Dear Carol,

I have a question I should maybe ask my doctor, but I’m not sure how to put it to him. I have recently had surgery for a life-threatening condition, and though I’m recovering pretty well, and the prognosis for my future health is also pretty good, I am noticing two problems I need advice about. Maybe they in fact are connected, I don’t know. The surgery left a really big scar on my abdomen. Right now it hasn’t healed fully; it’s still pretty red and angry-looking, but worst of all it makes my belly look kind of misshapen. I felt basically okay about my body before, but I feel like this scar is really ugly and makes me look unattractive. Also, my sex drive is just in the toilet. I have always been a pretty sexual person, with what I felt to be a healthy masturbation life even if I didn’t have a partner. But I can’t even be bothered to fantasize, and I wonder if maybe something about this surgery went wrong and affected me somehow. I guess I’m pretty distressed about it all and wonder if you would give me your thoughts. –George

Dear George,

You don’t say how long ago you had surgery, which might make a difference in determining whether you’re right on target in your healing process or whether your libido loss is lasting longer than one would expect under your particular circumstances. Major illness is one of the chief enemies of the libido, and several things about surgery make it hard on your sex drive: discomfort, interruption of normal bodily functions, being laid up and getting less exercise than usual, illness-related depression, and the effects of your meds. All these things could make a difference, and the libido plunge could take a while to recover from. It may definitely help to engage in libido-enhancing activities like masturbation (even if you’re not ragingly horny, do it anyway–it keeps the parts in good working order) or reading or watching erotica. It will probably also help to exercise as much as you can–don’t take it too fast, but at least walking every day is likely to make a difference. People searching high and low for aphrodisiacs rarely bother to take a walk or go for a swim–exercise will up your testosterone levels and limber up your body besides. Another thing you can do is get a massage, which can help you get back in touch with your physical body. After substantial illness it can seem like our bodies were AWOL (or sent off to the torture chamber)–and returning to sensuality and healthy touch is important. If you have a partner, perhaps he or she can help with that, and with cuddling and erotic play as you feel ready for it. Doing nothing will almost certainly make your recovery take longer.

Your distress about your scar may well be connected with your lowered sex drive; not feeling attractive is certainly a factor in many peoples’ experience of libido. Hopefully your doctor can reassure you that the scar will fade, and may be able to give you a sense of how long that is likely to take. It may help to know that part of what you don’t like about it is temporary. Gentle massage using oil may be good for the scar tissue, and it will make a difference in its flexibility. Your experience of your body as misshapen may also fade; it is possible that you are still experiencing some swelling related to the surgery–this is another thing to ask your doctor.

You can strive to accept your body as it is–affirmations may help, as may focusing on pleasurable sensations in erotic encounters instead of how your body looks. You may want to try turning the lights a little lower and wearing a kimono or lingerie to obscure the part of yourself you’re not eager to show off, but if you have a lover who is willing to spend some time touching your belly and lavishing love and acceptance on you, I’d say you should go for it. You might also choose to alter your body: many people with major scars elect to get tattoos which enhance and/or obscure the scarred area. (Have a look in David Steinberg’s wonderful book Erotic by Nature at poet Deena Metzger’s decorated mastectomy scars; some tattoo books and magazines may also depict scar decorations.) Folks with plenty of money might even get plastic surgery. By the way, you do know that there are folks out there who appreciate scars, don’t you? Not in a fetishistic way (well, yes, there are some of those too), but in more of a "Wow! Cool scar!" kind of way. Your scar is a badge of courage and survival –yeah, I know you’d rather not have it, but you’re alive, and under the circumstances that beats pretty much all the alternatives.

Dear Carol,

My boyfriend is encouraging me to talk in bed, like talking about our fantasies and stuff, and I am looking for inspiration. Specifically, what kind of books would have erotic stories about couples making love with another woman? That fantasy turns him on and I would like to get better at talking about it. –Cindy

Dear Cindy,

Anybody tell your boyfriend lately that he’s a lucky dog? My book Exhibitionism for the Shy has a few chapters about erotic talk and ways to get more comfortable; you might also like Penthouse letters-type stories (lots of threesomes there), and it just so happens that Penthouse has published a bunch of them in book form. If you can’t find them locally, inquire at www.grandopening.com.