When the sex has lost flavour...

The nurse rushed into the consultation room panting. I immediately noticed the anxiety. Awe was painted all over her face. I reflexively stood up ready to respond to whatever distress she had.

“Do we allow her in or should she queue like the other patients?” the nurse rattled.

“Who are you talking about, what kind of emergency is it?” I answered, walking towards the door to go and see for myself.

The nurse however blocked my path and pointed me back to my seat.

“She is a big VIP, I think she is a minister or a senator. She has policemen all around her, and she wants to see you,” she said, to which I nodded with understanding.

The lady was ushered into the consultation room. There was a pleasant scent of perfume all over the place. I noticed a battery of armed cops peeping in as she entered the consultation room and closed the door behind her.

“Jane is my name. We talked on phone and you gave me an appointment for today,” she said and burst out laughing as I frowned in disbelief.

No desire for sex

She was not Jane. She had hidden her identity when she called on phone. She was a famous political figure holding high office. I told her this, but she insisted that I record her details as Jane anyway.

People in high offices are always suspicious of things going wrong and she did not want even my most trusted assistant to connect my notes to her as the patient.

“My body is totally numb to sex, doctor. I don’t respond to a man’s touch. Everything sexual is mechanical and a legal duty for me, I hear people talk of orgasm and I wonder what they mean!” Jane said as she took the patient’s seat.

Jane was 54 years old and had three children. She was in a stable marriage. Her husband was a businessman.

“We need to unpack what you mean when you say that your body is numb,” I interrogated her, trying to come up with a diagnosis.

She explained that she did not have desire for sex. Sexual thoughts did not cross her mind. While in bed with her husband, she could not get aroused sexually. Foreplay was tiring instead of pleasurable.

She had learnt to feign pleasure and so her husband did not know what she was going through.

Molested by a priest

“But don’t you get pain during penetration?” I interrogated her further. “Without arousal, sex can be dry and painful.”

Incidentally, she had learnt to use lubricants, and to fake pleasure. I did a medical examination and laboratory tests but could not put a finger on a physiological abnormality in Jane’s body.

I dug deep into her socio-cultural, religious and life experiences. I concluded that her problem was psychogenic – a deeply embedded psychological problem resulting from some life experiences and subconsciously blocking sexual feelings.

As I went on questioning, Jane suddenly went into a fit of emotions. She started weeping uncontrollably. I realised that I could have touched a raw nerve.

“I was molested by our priest when I was 12!” she dropped the bombshell.

“I have never mentioned this to anyone, not even my parents.”

She went ahead to describe graphic details of how the priest tricked her on her way from school, took her to his house and molested her then warned her not to tell anybody. He then gave her painkillers and told her to feign sickness when she reached home.

Sexual dysfunctions

And so we had a diagnosis. Most women molested early in their lives are known to suffer sexual dysfunctions later in life. The commonest of such dysfunctions is lack of desire and feelings for sex. Others may literally dread sex and developed tightness of pelvic muscles during the act and this causes pain.

In some cases, there may be desire for sex but the woman fails to get aroused in the heat of the moment. Failure to get orgasm is another possible complication.

Jane had taken too long to seek help. She was already in menopause which complicated her issues more. With the change of hormones in menopause even a normal woman may experience a decline in sexual function.

“So is mine a closed case or is there treatment?” Jane asked, her eyes bloodshot from weeping.

I booked her for sex therapy. It was a journey that went on for three months. On her last visit, as always, she wore her make-up before walking out to meet her bodyguards. As always, she asked repeatedly if her hair, eyebrows and everything was OK.

“As a public figure people should never imagine that you have personal challenges. They look up to you as a source of strength in difficult times and you cannot afford to disappoint them by showing that you are weak and can also cry.”

I nodded reassuringly as she shook my hand and thanked me for my services.