eventually do have sex with a woman, but on the basis of probability, it is likely that you would climax rather quickly. In other words, you may well have premature ejaculation (PE), often referred to as hair-trigger trouble.

That would not be the end of the world! Many doctors estimate that around 10 per cent of the male population has PE. And these days, it can be treated, by retraining the man to last longer.

I suggest that you attempt a little simple retraining yourself. Experts now say that it is possible to do this while masturbating. The idea is that you should resolve that you will only do it for 30 seconds - and then stop and take five minutes' rest. Then resume for 30 seconds before having another rest.

If you follow that scheme for several months, there is a good chance you would establish better control. If you suddenly feel that orgasm is imminent, you should employ the famous Masters-Johnson squeeze grip, which takes away the desire to climax. You will find it described in detail at many sites on the Net.

I hope that when you find a partner, your sex life will turn out to be fulfilling and happy. I would say that the outlook for you is good.

Q When I was 13 or 14, I had no menstrual pain. But now that I am 18, I get great agony on the first day of the menses. Why has this change occurred, Doc?

What you describe is common. When a girl is 13 or 14, she may well have menstrual cycles in which she does not ovulate - that is, produce an egg. And cycles in which there is no ovulation are usually pain-free.

However, by their mid-teens, most young women are ovulating. So by that age, they frequently do get period pain.

I am sure that you have nothing to fret about, but you do need to see a doctor about this pain. She can give you medication that will reduce or eliminate the agony.

Q Doctor, is it OK to take the Pill if one smokes?

Taking the Pill and smoking do not make a good combination because they both increase the chances of clotting, particularly clotting in a leg vein.

Clotting (thrombosis) is not common in young women. Nevertheless, I would advise anyone who wants to go on the Pill to try to give up cigarettes.

Q A few days ago, I realised that when I passed a stool, I had also passed a little blood. I have done some research, and I believe that this is caused by a condition called anal fissure. What can you tell me about it? Can I treat it myself? Or should I go to a doctor?

Passing blood while going out is far more likely to be linked to piles (haemorrhoids) than to an anal fissure. A fissure usually produces intense pain.

Get your bottom checked out by a doctor. Indeed, I would give the same counsel to anyone who bleeds from the rectum.

The odds are that the doc will find that you have piles, and that he will give you easy-to-follow advice about diet and medication. I am sure all will be well.

Email questions and feedback to Doc at saturdaylife@gleanerjm.com.