Q: Can antidepressants have caused my husband’s loss of desire?

I’m so sorry that you’re experiencing this loss in your relationship. Both depression and the medications used to treat it can be culprits in a loss of desire, and given the relatively short time frame in which you noted the change (one or two weeks), the antidepressant is the likely explanation for your husband.

The situation that you describe is probably best addressed with the help of a therapist; someone who does sex therapy would be most helpful (you can find one certified by the American Association of Sexuality Educators, Counselors, and Therapists through their website).

You asked. Dr. Barb answered.As you’ve begun to experience, the longer this dynamic goes on, the more anger and resentment builds. Having a therapist to help you navigate the conversations is extremely helpful. And your suggestion of a therapist sends your partner the clear message that intimacy is really, really important for you and your relationship.

There’s some evidence that Stronvivo, a nutritional supplement for cardiovascular health, can improve both libido and function in both men and women; that could be a consideration as well.

Good luck!

Dr. Ruth: A Passionate Life

While reflecting on our anniversary, we were reminded of how many women have come before us, paving the way for straightforward conversations about women's sexuality. This is the second in a series (read the first here) launching our sixth year with gratitude to them!

The name of the world-renowned sex expert Dr. Ruth immediately brings to mind her warm, German-accented voice. Dr. Ruth Westheimer, 88 years old, has her own YouTube channel, where you can find clips of her answers to important questions such as I’m over 65—can I still have sex?, her frisky report on a kiss from President Obama, and even her thoughts on Fifty Shades of Grey.

Though only four foot seven in her prime, she’s been a huge figure in sex education since the early ’80s, when she started a fifteen-minute radio show,“Sexually Speaking,” on a local New York station. At first, the station was so wary of the subject that her show aired Sundays at midnight, and Dr. Ruth answered written questions only. Soon that evolved to an hour-long live call-in show with a seven-second delay. Live TV was next. She made several appearances on the David Letterman show, her radio and TV shows were syndicated, and she was on the cover of TV Guide and People magazine. She taught the nation that sex can be talked about, and on live TV!

She was reassuring and compassionate on-air with nervous people, especially the young—asking questions, putting them at ease. Even in her younger days, she exuded a grandmotherly air. It’s hard to imagine that, tiny as she was, she’d been trained as a sniper in Palestine.

She had a narrow escape from the Nazi horror. When she was 10 years old, her mother and grandmother sent her to safety in Switzerland. She spent the war in an orphanage with many other Jewish children, refugees from Germany. After learning in 1945 that her parents had been murdered in the Holocaust, she went to Palestine and trained in the army. She relates, “When I was in my routine training for the Israeli army as a teenager, they discovered completely by chance that I was a lethal sniper. I could hit the target smack in the center further away than anyone could believe.” But, she says, she never killed anyone. “Even today I can load a Sten automatic rifle in a single minute, blindfolded.”

She went on to study psychology in Paris, then immigrated to the United States, where she made her home in Manhattan. She earned advanced degrees from the New School and Teachers College, Columbia University, then did post-graduate work in sexuality with Helen Singer Kaplan from Vienna, a psychiatrist who pioneered scientific research about sex.

She retains a close association with Israel and Judaism. “For years, I wondered why I could talk about the things I talk about so openly. Now I know. For us Jews, sex was never a sin.” In her book Heavenly Sex: Sexuality in the Jewish Tradition, she writes, “The great rabbi Simeon ben-Halafta called the penis the great peacemaker of the home.”

In addition to her many books and recorded programs, Dr. Ruth’s Family Encyclopedia of Sex & Sexuality is available on-line. Those who helped her escape from Nazi Germany made possible a well-lived life, with a great legacy.

Q: Can my wife and I become intimate again?

