I believe in the philosophy of "Ignore what she says, watch what she does".
My definition of "love", is "being willing to make an effort, or pay a price, in order to enhance the life of another". You can measure how much a person really loves you, by how much time and effort she's willing to expend on enhancing your happiness.
If you've made clear to her that sex is what makes you happy, and she's not interested, then that means she's not interested in making you happy.
I've had more than one friend whose wife lost interest in sex with him, only to discover that she was still interested in sex, just not with him.
At this point, I’d be happy if she was cheating; at least then I would know it’s me. But for a mid-40’s woman to just lose all interest isn’t right. And not wanting to see a doctor about it, isn’t either.
Like I said, I’m just gonna pray about it, and before too long, I’m going to schedule the counselling session, with or without her.
You are right that sometimes the wife is not interested in her particular husband any more. Separation or counseling might be the only choices there if she doesn’t love you as a man any more.
But sexual interest is totally hormonal. Totally. Otherwise a lot more 10 year old boys would be out meeting chicks.
In the infertility world, infertility docs prime the woman with plenty of estrogen and progesterone as she begins to cycle to attempt pregnancy. Nearly every woman notices a HUGE, 100% increase or more, change in her sexual appetite. To the point of wet dreams. They are told to avoid sex after embryo transfer, and often call in worried sick because they had orgasms in their sleep! Every couple where the woman has desire issues definitely needs to get her to a good doctor who prescribes bio-identical hormones that are applied to her skin only, NO ORAL HORMONES. Topical hormones will be perfectly safe, will not cause cancer, and will enhance her life in many other ways too, better skin, less aches and pains, better sleep, etc. And the desire of her life.