Tis the Season

Yours truly was recently asked by a national woman's magazine to provide some appropriate medical commentary for an article on causes of low libido. We all know Dr. Martinez has an abundance of commentary, but keeping it appropriate was a challenge.

They should have just had me write the damn article, because the hack that is getting paid couldnt write it all down fast enough, and tragically she got the abridged, PG13 version.

So, in the spirit of the season, I am going to provide you with the unedited version here. Take warning, its not for the faint of heart or those currently eating soft cheese.

Seriously though, as a gynecologist it is downright depressing the number of women who don't like sex. That's just not fair. Women have to deal with all of the risk of pregnancy, and a much higher risk of sexually transmitted infection. We should damn well be having an orgasm for the trouble.

The hack wanted comments from me on how birth control pills can lower your libido, and we all know that Americans like for a pill to be the answer, but she wasnt getting that out of me. Birth control makes the world a better place. I instead offered that while there are some medical reasons that sex can be painful and libido affected, that it's rarely the explanation for whats going on. At least in my practice, where admittedly women do get into fights at their baby showers, most of the sexual dysfunction has more to do with the fact that couples aren't communicating properly.

Sometimes its that women are too insecure or shy to say what they want, and sometimes it's that your new husband is a transvestite.

She was double booked into my 4pm spot on a Friday afternoon and had driven in from a small town forty five minutes away. Through sheer determination and prodding of reluctant medical assistants who'd rather be taking a smoke break, my clinic is one of the few resident clinics that actually runs on time. Its a point of pride.

So, after her vitals have been taken, I flip through her records and head into see why she's here. She tells me that she would like a "pill to fix her." I tactfully enquire as to what is broken. Brenda relates that she married her high school sweetheart just three weeks ago, and she is no longer attracted to him sexually.

They were virgins when they married, so I'm not entirely suprised the sex is lousy. I mean, it unfortunately seems to take some men a while to realize that women are not ATM machines. You don't just walk up, insert your um, card, push a couple of buttons, make your withdrawal in a matter of seconds, then end the transaction. No effing way. Unfortunately it also seems to take some women a while to realize they need to have higher standards.

Anywho, in the next five minutes I diplomatically navigate a series of questions to try and elicit whats going on. Pain? Depression? Alcohol? Insufficient foreplay? Intimacy issues in the relationship? I ask if she has thought about seeing a counselor- "Yeah, but that wasn't really helpful. She just told him to quit stealing my lingerie and makeup, because it upsets me that he looks better in them then I do, and I don't really want to wear that strappy on thing."

Its heartbreaking really. Why do women always think it's their fault?
If anything screams "not about you" louder than this, I can't for the life of me think what it would be, but she needed to hear it from a doctor.

Dr. Hernandez is known to be more decisive than most, but still she has a hard time understanding women who don't know what they like. Even more of a conundrum is those that dislike something that's supposed to be fun, but endure it silently anyways. Disliking sex is akin to silently suffering while on vacation in Hawaii.

This next gal was in her mid forties with cafeteria-lady hair and was an assistant manager at the local Mail Boxes Etc. She came in still wearing her work uniform of pleated front khakis, and psuedo denim button down shirt. She was the essence of frump and sincerity.

She plopped onto the exam table, and without further ado announced, "So, I've got this new boyfriend, and he really likes me to take it up the butt, and I don't know, I mean, it doesn't feel good, and crap keeps leaking out all over the sheets, but you know, I really like him, so that's fine, but what I can't figure out is why throat is so sore all the time and my cookie smells so bad...."

Let it be noted that Dr. Gomez wholeheartedly supports consensual adults doing whatever their thing might be, but she does NOT understand why the hell you would need to see a doctor to solve this riddle.

The second hand slowly traversed the clock as I rapidly considered how to best explain, as politely and clearly as possible the state of affairs. Inspiration struck.

I smiled and said, "Would you walk into your house, even through the back door, with muddy shoes on, then come out, muddy shoes still on, and head in through the front door before then walking upstairs?"