My wife and I have been married for 19 years. We have a solid Christian marriage, but our sex life began to deteriorate after our second child was born. My wife has lost virtually all interest in sex and refuses to talk about it. Is it usual for a woman to lose interest in sex as she gets older?

No, it is not "usual" for women to lose interest in sex as they get older. Loss of interest is usually related to issues other than age. If, for example, your wife's interest in sex had begun to diminish after your first child was born, we would suspect the effects of pregnancy and childbirth. Fatigue, body changes, 24-hour responsibility for a totally dependent infant and changes in self-image ("now I'm a mother, not a sexual partner") could affect her interest level.

However, since the loss of desire started after the second child was born, we would first question some physical issues. Does your wife experiences pain during intercourse caused by the birth of your second child? Has she had a complete hormonal evaluation including a free or bioavailable testosterone level? If free testosterone is low normal or below normal, she may need to have her physician order a 1% testosterone cream to be applied to the vulvar area daily.

We also wonder if your response to her dip in sexual desire has, in any way, exacerbated the problem. We find that when a husband is anxiously preoccupied with his wife's lack of interest or seems to need her to want him sexually to feel good about himself, then her normal ebb and flow of sexual desire will spiral downward with his negative concern. It may be very difficult to rekindle the fires of passion when negative attention is fixed on what may be a normal "dip."

If this is the case with you and your wife, you need to back away from any expectation for sex and your focus on her diminished sexual desire. Instead, focus on other critical dimensions of your relationship and affirm any flicker of sexuality in her. Take time to communicate, to really get to know your wife's heartbeat. Take walks; enjoy being together. Slowly, over time (and yes, it may take a long time), the building of this nonsexual intimacy will lay the groundwork for a more fulfilling, less frustrating sex life for both of you.

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