What Is Low Sexual Desire?
People normally differ in their degree of sexual appetite. There is no single standard of sexual desire, and desire differs not only from person to person but also for the same person over the course of a relationship.
One of the most common sexual complaints among couples is a disparity in sexual desire. Sexual desire can be low for a variety of reasons, many of them psychological and interpersonal. But that doesn't necessarily make it a disorder. It becomes a diagnosable condition only when it diminishes the quality of one's life and creates distress, or when a disparity arises in the sex drives of partners, evolving into a matter of unresolved contention in the relationship. Loss of sexual desire can both result from relationship problems and cause them.
Moreover, what constitutes "low" (or hypoactive) sexual desire is relative. Partners who use the degree of sexual desire experienced early in a relationship as a standard of comparison may label as a problem the drop in sexual desire and activity that often accompanies long-term partnerships. Further, a person who experiences low sexual desire that is problematic relative to one partner may not experience any disparity in desire with a different partner. What is designated as one partner's low libido may more accurately reflect a hyperactive sex drive in the other partner.
Sexual desire and responsiveness normally differ between men and women, and assumptions about sexual equivalency may falsely suggest the existence of hypoactive desire disorder. Men are more readily physiologically aroused than women, and for them, desire is tied tightly to this arousal. Among women, sexual desire is typically more psychological and situational, influenced by how they feel about their bodies as well as the quality of relationship with their partner. Moreover, women often do not experience desire until after they are genitally aroused, and arousal may require an extended period of foreplay.
What Counts as Low Sexual Desire?
How much sex—and desire for sex—is “healthy” depends on the individual. Levels of sexual desire can change for various reasons, and decreased desire doesn’t necessarily cause distress, but it can. How to classify the problems related to low sexual desire and whether particular psychological or medical treatment approaches are effective in alleviating those problems are subjects of continued debate among clinicians and scientists. Much of the conversation centers on how the workings of desire and arousal tend to differ between men and women.
Symptoms of Low Sexual Desire
Loss of sexual desire usually manifests as a lack of response to a partner's overtures for sexual activity. Symptoms of low sexual desire might also include:
Causes of Low Sexual Desire
Physical causes of low libidos, such as changes in endocrine hormones, must be ruled out. Most often, the causes of low sexual desire will not be revealed by medical or laboratory tests. The single biggest psychological cause of hypoactive sexual desire may be depression. Fatigue is up there, too, and a highly stressful lifestyle can have an impact on sex drive. People who have body image problems may also experience a lack of sexual desire.
Relationship experts report that resentment is a major cause of libido loss, and it strikes men as well as women. Anger at a partner—for being overly critical, for being too dominant or too passive, for ignoring one's needs, for any reason at all—can dampen sexual desire.
Decreased sexual desire is a well-established and common side effect of treatment with antidepressant drugs.
Treatment of Low Sexual Desire
Sometimes, the best treatment for low sexual desire in either partner is counseling—to resolve overt conflicts, hidden resentments, power struggles, or other interpersonal barriers to erotic interest. Since depression is a frequent cause of diminished desire in both men and women, treatment of depression is another important path to the resolution of desire problems. Psychological therapies, such as cognitive-behavioral therapy, not only may be more effective than pharmacotherapy in relieving depression, they do not interfere with libido, as many psychoactive drugs do.
There is no magic pill for restoring sexual desire in women, nor is there likely to be. Perhaps the most effective route is educating both men and women about how women actually become aroused. One treatment of hypoactive desire in women that is proving highly effective utilizes mindfulness to connect bodily sensations of arousal with psychological arousal.
Among men, a drop in testosterone levels can profoundly impact sexual desire, and for some men, treatment with testosterone may help restore desire.
Sexual Desire in Men
Sexual desire is now believed to be more biologically driven among men than among women. It is spontaneous and generally considered the first step toward intimate feelings and behavior. Loss of sexual desire and sexual inhibition may be more common among women—but these problems are not unknown among men.
Men often experience decreased sex drive in response to heavy alcohol consumption. Erectile dysfunction, performance anxiety, medical conditions, medications, and stress can all diminish sexual desire. While some clinicians report that men's excessive use of pornography leads to diminished sex drive within a relationship, some studies show mixed positive and negative effects of pornography on relationships while others find no negative impact at all.
Sexual Desire in Women
Sexual desire in females is both more complex and more fragile than it is in males. It is generally more variable, related to women's hormonal state, how they feel about themselves and their partners, and other events in their lives, to say nothing of a partner's lovemaking style and technique.
But experts agree that, in general, sexual desire is lower among females than among males, so a further drop in female desire for any reason may be more problematic in relationships. Because female sexuality is multifactorial, involving various combinations of mental, physical and social factors, there is no one, simple solution for treating women who experience low sexual desire.
The Effects of Age on Libido
The physical changes that accompany aging don't necessarily lead to declining sexual desire and function. The level of sexual activity maintained over time varies and depends on many factors. These include physical and mental health, personal interest in sexual activities, comfort with one's own sexuality, and intimate relationship status.
Problems with diminished libido, erectile dysfunction, and other age-related changes are common, as are side effects from chronic health conditions and some commonly used medications that affect sexual function. Negative cultural attitudes and myths can also interfere with the pursuit of satisfying sexual activity among older men and women. When properly addressed, most of these problems are not insurmountable and can often be resolved with the appropriate treatments and therapies.