Marianne, age 40, was not getting turned on in sex. She and Dora had been together for eight years, and sex had been loving and passionate. She could not understand why her arousal had stopped over the past eighteen months. She had changed her job about the same time, and was now earning less, and she had a new boss who was on her back all the time. Dora was being kind, but was worried that there could be some underlying illness.

Assessment

As there was no clear reason why Marianne might have lost her arousal, she saw her doctor, who checked blood pressure, hormones for early menopause, blood tests for diabetes and thyroid imbalances, and for tumors. Her nervous system was checked as well and she had a clean bill of health. Her mother had died of breast cancer at age 41, and they couple wondered if that had anything to do with the change in Marianne. In the end, it was agreed to go ahead with *Sex Therapy* without knowing the cause.

Sex Therapy
This went well from the start. Marianne and Dora loved doing the homework exercises, and spent plenty of time on them! As a result, they were a bit down when Marianne got her arousal back and they could stop the therapy. But they decided to do the exercises from time to time anyway.

Keeping up the good work

They never found out why Marianne had lost her arousal. There was no clear reason. It might have been the change of job and less money, or just one of those things. Sex can change for no reason. Marianne and Dora learned in therapy how much they liked slow stroking and gentle massage, and just being close.