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TODAY contributor
updated 9/29/2009 4:58:55 PM ET 2009-09-29T20:58:55

Q: I was married (I am a widow now) and never liked sex at all. It did nothing for me. I had two kids because I wanted children, but not for sexual enjoyment. Do you think some people were just born to be single, or am I a freak?

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I would love to have a live-in or dating situation that is totally sexless. Heck, I guess it could even be with a woman if it is sexless. I am totally questioning my sanity at this point. I even isolate myself so no one approaches me. What do you think?

A. There is a natural variation in sex drive, with some people having a lower drive than others. But being asexual and having no desire are two different things.

Lack of desire is called hypoactive sexual desire disorder. Often, somebody had desire and lost it, but sometimes they were always that way.

This can be due to low testosterone. For women, testosterone is the hormone of desire. A woman concerned about low or no desire should have this level checked.

Sometimes, lack of desire is psychological. Somebody may have had sexual trauma in the past or some other experience that makes sex seem completely unappealing.

Sexuality is a gratifying part of many people’s lives, so I don’t know that you should just give up and forget about it for the rest of your life, especially if your lack of interest is bothering you. I think you would be better off seeing a gynecologist or therapist to find out whether there is an explanation for your lack of desire.

In other words, if there is a whole unexplored area of potential gratification for you, you should check that out.

If you were not at all bothered by your lack of interest in sex, and were always "asexual" without feeling bad about it, then I would be apt to consider this normal for you and not something that requires help. But you are clearly troubled by your lack of interest in sex.

You note that you are even isolating yourself. That kind of intense avoidance indicates there might be some psychological issue. 

It makes me wonder: Is your complaint about sexual desire or about loneliness?

If sex doesn’t matter to you, you could indeed live with a woman, a roommate or a friend. There is nothing wrong with that. Many people have such living arrangements and enjoy the companionship. Obviously, you like social interaction. So I highly recommend you seek it out, because otherwise you will be very lonely.

But your avoidance of people because of your avoidance of sex is a red flag. You might also consider seeing a psychiatrist with an expertise in women’s issues and sexuality, or a certified sex therapist. You can locate one at aasect.org, the Web site of the American Association of Sexuality Educators, Counselors and Therapists.

Dr. Gail’s bottom line: Sexual gratification is an important part of gratification in life. If there is an obstacle to sexual gratification that you find troubling, you should seek treatment rather than avoid the issue.

Any ideas, suggestions in this column are not intended as a substitute for consulting your physician or mental health professional. All matters regarding emotional and mental health should be supervised by a personal professional. The author shall not be responsible or liable for any loss, injury or damage arising from any information or suggestion in this column.

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to TODAY. Her most recent book is “The Ripple Effect: How Better Sex Can Lead to a Better Life” (Rodale). For more information, please visit www.drgailsaltz.com.

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