LOW SEXUAL DESIRE
Sexologist & Sexuality Educator
©2001
WHAT IS SEXUAL DESIRE?
When we talk of "low sexual desire," we are talking of a lack of interest in sex. In street language, the person with low desire does not get "horny," or does so infrequently. Without desire, there is little or no biological motivation to be sexual. Individuals without a sex drive do not understand why they are not interested, and might not even know what it is that's missing. They feel powerless when expected to want sex.
Traditionally, sexual drive was called LIBIDO, and this term is still used by those not trained in the diagnosis and treatment of sexual disorders. Clinically, low sexual desire was initially classified as INHIBITED SEXUAL DESIRE (or ISD), but in recent years has been relabeled HYPOACTIVE SEXUAL DESIRE (or HSD).
Regardless of what it is called, when the level of sexual desire is down, a person's lack of interest can create serious problems within a relationship. However, this is only true if the partner has a higher level of desire. There is no problem if both want sex once every day, and there is no problem if both want sex once a month. However, if one wants it every day and the other only once a month, this discrepancy is likely to cause concern. In other words, it is the discrepancy in levels of desire that is potentially disturbing.
Think of sexual desire as a hunger. If a person is hungry for food, he or she will be motivated to eat, will enjoy eating, and will be satisfied once having eaten his or her fill. The person will reminisce about a good meal, will tell friends about what tastes good, and will look forward to eating again. The sexual drive is also a biological hunger that motivates behavior, influences thoughts, and invades fantasies. Despite the similarities, there are differences, however, between a hunger for food and a hunger for sex. A person is not likely to feel hurt, rejected or unloved if a partner does not want to eat with him or her. Not so when a one is not sexually motivated, for this is often taken much more personally by the partner with the greater appetite.
WHO HAS LOW DESIRE?
The answer the question seems easy. Everyone has low desire... at times. If a person is depressed or temporarily ill, his or her sexual drive is likely to drop. Immediately after being sexually satisfied, desire fades. During a pregnancy, some women lose their sexual appetite. For some women their "horniness" fluctuates in synch with their menstrual cycle, with some women being more interested mid-cycle and some during their periods. We know that certain medications will adversely impact libido. During times of stress and high anxiety, desire will diminish. We have all experienced these low points from time to time. Aging, chronic illness and physical disability can have long term effects on sexual interest.
In real life, questions about desire are not that easy. One must first ask, "How much desire is enough?" The answer is, it all depends! It all depends on the partner's level of desire. Counting the frequency of "horny attacks" is meaningless and once more we must return to the concept of a desire discrepancy. If one partner would like to be sexual twice a week, but the other would like sex four times a week, there might be just as much tension in that relationship as when one partner is totally disinterested and the other feels amorous every third Saturday morning.
The old jokes typically have a woman saying, "Not tonight dear, I have a headache." In reality, however, it seems that in about 45% of the relationships with a desire discrepancy it is the man claiming the migraine. So, put aside that myth that it is only women who have low sexual desire. Levels of desire vary among both males and females. Some men are chronically disinterested as are some women, and the reasons are not always clear.
TRYING TO UNDERSTAND THE DILEMMA
All too often we confuse sexual desire with emotional love. I have heard many people, men and women say to their partners, "I you loved me as much as I love you, you would want me as much." Love and sexual appetite are not the same. Physical attraction, sexual chemistry, physical lust operates on a totally different program than emotional caring and commitment. It is wonderful if there is both love and mutual sexual passion, but by a desire for hot sex is not the same as loving and loving is not the same as wanting. Those who would argue with this must be fortunate to have both, but loving couple with a desire discrepancy understand what I am talking about.
To fully understand the nature of desire, one has to consider that when everything is working, desire precedes sexual excitement, and desire is the motivation to seek that arousal. Arousal precedes orgasm. It is in being arousal that orgasm becomes a very attractive goal. In a sense, then, the sexual response cycle is wanting to get something started so that it can be ended. In the process of doing so, it is nice giving pleasure to a receptive partner, fostering the intimacy of a relationship, and nurturing the shared love... but biologically, the drive is to get started, get hot, and get finished.
Ironically, any one of the three phases (desire, arousal and orgasm) can occur independently, without all the phases happening. That is, there can be desire and arousal, but no orgasm, a concern experienced mostly by women (addressed in other articles). Some older men still have desire, but are unable to become aroused, yet with stimulation of their soft penises, they will ejaculate (orgasm). There can also be arousal and even orgasm without being driven by desire. In another article on this site I talk of "jump-starting," and I'll not repeat that here, other than stating that there are times when a person with no libido can become turned on and experience a wonderfully pleasurable orgasm, but shortly afterward will honestly state, "That was nice, but I don't ever need to do it again." This can be very frustrating to a person who believes that by providing a fantastic orgasm for a disinterested partner, that partner will be "cured" of their low desire. It doesn't happen that way.
Concerns about desire discrepancies make up the most frequently heard complaints in the offices of sex therapists and on the online question and answer boards. Unfortunately, this is the most difficult situation to reverse. It is practically impossible to talk someone into feeling something, and often the attempts to do so either drive the persons further away or cause them to feel guilty.
IS THERE ANY HOPE FOR INCREASING SEXUAL DESIRE?
If one were to ask, "How many sex therapists does it take to change a light bulb?" the answer would be, "Only one!" However, the light bulb must really want to change. A person who has felt desire but then has lost it, is likely to miss the feelings and want to pursue change. On the other hand, a person with chronically low desire does not, in essence, know what it is he or she is missing and is less likely feel motivated. In fact, they often perceive the problem as being their partners' problem. Any feelings of anger, resentment or guilt within the relationship will further dampen an interest in discovering what it is to crave sexual arousal and orgasm with a partner.
If the relationship is good, and emotional issues will not get in the way, sex therapy can help discover ways to stir arousal. However, this often will seem a bit mechanical as, for I have said, it is difficult to build in a biological hunger. There is hope, however, for the many woman who will benefit from testosterone. If a woman's testosterone levels are found to be low, her physician can prescribe hormonal supplements in the form of a pill. If levels are not low, a testosterone cream might be prescribed. A post-menopausal woman on hormone replacement therapy can be give a pill that combines both her estrogen and testosterone. These are all available only by prescription, and require the women to consult her physician.
Experiments with a female form of Viagra have not been promising. Furthermore, there are no known herbs or over the counter pills, creams or ointments that have proven to be effective. The best approach remains couples therapy with a qualified sex therapist, coordinated with medical intervention by a physician knowledgeable in the treatment of sexual dysfunction.
©2001 Robert W. Birch, Ph.D.
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