Problems: Sexless partnerships

DON'T TOUCH

WE used to have a great sex life but now I can't bear my partner near me. I am menopausal and have had a few hot flushes but these don't trouble me much. I feel really sorry for my husband as it's hard to put into words what is wrong. Can you help?

You are probably suffering from a drop in levels of testosterone, which can occur during menopause in some women. This hormone is responsible for sex drive in women as well as men, and does not respond to normal HRT. Added testosterone can be

given in the form of a patch called Intrinsa, which is prescribed by a doctor and applied daily. This will only help women who have a genuine hormone loss – it doesn't help if there are other causes for low libido such as resentments within the relationship or even the fact that she doesn't fancy him. These issues would be better addressed with the help of a relationship or sex therapist.

MISCONCEPTIONS

I have been married for five years and started attending an infertility clinic with my husband three years ago. No cause was found for our infertility but we were encouraged by the doctor to have sex when I was ovulating. This led us to make love by the calendar and my husband eventually refused, saying he felt I didn't want him, just his sperm. We are still together but unhappy and still don't have sex.

Sex can become a chore when a couple are trying to conceive and it is important you don't lose the loving aspect of your physical relationship. Some believe the sperm will be stronger if there is a period of abstinence but this is not the case. Infertility puts stress on a relationship, and couples can react differently; she may be willing to spend thousands pursuing every possibility while he may want to come to terms with their childless state. Each will feel the other doesn't understand them and stop communicating. You would benefit from relationship counselling to talk through any disappointment and resentment.

LET DOWN

I am 58 and was made redundant a year ago. Ever since then I have suffered from erectile failure. I'm no longer the breadwinner so I don't feel like a real man. I think my wife is disappointed we don't have sex but we don't talk about these matters.

It is understandable you are avoiding sex but it is also a pity as it would give you the extra comfort you need. Drugs such as Viagra or Cialis can help restore erections and as the problem is more than likely a direct result of the redundancy, with its effect on your sense of self as a capable man, they could be just what you need. It would also be important to have a medical check as the problem could be related to a disease that might require treatment.

Your wife may not worry that you have gone off her or worse still, that you are having an affair.

On the other hand it is possible that she's quite happy that sex is no longer on the agenda. If you aren't able to resolve these issues by talking about them on your own then you might wish to consider the help of a sex therapist to look at the communication within your sexual relationship.

Dr Lyndsey Myskow is a GP and sex therapist at Medicalternative, Edinburgh, and associate specialist in human sexuality at Edinburgh Royal Infirmary

This article was first published in Scotland on Sunday, April 11, 2010