A: Childhood sexual abuse is a terrible experience; clearly it has affected your sex life as an adult. But if therapy has not worked out for you so far, it may not be the answer.
I worry about your depression (which suppresses sexual interest) and your anti-depressant medications (which depress libido). As long as you are taking significant doses of an SSRI (drugs such as Paxil or Prozac), it's unlikely you will feel much interest in sex. Appeal to your doctor: Can she or he prescribe an anti-depressant that will not sap your sex drive?
Just because you don't feel like having sex, however, doesn't mean you can't feel aroused when touched. If you could enjoy a massage, you might enjoy being touched by your husband. If you held him, kissed him and gave him your body lovingly, you might enjoy the fact that you were giving him pleasure - even if you didn't feel passion or have an orgasm. Many therapists suggest this "as if" strategy; when you act interested and begin sexual play, you may find you are interested.
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Certain medications currently undergoing FDA trials have the potential to boost female libido. Keep a lookout for these. In the meantime, know that hormone treatments are not painful - and hear out your doctor's recommendations on that front.
Q: My wife and I have been married for over 25 years and sometimes go months, even years, without sex. We have gone to counseling, to no avail, and there are no medical issues I'm aware of. (My wife once suggested I "just go out and resolve the problem.") Her lack of commitment to our marriage, her lack of compassion for my feelings and her flippant attitude tell me the marriage will eventually die, no matter how much I want to save it. Should I get out now, before resentment and hatred replace my current frustration and confusion? It's sad - I love my wife, and we've built a life together.
A: It sounds like sex has become a proxy fight for larger issues in your relationship. In most marriages built on the a promise of monogamy, the partners are morally and historically entitled to enjoy a sexual relationship. In this case, however, your wife seems willing to modify that contract to avoid having sex with you. That means she's angry, or sad - likely both - and has rejected the union in all but name.
You are definitely on the road to divorce or complete emotional disconnect. As I see it, you have three choices:
1) Tough it out. Hmm, maybe this is less a choice than a cop-out: You've been going through this cycle of frustration and deprivation again and again. Do you really want to continue this way?
2) Make one last try. Try seeing a counselor again, first making certain the therapist specializes in sexual issues. If a glimmer of love is still present, the two of you may be able to step back from the brink. If your wife harbors only anger, disgust and rejection - if she simply will not work with you to create a better marriage - there's not much you can do but leave.
3) Negotiate a deal to have sex outside your marriage. "What?!" most readers will say. "That's a terrible choice!" Yet you would hardly be the first person in the world to arrive at this accommodation. Many people "cheat" when they are caught in precisely this bind: reluctant to leave the relationship but unwilling to remain celibate the rest of their lives. If you've agreed to have an "open marriage," of course, technically this would not be cheating. Just be forewarned: Relatively few spouses are willing to remain in a relationship once they become "brides without borders."