This is the kind of question that makes me grateful to have Mary Jo Rapini, who specializes in relationship counseling, as an advisor to MiddlesexMD. When I shared some of your story with her, she said:
It sounds as though your wife may have felt detached from you for a number of years. Recent events have caused her to realize that her concern for you was actually still love, which is a first step: She still loves you, and you still love her.
I often see that couples who lack intimacy actually lack communication. I'd recommend that you focus on communicating better, resolving conflict, and taking every opportunity to be intimate without a focus on physical intimacy or intercourse. It sounds as though your wife has feelings she's uncomfortable talking to you about, which suggests that counseling for her alone would be wise. A therapist can help her understand what she is feeling so the two of you can work together to restore a healthy sex life.
Therapy is also best when you are both healthy physically—including your sexual health. Some women react to perimenopause with depression or anxiety, which it's helpful to address first.
We hope that's helpful, and that you and your wife are able to have a full life together. We're all in favor of healthy, lasting relationships!

Together but Alone

I hear from a number of women that although they’re in long-term relationships, they’re feeling alone. Sometimes this becomes apparent as part of adjusting to other changes—like sending the last kid off to college, welcoming a parent into the household, or adapting when one or both partners retire from a career. I asked MiddlesexMD advisor Mary Jo Rapini, a psychotherapist who specializes in intimacy and relationships, what women can do when they find themselves unsatisfied.

The loneliest feeling doesn’t come from being single. It’s being married or living with someone, but feeling alone. This happens when one of the partners checks out emotionally but eats there, does their laundry there, and sleeps there. For all other purposes, though, there is no partnership. This happens to couples who live together as well as couples who date and marry. Many times some type of crisis precipitates a partner’s emotional distance, but sometimes it just happens. You may sense your partner no longer values your judgment. You may notice your partner no longer listens to you, talks to you, or wants to engage with you.

When a woman first begins to feel lonely in her relationship, she doesn’t automatically get help. She’ll usually try to understand what is going on in her partner’s life. She may ask, “You okay?” or “What’s the matter?” Those questions are usually answered by, “Oh, just work,” or, “I’m just tired.”

Sometimes the partner will come back with, “Nothing I say is good enough, and you fight me on everything.” When this happens, the partner who asked the question begins feeling even more alone and more stuck in her loneliness. They may reach out to friends or family, or begin reading self-help books. Her friends may validate that her partner is cruel, insecure, having an affair, or all of the other things friends try to do to make one feel better. The bottom line is, she’s in a bad position. She is committed to someone and very much alone.

The amount of distance in a relationship is determined by the couple and the style they develop. Many of us like more distance between ourselves and others, and this is reflected in how we relate. Just as some people are very private and others extremely open; some couples cannot go to the grocery store without the other, and some travel across the world without each other. It’s a personal preference; neither is right or wrong.

Feeling alone is much different than actually being alone. Feeling alone means the communication is broken. Your partner may be in Africa and you in Texas, but if you are talking on the phone and sending silly texts or emails, you’re together. If he is at your side, but no longer engaging with you, talking to you, wanting to be with you, he might as well be in Africa.

As with most things, this emotional distance is easier to prevent than to fix once the damage is done. But here are three steps to take to feel less isolated in your relationship:

  1. Ask yourself if you really want this relationship. Sometimes we become lonely when we long for someone or something else. Your partner may sense that you’re not communicating that you feel stagnant or want out. Your partner may be withdrawing as a way of limiting—or pre-empting—the hurt.
  2. Talk to your partner about how you feel. Does your partner know you feel unloved or distant? No one can read your mind. It’s possible that your partner is feeling the same distance and will welcome you raising the issue.
  3. Are your beliefs about money, sex, or faith getting in the way of your need to be connected with one another? Couples who are fighting may project the anger from the disagreement onto the relationship. The distance created is actually about disagreeing over a topic. If you talk about this, it will help bridge the distance you feel.

Our relationships are a way to receive—and to give—the love, acceptance, and security we need to grow and evolve. To be physically and emotionally alone in a committed relationship is unbearable because the hope of connection is lost. Study after study has shown what happens to babies who are isolated from human love, acceptance, and security. We never outgrow that need.

If you still feel stuck, get help. Couples therapy has helped thousands of people reconnect. And if your partner isn’t interested, a trained, objective counselor can help you to evaluate where you really are and what your options might be.