Miniguide

Sexual Desire

There's a lot of confusion out there about how much sex we're "supposed" to be having. Images in the movies, on television and sex advice in magazines seem to send the message: the more sexual desire, the better. And while we're all for a healthy, robust sex life, sexual desire is a complicated part of each person's sexuality. Sexual desire is part of what makes us who we are sexually, whether single or in a relationship. Not all those with a high sex drive express it with sexual behavior with a partner, because our values, morals, life experiences and available partners all affect how sexual desire plays out. Similarly, not all who are sexually active are always expressing something healthy or authentic.

Not surprising, sexual desire is often a couples issue: One partner wants more sex and the other wants less sex, and who's pursuing who may change at any given point in time. Sex may be more important in a relationship at certain times, and other times it fades into the background, because of other priorities or responsibilities, or because a couple feels disconnected. Sexual desire ebbs and flows naturally over the course of a relationship—and the course of a person's life. Declining desire can be a function of age or health problems. But more often, it is the result of relationship problems, fatigue or stress. Low sexual desire is a common issue that many women and men face, whether or not they are in a relationship. Studies have found that 20 to 30 percent of women and 10 to 20 percent of men may report low sexual desire.

Whatever the case, sexual desire is an important issue, for singles and couples, for young and old—and finding satisfaction is up to the individual.

Table of Contents

When one partner wants sex more than the other.

When one person in a relationship wants sex more than the other, both may struggle with feelings of inadequacy and frustration. It is a common couples issue, but over time, frustration can build and one or both may resent or blame the other. Usually, the partner who wants less sex feels at fault for their sexual problems, yet, at the same time, resents the sexual advances of their partner. It may get to a point where any gesture of affection is rejected for fear it will lead to sex. Then the partner who wants more sex can become increasingly frustrated, more starved for intimacy and feel rejected.

One solution is to embrace your desire differences and find a frequency that works for both of you. For the partner who wants more sex, consider what you really want. Is it to have more orgasms more often? If so, then masturbate some of the time. If it's physical intimacy with your partner you want, perhaps you can share a bath or a massage with your partner—without the expectation of sex. Make sure to kiss and hug each other just for the sake of kissing and hugging, without trying to have sex. Once you stop making every gesture of affection a proposition for sex, you may find that your partner starts initiating more often.

For the partner who wants less sex, be clear about what you're saying “no” to, because your partner is apt to feel unattractive or rejected. Explain that you don't want to have sex because you're tired, or having a rough week, or upset today, or that you just don't have the same level of desire as your partner (which is completely okay; two people rarely have exactly the same level of desire). Help your partner understand, then try to say “yes” some of the times you want to say “no” to meet in the middle ... and you just may find that as you kiss, hug and take things further, you begin to get in the mood.

Sexual desire after childbirth.

Giving birth to a child is called labor for a reason—it is a physically and emotionally taxing experience that requires a period of recovery afterwards, which often goes far beyond the 4- to 6-week time frame that doctors typically suggest. Between fluctuating hormones and the physical and emotional exhaustion of caring for a new life, sex is often the last thing on a new mother's mind. In fact, many new fathers temporarily lose their desire for sex, too.

While the genitals or an incision from a C-section may heal within a couple of months, it often takes up to six months for a couple to find that their sex life has returned to something near their "pre-baby" days. Low estrogen levels after childbirth and during breastfeeding can cause vaginal dryness and pain during intercourse. Both make sex uncomfortable and affect desire, which may be compounded by low levels of testosterone after giving birth. Store-bought lubricant can help to make sex feel more comfortable as can spending more time in foreplay before penetration.

A couple's whole life together changes when the baby arrives. New stresses emerge, and the focus is on making sure a new life survives. For the new mother: It's okay to listen to what your body is telling you during this time, which is often not to have sex. Give yourself six months and remember, your hormones are going to be in flux for as long as you're breastfeeding, which can prolong the experience of low sexual desire and vaginal dryness—something for the new mom's partner to keep in mind, too.

Declining sexual desire in long-term relationships.

The beginning of a relationship is marked by a heady mix of hormones and chemicals in the brain. New attraction triggers the release of dopamine, norepinephrine, PEA and sex hormones, which throw lust and infatuation into high gear. The result is often plenty of sex that seems to happen effortlessly.

As time goes on, however, differences in sexual desire often emerge and a couple's frequency of sex declines, which can make some couples panic that the relationship isn't right or leave other couples reminiscing about the good old days.

The fact is, sexual desire becomes less urgent in a long-term relationship and sex happens less frequently. It's a natural part of the relationship cycle. Sexual desire also changes with age, as a result of declining hormone levels and other health conditions. The focus shifts from the quantity of sex to the quality of sex, as a couple becomes more comfortable with each other, with their bodies and what else the relationship has to offer them. The good news is that although sexual frequency tends to decline over time in long-term relationships, sexual satisfaction tends to be very strong among committed couples, thanks to the effects of greater trust, growing comfort with each other, and plenty of practice to find out what works well with each other's bodies.

Male low sexual desire.

Low sexual desire in men can be a thorny issue. Some of our oldest jokes focus on men wanting sex all of the time and women fighting them off. As a result, men often feel more shame about low libido than women do, and men and their partners may have a particularly difficult time talking about it. About 10 to 20 percent of men report experiencing low desire, compared to 20 to 30 percent of women.

