Depression as a cause of reduced sex desire

Reduced sex desire in a woman
Mr and Mrs. X came to me with c/o reduced sex desire in woman. She was 36 years old, married for 12 years, post graduate and was running her own business at home. The husband was 38 years, professional, working in a company requiring frequent travel, occasional alcohol abuser & a smoker. Morning erections were occasional. Initial time, for around 3 years were good, had sex every night. They had a 9 years old son.

The husband could recollect that it all began after the birth of son. But since then, Mrs. X would avoid intimacy, would sleep early or would tell that she had headache. Post delivery, there was no sex for 1 year. When they attempted sex, there was poor erection so it was not satisfactory. He tried to have sex with another woman where it was good. Next time, Mrs. X felt a lot of pain, vagina was dry and she presumed that it was due to operation (baby was born after lscs) the man would request for sex, but she would repeatedly take one plea or the other to avoid it.

Physical examination was normal, lab investigations were normal as well. The woman was found to be having moderate depression with sadness, disturbed sleep, reduced energy, headache and getting no pleasure from any source. We put the woman on antidepressants, gave them sex counseling with emphasis on spending quality time together, start touching, fondling and going for outing once a week. The man was suggested life style changes, quit smoking. It had magical effect in 6 weeks time. Now they are having sex 3-4 times a week and happy