Sexual Anorexia: The Flip Side of Sexual Addiction

Sharon O’Hara is the former Clinical Director of the Sexual Recovery Institute and sees private clients for individual, group, and couple therapy both in Beverly Hills and San Pedro.

Sexual addiction occurs when a man (or woman) becomes so obsessed with certain sexual rituals or behaviors that he can’t even stop after serious consequences, such as job loss, divorce, disease, or constant shame attacks. In early recovery, a period of celibacy is often prescribed in order to break the destructive patterns. But what happens after that? Often celibacy turns out to feel safer than the risky business of trying to have healthy sex with someone you love but with whom you might feel guilty or ashamed. Sexual anorexia then sets in—with the partner feeling even more rejected than before.

A loss of sexual desire in sex addicts can also occur as a side effect from antidepressants, or because of physical problems from prostate cancer to menopause. Often the partner of a sex addict (or other addict) is shut down, partly because of valid trust issues, such as worrying: “Is he going to give me a sexually transmitted disease?” I have also noticed, in 10 years of working with sex addicts and their families, that there is a very high percentage of male sex addicts who marry women who were sexually abused as children, often creating sexual anorexia as a kind of coping skill to ward off the possibility of any future sexual abuse. This person may feel drawn to marry a sex addict from many of the same impulses that lead children of alcoholics to marry alcoholics themselves.

This topic of sexual anorexia is explored further in this selection of questions and answers culled from the last four years of Sharon O’Hara’s column on “Love & Sex” appearing monthly in Steps For Recovery newspaper. Perhaps one of these problems may match your own.

Q. After being a year sober, I met this real sweetheart of a guy in AA. We got married after a 6-month courtship and I thought that everything was finally going my way for once. Only problem is, we’ve been married for a year and a half now, and I don’t want to have sex much anymore. Before getting sober, I used to do sexual stuff with men I didn’t even like much, just to keep them around. Now that I’m sober I remember what I did and the whole idea of sex brings back these flashbacks. I don’t really want to lose my husband, but when he pressures me for sex, I just want to have a drink. What should I do?

A. Now is the time to give yourself the gift of some personal shame-reduction therapy. Going to 12-Step groups can help keep you sober, and there are some great Women Only groups where you can talk more freely about sexual issues in recovery. You know that drinking won’t really solve your sexual problem—drinking will just add another problem to your existing list. Your current sexual anorexia sounds like a post-traumatic stress type of reaction. Shutting down sexually is a fairly common way of handling sexual shame and guilt.

You also might want to see a therapist about how to talk to your husband more effectively. If he’s a recovering person himself, it’s likely that he has a few hang-ups himself in the sexual arena. Try to remember that you are both in this recovery thing together. Sometimes guys forget that a marriage license is not a mating license, to be hauled out every time one person wants to have sex and the other doesn’t. Sex needs to be consensual even when you are married. A good therapist can help you both to regain intimacy with some sexual trust exercises. Reading Wendy Maltz’s book The Sexual Healing Journey might be a good way to get started. Or look into Patrick Carnes’ book Sexual Anorexia. Good luck to you both.

Q. I’m on Zoloft because I used to be angry and depressed all the time, and being sober from alcohol didn’t exactly improve my mood. I thought that my wife was going to divorce me because I was such a jerk when I was drinking, but once I got sober I was a really angry guy, and I thought she was going to divorce me because of that. Zoloft helped even out my moods but now I can’t keep an erection half the time, and now I’m afraid my wife is going to divorce me because of that. Have any advice?

A. Yes, it’s true that one of the side effects of Zoloft and Prozac is a tendency for some people to experience less sexual desire or an inability to achieve orgasm. You might want to talk to your psychiatrist about this problem because there are some new antidepressant drugs on the market that may not have these side effects. Or perhaps your doctor could adjust your dose of Zoloft so that these symptoms were minimal. Viagra is another option, if you are able to use it responsibly. Another suggestion is for you and your wife to discuss opening up your sexual repertoire to include more activities that are not necessarily centered around penile-vaginal intercourse. After all, the largest sex organ in your body is your brain. You might want to use it more imaginatively. This could be an opportunity for you and your wife to explore a variety of ways to pleasure one another, including holding, kissing, stroking, massaging, talking, and being close. Not every sexual encounter has to end in orgasm in order to be enjoyable. You could try some of the exercises in books on Tantric Sex, which often describe how the male orgasm is enhanced after a period of voluntary orgasmic discipline.

Q. My wife is having some pre-menopausal symptoms—she’s 48 and I’m 52—and now she’s fearful all the time that her sexual desirability is on the wane. She used to really enjoy sex, but now all she talks about is being a dried up prune for the rest of her life. It’s gotten so that I’m afraid that I am married to a woman who will truly be a dried up prune for the rest of my life. What can I say to her?

