Sunday, March 8, 2009

Sex in the City

Today I was finishing up the afternoon at the office. My last patient was a 40 year old mother of three there for an annual exam. After I finished the exam and reviewed the usual preventative health recommendations, I asked if she had any more questions… I’ll admit I had one hand on the door as I said this. There’s just one more thing doctor. I just have no libido.

At this point I sit back down and take a deep breath. This happens to me a least twice a day. I start with the usual questions (I’ve answered with the most common answers):
Does it hurt? No
Do you like your husband/partner? Yes
History of abuse? No
How often do you have sex? 2-3 times a month *
Do you like sex when you have it? Mostly, I’m just so tired I don’t ever feel like doing it.
Does your libido improve when you go away for the weekend with your spouse? I don’t know, we haven’t done that in 10 years

It’s at this point that I want to say, and occasionally do depending on how well I know the patient, “You mean after working full time, taking care of 3 kids, dishes and homework, you don’t suddenly feel like Samantha on Sex in the City the minutes the lights go out.?”. I don’t know it this is “normal” but I know it’s very common.

Women are multitaskers. But the one place not to be a multitasker is the bedroom. There was a recent study that showed women enjoy sex more if they are able to “live in the moment.” Well DUH!!! Honestly, it is hard to be in the moment, with so many “to do lists” floating through your head.

When I first start clinical rotations in medical school I definitely had a time of transition. After watching my first Vag Hyst as a student I couldn’t have sex for a week. Slowly, like all the other issues you some how learn to separate work from home, most of the time. The pager does occasionally go off at an inopportune time.

Although, I have become a little jaded from my profession. During a recent conversation with my husband I remarked “We have a great sex life, I mean… it doesn’t hurt, I don’t get yeast infections and I don’t have to worry about you giving me Herpes.” He gave me quite the incredulous look. I guess its all relative.

*I had a newly wed patient who was having trouble with painful intercourse. After several visits, ultrasounds, creams ect. I finally asked her how often she was able to have intercourse. When she said 5 times a day for 6 months straight…… I discovered the cause of her discomfort.


  1. Great post.

    We forget that libido is so tied in with the rest of our lives, how we feel about ourselves and our partners, and how much energy we have (or don't have).

    I have a number of patients who complain of no libido, and when you ask them, turns out they are angry with their hsbands about so many things and not dealing with that. Sometimes libido is the canary in the coal mine of a troubled relationship.

  2. The cure for that newly wed patient - have kids! :-)

  3. I sympathize with your patient and have others exactly like her. I also have patients on the other end of the spectrum (I guess FPs see it all). Young uneducated and unemployed women who are pregnant again at their post-partum visit. I have one disabled man with a broken back who asked for viagra because "I'm so bored not working".

    I feel for the woman who is too busy to enjoy sex, because I am too busy to enjoy sex too, sometimes. But when I see how much some of my not so busy patients are enjoying sex - it makes me wonder why the Hell I'm working so hard myself! Maybe they have it right, and we have it worng?!


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