When a sex slump slides into a passion pit

Q:  My husband is not often interested in sex. This problem started the day we got married. He was seen by a doctor for an infertility workup (we had sex often enough to conceive when I forced him) and the urologist diagnosed him with low testosterone, varicoceles and a low sperm count. The varicoceles were fixed and the doctor told him he could give him a testosterone supplement but he suggested my husband not take it because it would make his hair fall out. He was given Viagra. I think it is still sitting in the medicine cabinet 11 years later. He was of normal weight when we got married, but he is now almost 300 pounds. He has been diagnosed with a vitamin D deficiency which caused hyperparathyroidism. He has chronic kidney stones. Now he has developed high blood pressure and was recently diagnosed with insulin resistance. He said today he would talk with his doctor about the testosterone. I am feeling like I am nearing the end of what I am willing to take. So my question is, would testosterone really help or should I just skip now before going through any more pain and let the next woman who comes along deal with it? 

A: The staff here at Sexploration HQ fell in love with you a little bit while reading your letter. You’re married to a medical Superfund site, have been deprived of sweet bedroom bliss and you still want to have sex with the guy. Not that we’re flirting — sanctity of marriage and all that  — just that we admire low expectations.

Now on to hubby. Varicoceles, for the uninitiated, are essentially varicose veins of the scrotum caused by malfunctioning blood flow in the vessels that run along the cord that suspends our man jewels. They can be painful (or not) and can lead to “testicular atrophy” which means our virile boys wind up looking like Grandpa from "The Munsters." They can be fixed by surgery or embolization.

As for his other conditions, the good news is that your husband’s problem might be summed up in one sentence: He’s too fat. Losing the weight could go a long way toward curing what ails him (and you), says Dr. Alvin Matsumoto, an endocrinologist and professor of medicine at the University of Washington based at the VA Puget Sound Healthcare System.

Matsumoto says your husband's hyperparathyroidism, kidney stones, insulin resistance and high blood pressure could all be linked to obesity.

And in a recent study of 1,667 men in the Massachusetts Male Aging Study, Thomas G. Travison and his colleagues found that increasing your Body Mass Index by just 4 or 5 points can depress your testosterone levels as much as aging 10 years.

Your husband should see an endocrinologist to find out if he truly needs testosterone replacement. (You should know that testing for testosterone levels is not as exact a science as it might seem.)

If he does, it won’t make his hair fall out unless it would have fallen out anyway, Matsumoto said, due to, for example, baldness as a family trait.

Your husband’s willingness to whip himself into shape, get a hormone boost (if necessary), and get his body back into some kind of working condition will go a long way toward answering your question about skipping. If a relationship is a partnership, both members have to, uh, pull their weight. If he’s unwilling to give it the old college try, and you really don’t want to live in permanent frustration, skipping may be your only option.

Once again, let’s all repeat the Sexploration mantra: good health is good for your sex life, and a good sex life is good for your health.

Q: My wife and I have been married for 20 years this month. When we were dating, we had sex constantly. Since our two children have been born, we have had sex very infrequently. As a matter of fact, it has now been seven years since we have last had sex. But we are very happily married. It is not a problem to either one of us. My question is: Is this OK? Why is it not an issue for us? Thanks!

A: The Sex Police do not enforce a mandatory minimum frequency, and, according to the U.S. Constitution (you have to read between the lines), you have the right to a fallow period, especially after having kids. 

It’s a fact: Parenthood is bad for your sex life. Last year, a Norwegian study of 452 couples surveyed at six months after becoming parents, and four years later, found that “sexual contentment remained low.” 

But hey, if you’re content, and your wife is content, way to go. Still, the reason it’s not an “issue” could be that it has become a habit. So talk about this once awhile. When you do, ask yourselves if, though you do have a good marriage without the sex, it could be even better with it. Sex reinforces bonds, helps establish trust and is — let’s say it again — good for your health. Plus it’s fun and cheaper than two tickets to "X-Men Origins: Wolverine."

Brian Alexander is the author of the book “America Unzipped: In Search of Sex and Satisfaction," now in paperback.

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