DR. HOOK- Bed death: Where did the love go?

There are many different types of death. Death of a family member or friend. Death of an era. Death of a Salesman. Death Becomes Her. Death Leppard?

But what happens in a relationship/marriage when there is Bed Death? When I was child, I was watching some TV show (surprise, surprise)­ I think the Waltons or Little House on the Prairie– and an older woman says to a newlywed couple, "If you put a penny in a jar each time you make love during the first year of your marriage, and then you remove a penny from that jar each time you make love during the rest of your marriage, you will never empty the jar." (Hmmm, maybe it was a different show?)

That was a depressing thought, and I rebuked it. However, as a physician who always includes sexual health (call me Dr. Ruth minus the puffy red hair and NY accent), I see there is some truth to that TV statement.

I really don't give advice on how to improve one's sex life. That would be like Dr. Laura (who isn't really a doctor but an exercise physiologist) giving advice on how to be a nice person. Instead, I explore physical and emotional reasons that could explain a drop in libido. When the "Dance of the 7 Veils" becomes the "Dance of the 21 Veils" without hitting blackjack, it might be time to look for medical reasons for bed death.

First of all, one partner should never force the other partner to have sex. That's called rape. However, if one partner is interested in having sex but the other partner never wants to or "not enough," there can be a billion reasons for this (like "your partner is a jerk"). That means I can't go into all the reasons.

For women, gynecological pain can be deterrent. Menopause, in particular if caused by a complete hysterectomy, lowers estrogen that can lead to low libido and sexual response difficulties.

Men are often viewed as being "horny devils," but is that the reality? As men age, testosterone levels usually drop. About 50 percent of men over the age of 50 have some erectile dysfunction, and it gets worse with every decade. Performance anxiety often becomes an issue.

Body image issues occur for both men and women as age increases. The US is very focused on youth. Annie Lennox ironically sang it best in an oldie, "Look young and beautiful if you want to be loved."

Medical problems like heart disease, emphysema, and diabetes can damper a person's sex drive. Chronic pain patients usually don't think about sex– they're thinking about their next dose of Percocet.

Medications can contribute to bed death. Some antidepressants lower libido and sexual arousal. Blood pressure medications can contribute to erectile dysfunction. Alcohol and drugs can initially steam up the bedroom, but eventually they burn down the persons.

How often do we see ants having sex? We don't! They're too busy working– well, at least when we're watching. Our society is exhausted from working too much, in addition to taking care of the kids, paying the bills, and doing household chores. Casanova is working overtime­ at the office!

I'm not a gambler. When I go to a place with a casino, I don't place bets. Instead, I watch people blow their money at the tables or on the slot machines. I don't gamble with my patients. But it would be nice to have them hit the jackpot like a slot machine to get all their pennies back– and more.