“I don’t want to have sex anymore”
Low sexual desire in women is the most common presenting complaint in our practice. Research indicates that between 10-28% of women experience low sexual desire for a period of 6 months or longer, and experience the following symptoms:
Lack of interest in sex
Reduced or absent erotic thoughts
Lack of initiating or responding to sexual activity
Reduced pleasure during sex
Reduced or absent desire during sex
Reduction in genital and non-genital sensations
“My wife doesn’t want to have sex with me”
The most recent models used to understand and describe women’s sexual desire describe it as resulting from a combination of a sexual response system and effective stimulation to activate the system. This is known as the incentive motivation model of sexual response.
Within this model, both biological and psychological factors interact with sexual stimulation to influence how responsive a woman is. It also accounts for sexual desire occurring after sexual arousal — referred to as responsive sexual desire. A woman doesn’t have to feel desire before she is physically aroused. This is an important educational distinction for women to understand that they don’t have to feel desire prior to initiating or accepting sexual interactions. Sexual desire can occur after sexual arousal.
“I wouldn’t care if I never had sex again”
Many women with low sexual desire and their partners wonder if the cause is “hormones”. While hormones can play a role in sexual responsiveness, that is usually not the cause for women seeking treatment for low sexual desire. For example, studies show that although testosterone has been given to women to treat low sexual desire, there is a minimal correlation between testosterone levels and sexual desire.
Other medical factors should be considered and referral to the appropriate medical professional is needed in more complex cases. There are some non-medical causes of low sexual desire in women as well. They are:
Relationship Problems. Low sexual desire can be caused by a lack of emotional intimacy, trust, and respect towards one’s partner. A woman’s feeling towards her partner is a major contributing factor in sexual desire.
Lack of Differentiation in Long-Term Relationships. A married woman’s desire can decrease with overfamiliarity, routine, and enmeshment.
Partner Factors. A woman’s sexual desire can dampen if there is pressure for sex with inadequate stimulation, poor sexual technique, incompatible sexual needs, and lack of sexual attraction or partner sexual dysfunction.
Clinical Depression. Experiencing depression can decrease sexual interest — a ‘loss of interest or pleasure’ is a symptom of Major Depressive Disorder. In addition, women who take SSRI anti-depressant medication frequently experience sexual side effects such as low sexual desire and inability to orgasm.
Sex-Negative Cultural Messages. Women many times receive negative messages about being sexual, for example: “good girls don’t”. In addition, women receive a negative message about masturbation.
Inadequate Sexual Education. In our culture, most people learn about sex through a biological, “the birds and the bees”, medical, or pornographic lens. These narrow viewpoints don’t provide information on sexual pleasure, eroticism, sensuality, connection, sexual self-expression and many other sex-positive aspects of sexuality. Many women lack basic sex-positive education about their female anatomy and sexual response. The lack of education can create a disconnect in a woman’s experience of her sexuality.
Family and Word Demands. Women tend to report lower sexual desire when they are under the demands of a challenging family and work-life balance. Women who are able to take time for themselves and to connect to themselves and their bodies will feel more sexual desire.
Sex-Negative Religious Education. Research has shown that the more fundamental a religion, the more sexual dysfunctions occur. Many women internalize religious constrictions or shame around sexuality, which leads to low sexual desire.
We will talk through the options for treating low sexual desire in women in our next post. But if you would like to learn more in the meantime, feel free to read our other blog posts.