Sex Talk: Why isn't he interested in having sex with me anymore?

Dr Tlaleng Mofokeng answers your sex questions

Q: My husband and I have a young child. I do most of the work and it seems like I also have to initiate the sexual side of our relationship. It feels like another chore to add to my list. Why is he not making the effort?

A: It is very common for two people in a relationship to have differing levels of sexual desire and many couples struggle with this issue. You describe what sounds like a relationship in which you feel lonely and need support with household chores and child-rearing - a stressful situation made worse by the lack of sexual interest from your husband.

Sexual desire often evaporates in a relationship that lacks intimacy and is marked by conflict and arguments that destroy emotional connection. Many people in situations like your own feel unwanted, undesirable and unloved.

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Your partner may be aware of this issue but may be too embarrassed to discuss it; however, you both need to address the problem by communicating your feelings.

Give each other an opportunity to explain in your own words how you think your relationship could be improved.

Sometimes our partners may go through periods of being asexual (which can be normal). Although they may be content not to have sex, this can be stressful if the other partner's libido is still strong.

Some men have low testosterone which can lead to loss of sex drive, erection problems and infertility.

Other conditions, for example kidney or liver disease, obesity, problems related to the pituitary gland, the side-effects of medications and financial- or work-related stress can also lead to loss of sexual desire.

If you hold resentment and anger for your partner, you will need to work through these feelings and may require the help of a therapist. It will take time and effort from both of you to revive your sex life.

Q: We have three kids and two were not planned. The stress makes me not want to have sex with my wife. What can I do?

A: The risk of a contraceptive failure can be a big source of anxiety for some couples, especially those who've had an unplanned pregnancy or a scare in the past. That anxiety can, in turn, lead to erection problems - and cause the same vicious circle that makes performance anxiety such a mood killer.

I am firmly of the view that more men should have vasectomies, as they have an effectiveness rate of 99.9%.

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

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