A. Probably the best thing you can tell her is that old standby: “I love you.” Menopause can last from two to ten years. The good news is that some women report this time as a period of renewal, of finding inner empowerment, of discovering who they really are and how their priorities might change. Some women actually report an increase in sexual desire. Others report a number of symptoms such as dryness, mood swings, night sweats, headaches, and weight gain. There are a number of ways for your wife to minimize her symptoms, from estrogen and/or testosterone replacement therapy to acupuncture, but she may need the help of a menopause specialist. The North American Menopause Society has a list of doctors who specialize in helping women make it through the “change” with a minimum of problems.

Quite frankly, menopause also forces women—and the men who love them—to face their own mortality fears. This is a time when couples often can re-prioritize their lives, find more time to enjoy one another or explore new options. Your wife doesn’t have to be “a dried-up prune” for the rest of her life. It might help if she, and you, started by reading one of several very good books on the market about menopause, such as Lonnie Barbach’s The Pause, or Gail Sheehy’s Menopause, the Silent Passage.

Q. My wife was sexually abused as a child by her uncle, and she kept it a secret for a long time. I’ve tried to be understanding, although first I wanted to go out and kill the guy. We’ve been living together for 3 years, but I didn’t know about this abuse until six months ago. We’re both going to Adult Children of Alcoholics meetings, and it’s helping a lot in terms of handling anger and resentment. However, my wife is having a lot of sexual problems. We’re only having sex about once a month these days. When I first met her I thought that I had found my sexually ideal woman. She’s beautiful, and she used to be willing to do anything in bed. Now she says that she was putting on an act to please me. The weird thing is that she likes to use vibrators, by herself, lying face down on a bed. I found her that way once, and I became upset that she would prefer to masturbate rather than have sex with me.

A. Many women who were sexually abused as children have struggles with their sexuality as adults. Interestingly, it may be a myth that such women are unable to enjoy sex. However, it is true that they may feel guilty about enjoying sex. Your wife needs to know that you love her for more than her beautiful body, because sexual abuse teaches a woman that her body is the only thing she has that is worth something. Some women are truly afraid of their sexual potential, because they are afraid that enjoying sex as an adult may mean that they deserved the abuse they got as a child. Most sexual abuse survivors report feeling more empowered after therapy with a trauma specialist, or by joining something like an incest survivor’s group. And the two of you together might want to find some safe ways to talk about your sexual future, perhaps by finding a couples therapist who has had experience with sexual abuse issues.

Q. I don’t know which is worse: what my husband was like before he joined Sex Addicts Anonymous, or what my husband has been like since he joined SAA. Before was when he was getting hand jobs from prostitutes in massage parlors. I can’t believe how much money he spent on that!! Then he joined SAA and stopped seeing the prostitutes. But he also stopped having sex with me. At first I was so mad at him that I didn’t care if I never had sex with him again, and I began thinking seriously of divorce.

But I have two little boys and my husband was so remorseful—after he got caught—that I decided to see if we could still make the marriage work. I did some research on SAA and found out that many recovering people go on a celibacy contract for 30 days or even 90 days, but it’s been 4 months now. He tells me he loves me, but he just isn’t ready. Last night he finally told me that he’s afraid that if he has sex with me, then he’ll start wanting to have sex with prostitutes, so it’s better to shut down altogether. I don’t think that this is a great solution for saving a marriage. What do you think?

A. You’re right: no sex at all is not a great solution for saving a marriage, especially if one of the partners is unhappy with that solution. Your husband is afraid. He obviously cares about you, and he’s afraid that if he were to slip and see a prostitute that you might leave him. I think it may be time for the two of you to see a marital therapist who can help the two of you to come up with a plan for healthy sex. For example, for many couples in recovery, it is important to start out slowly. Some couples go out on dates, for example, and they get to know each other through courtship rituals that do not in the beginning involve the genitals. Then they move to hugging, kissing, holding and so on. Most people put lots of energy into career goals or investment strategies but never take the time to plan for intimacy. Remember that your husband has an intimacy disorder, not just a prostitute problem.

Q. When we first got married, my wife and I couldn’t seem to get enough of each other. We made love almost every night. Then we had some rough times due to my drinking, and we started to grow apart. She spent a lot of time at her job, and finally she gave me an ultimatum—to stop drinking or she’d leave me. I went into rehab, and I haven’t had a drink in a year. The problem is, our sex life just isn’t what it used to be. She’s still busy at her job, and I’m going to a lot of meetings. We’re both tired all the time, and it seems like we pass each other like ships in the night. How can I rekindle romance?

A. I once saw a book that had a great title: “How to Fall in Love With the Person You Already Live With.” I don’t remember exactly what was in the book, but the general idea was to start back at the beginning, with the courtship stage. In other words, suggest to your wife that you have an “intimacy date” that doesn’t include genital sex. Take her out for dinner, buy her flowers, say something complimentary, such as how you appreciate that she stayed with you through rehab. Come home and cuddle, rub her feet, and ask her opinion on something. Listen. Don’t give advice. Hold her when you go to sleep.

Sharon O’Hara, MFT, CSAT, has offices in the Beverly Hills and Torrance/San Pedro area, specializing in treating sex addicts and their partners. She can be reached via email at

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