Like women, men may experience low desire for a variety of reasons, including changing hormone levels, certain medications and health conditions, as well as the normal process of aging. Men may also find that their sexual desire declines when their relationship is unsatisfying or other parts of their life are in conflict or stress. Both partners are often spread thin across personal and professional obligations, and men feel a cultural expectation to always want sex. In reality, men face the same fears and anxieties that can affect a woman's sex drive. They may feel out of shape, unattractive, too stressed or disconnected from their partners.

If low libido is a problem, carve out time together by simplifying your life and focusing on reconnecting as a couple. And keep in mind that in some cases, a man's diminished sex drive may have nothing to do with his partner or his relationship. Low testosterone is a common physical culprit and, when a blood test reveals low testosterone levels, testosterone-replacement can provide many of the physical and psychological benefits of natural testosterone.

Menopause and sexual desire.

Women experience a distinct hormonal shift when they go through menopause, and it can affect their desire for sex on many levels. At menopause, the ovaries stop functioning and, as a result, levels of estrogen, testosterone and progesterone decline. Low estrogen levels may cause vaginal dryness and pain during intercourse. Low testosterone levels may be associated with changes in sexual desire. And although genital sensation seems to decline with aging and menopause, it is unclear to what extent the change in sensation may be related to sexual function or orgasm ability.

Emotional changes around the time of menopause can affect sexual desire, too. Some women experience an increase in sexual desire or interest after they have reached menopause because they no longer worry about contraception and pregnancy. Other women may feel that they are no longer viewed by others as sexual, since our society tends to place different values on young women's sexuality. Menopausal women also may experience insomnia, irritability, depression and hot flashes from declining hormone levels, all of which may affect a woman's interest in sex.

Working with these changes is the key to staying sexually active. Hormone replacement therapy (HRT) and other treatments can help with vaginal dryness and pain, as well as other common menopausal symptoms. It's also helpful to explore different types of stimulation during sex, whether it be vibrators, different intercourse positions or oral sex, and to spend more time in foreplay. Don't assume that what's worked in the past is going to work now, and do focus on how you can adapt to your body's changes and continue to have a fulfilling sex life.

Stress and sexual desire.

Stress is perhaps the number one culprit in low sexual desire. We're all running around with more things to do than there are hours in the day, leaving ourselves feeling exhausted and often frustrated. Stress can greatly affect men's and women's desire for sex. Too much stress often saps away a person's libido, by affecting hormones and mood, and by interfering with the quality time that helps a couple stay connected.

The good news is that too much stress is fixable! The key to boosting libido is to have a more balanced life—in all ways. It's not just the big stresses, such as financial worries or losing a loved one, that contribute to low desire or less enjoyable sex. It's also the small, daily stresses. Running late, trying to fit too much into a day, not eating right and constantly bickering with your partner all can affect your sexual energy.

Simple changes can make a big difference: Get enough sleep, eat right, exercise and manage your time smartly. When life gets crazy, do what you need to give yourself a break. Take care of the important stuff—whether it's cooking dinner for the kids, cuddling with your partner, or paying the bills on time—and let the rest of it go for the time being. If you can restructure your daily life to feel more manageable, your sex life and your relationship will benefit.

Low sexual desire: mental and physical causes.

A healthy sex drive is part physical and part emotional, and everything that's going on in someone's life needs to be considered when dealing with low sexual desire. The physical causes of low desire may include low testosterone due to aging, menopause or andropause, or recent childbirth; certain medications, such as many antidepressants, antihypertensives or hormonal contraception (such as certain birth control pills); and other chronic diseases. While a general practitioner may be able to run tests to determine a diagnosis, it can be helpful to see a specialist--males can see a urologist and females can see an OG/GYN. If hormones are a possible culprit, men and women can see a endocrinologist.

While the health-related causes of low desire tend to be emphasized, however, relationship quality and daily stress are often more important—and sorely neglected when looking for a solution. Low sexual desire is a common result of depression, relationship conflict and anger, past trauma or abuse, or too much stress in a person's day-to-day life. Low sexual desire also may occur because of other sexual function complaints, such as trouble with arousal or orgasm, painful intercourse or erectile dysfunction, since sex becomes a source of stress, not pleasure.

Ultimately, while there is a place for testosterone and other medical interventions in the treatment of low desire, usually the health of a person's relationship and other quality-of-life issues hold the real solution. Sex therapy, couples therapy or individual therapy may be of great help for anyone experiencing low sexual desire.

What type of expert to see for help.

It can take a lot of courage to seek help for sexual concerns. Some men and women may get help on their own, and others may go with their partner for support and to work through the issue together.

If the cause may be psychological in nature, it's helpful to see a sex counselor or sex therapist. In general, sex counselors and sex therapists tends to get specific training about sexual issues that sabotage sexual satisfaction, especially when anxiety, insecurity or other factors are involved. It is important to find a counselor or therapist who is certified by the American Association of Sexuality Educators, Counselors and Therapists (AASECT). As, experts with this certification have had training related to both relationship issues and sexual concerns.

Following is a quick reference guide for the various academic degrees and licenses a mental health professional might obtain:

  • Psychologist: Usually has a PhD, PsyD or EdD in psychology or other mental health specialty.
  • Social Worker: An MSW pr PhD in social work.
  • Counselor/Therapist: An MA or MS in clinical psychology, counseling, mental health, or sexology.
  • Psychiatrist: An MD in psychiatry, generally licensed to prescribe medication. Some, not all, psychiatrists are trained to provide therapy, in addition to prescribing medication. Many people see a psychiatrist in conjunction with a therapist.