Low sexual desire

Hypoactive sexual desire (HSD) or low sexual desire is a common sexual difficulty. Although it can be experienced by both men and women, it seems to be much more prevalent among women. Having low sex desire means that the individual lacks interest in sex, even though they get aroused and may have orgasms when they do have sex. Low sexual desire can range from mild to extreme. In mild cases a person may go through periods of not thinking about or wanting sex. Others will not hunger for sex, but enjoy it when it does happen. In extreme cases, people do desire sex and may become anxious when presented with the possibility that sex may occur. Life long HSD is rare, but some people never show interest in masturbation, sexual fantasies or any sexual aspects of sexual relationships. No matter what level of low sexual desire a person experiences, it only becomes a problem when individual or the couple begins to find it problematic. For some couples it may be all right that one partner that is not very interested in sex for that relationship, while another couple might find this a serious problem. There are many ways to try to increase sexual desire in a relationship so that this problem does not cause conflict in a relationship (see treatment section below).

What causes it?

Low sexual desire has many possible causes that include:

• Age: As an individual ages many changes occur in the body that affects sexual desire.
• Menopause: In women, the changes of aging start when she is beginning menopause, which is the cessation of ovulation. Her changes include decreased lubrication, lower estrogen levels (the female sex hormone), lower testosterone levels (the hormone believed to be responsible for female sexual arousal), and many other changes in the sexual response cycle.
• Hormone deficiency: Decreased amounts of testosterone in the body are liked with declines in sexual desire for both men and women.
• Gender: Although men and women may experience low sexual desire, it is much more prevalent among women.
• Bad experience with sex: Low sexual desire can result from having painful intercourse (dysparenunia), aversive events in childhood, or unusually high levels of inhibition. For instance, people who were sexually abused in childhood or view sex as a sin often do not have very much sexual desire.
• Depression: People who suffer from depression usually have a general decrease in mood, which tends to decrease their sexual motivations and activity.
• Anxiety & stress: If the individual suffers from either of these conditions, it may cause temporary to more long-term decrease in sex drive, depending on the amount of stress or anxiety being experienced.
• Medicinal or psychoactive drug dependence: Certain medications, especially psychoactive drugs (for instance those used to treat depression), may affect sexual desire. For individuals who use these types of medications, decreased sexual desire is a common side-effect.
• Habituation to one's partner: When a person becomes used to and comfortable being around his or her partner, sexual interest may decline.
• Relationship problems: Very commonly Very commonly HSD stems from problems that have not been resolved in the relationship. This is especially true for women: If they are not happy with their relationship, they tend not to want to be sexual until all conflicts are resolved.

Symptoms and Signs

• Individual is not interested in sexual activity.
• Decreased frequency in sexual activity.
• Decreased frequency in sexual activity becomes a problem in the relationship and causes conflict.
• Apathetic feelings during sex, despite attempting to please his/her partner.
• Habituation to his/her partner and decreased desire is evident only in association with him/her.
• There may also be selective desire deficiencies, in that the individual may respond physically, but be disinterested mentally.
• No interest in pursuing sexual interaction.
• Physical signs may include: vaginal dryness, weakened erections, decreased genital sensation, difficulty achieving orgasm, genital pain with or without sexual contact, or lack of sexual interest.

Treatment

Depending on the causes of low sexual drive, different therapies will apply. Both partners are encouraged to explore more exciting forms of sexual play and genital stimulation. Treatment is also aimed at relieving the tension between partners, removing stressful factors, or changing medications. The couple should make sure that they work through any relationship problems. Making sure there is effective communication in the relationship may solve part of the problem. Other treatments are the use of sensate focus, masturbation, and sometimes Kegel exercises are recommended.
One of the most basic therapies used to help the partner who is experiencing the low sex drive is to encourage sexual self-exploration. That person is instructed to follow the seven-step model illustrated below in privacy with soothing music playing in the background. Since women are more likely than men to have low sexual desire, the seven steps are discussed from a female perspective.

1. Look at her own body (in private, perhaps after bathing)
2. Feel her body
3. Touch parts that feel arousing
4. Try to get sexually aroused
5. Extended masturbation until orgasm
6. Male watches her masturbate
7. Male imitates her techniques

This technique along with the other treatments may help to increase a woman's sexual desire. It is also important to make sure that the individual is not on a medication that decreases sexual desire. Check with a physician to see if hormonal imbalances could be involved: A simple blood test is all that is needed.

© - Reproduced with permission of SexInfo, University of California at Santa Barbara, 2007.