“Incongruent desire.” It’s a phrase I made up for my documentation to describe the situation when one person in a couple wants to have sex more than the other person. For example, I recently saw a woman with a complaint of vaginal dryness and decreased libido. At the initial appointment, we talked about her physical symptoms and I inquired into the state of her relationship and her general mood. She assured me that her mood was good, her partner was a nice guy, and that she was happy with his sexual technique. We checked a few labs, talked about using lube and made an appointment to discuss the results. The lab results were normal. I delved a little deeper into her sex life. It turns out that my patient is a nighttime sex person who says that she would be happy to have sex 2 times a week. Her partner is a morning person. Like, an early morning person. Early as in 5 a.m. every day before he goes to work. Every. Day. At. 5 a.m. My patient didn’t find this as bothersome as I would. She just felt bad that she wasn’t wet and ready every day at 5 a.m. when her partner was horny. I gave her the speech about how there are different types of normal for people, and that her level of sexual desire sounded perfectly healthy to me. I encouraged her to talk to her partner about ways that they can compromise on the timing of sexual activity. I informed her that contrary to her hopes, there is not a pill that can turn her into a horny morning person. What I didn’t say was that my partner would be getting nothing but an angry elbow in the ribs if I was being woken up at 5 a.m. for some lovin’.
A little problem I like to call… June 10, 2010