1. Help. I am a 51-year-old female. I want to get married again; I’m dating a great guy. There’s nothing he won’t do for me. I have been having a problem also of not being able to have an orgasm. I go through the motions of enjoying having sex. I have all the thoughts of a romantic night and that’s as far as it goes. We went on a cruise and I stayed in the casino until I knew he was asleep. I fake most of the sexual feelings when we have sex. In my mind I want to make love, but when it’s time I just don’t have the desire. How can I find a doctor to help me? I don’t want to lose him because of this. But no one wants to marry any one with out a sex drive. 

A:  It sounds like you are referring to both low desire and low sexual response. These are two areas of complaints that are separate but often interrelated. Both are complex and have a range of emotional, relationship, and medical causes. I would certainly look into all of these. At the very least it would be important to get a psychosexual evaluation to rule out the potential emotional causal factors. Also, you would want to have a blood test to make sure your total and free testosterone levels are where they should be. Also, you may want to have further testing in order to evaluate the blood flow in your genital area as well as the genital sensation in order to determine the potential medical causes of your difficulty achieving orgasm. 

Unfortunately there are only a few centers that do the range of testing that we do at the Female Sexual Medicine Center. However, any doctor should be able to measure your hormonal levels. If your doctor is resistant, bring him/her information on the topic (see our book “For Women Only” or newshe.com for resources on low testosterone and low desire and response). 

If that doesn’t work, keep trying until you find a doctor who is willing to work with you on this! Best of luck and keep us posted. 

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