Sex Talk: Why do I feel nothing during sex?

Q: My problem is that I don't have any feeling during sex. I don't enjoy sex. I am scared of talking about my problem as I feel embarrassed.

A: As much as sexual pleasure may be derived from kissing, touching, masturbating and from stimulating areas other than the genitals, most people suffer incredible distress if they fail to derive pleasure from penetrative sexual activity.

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Any disturbance in the sexual response cycle, which is made up of the excitement, plateau, orgasm and resolution stages, can result in sexual dysfunction. Causes may be physical, for example hormonal imbalance, chronic kidney disease or menopause.

Unsatisfactory sex can also be a side effect of taking anti-depressants or the result of fatigue or psychological issues such as guilt, anxiety, past trauma or depression. Conflict in relationships, infidelity, lack of technique and intimacy may also contribute to people not enjoying sex.

Painful sex, inability to become aroused, poor lubrication, inhibited desire and lack of orgasm may be present alone or in combination. It is important to determine whether you are able to derive pleasure from masturbation, and to check if the problem is a symptom of a psychological condition, or is caused by recent stress, possibly as a result of financial issues.

To start with, please see a doctor who will take your detailed history and conduct a physical examination, including appropriate blood analysis.

You may require several sessions with a therapist to understand the cause and get appropriate help.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, DISA Clinic, 011-886-2286, visit safersex.co.za

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