Low Sexual Desire

Low sexual desire is a condition that can impact both men (lifetime prevalence: 15-16%) and women (lifetime prevalence: 34-40%)

Symptoms for Female Sexual Interest/Arousal Disorder include the following:

  • Absent or reduced interest in sexual activity
  • Absent or reduced sexual thoughts and/or fantasies
  • Reduced or no initiation of sexual activity
  • Absent or reduced sexual excitement or pleasure during most sexual activity
  • Absent or reduced sexual interest or arousal in response to internal or external cues, such as a partner's attempts to initiate sexual activity or exposure to erotic images
  • Absent or reduced genital sensation during sexual activity

To meet criteria for Female Sexual Interest/Arousal Disorder, the symptoms must be present for at least six months and cause significant distress to the individual. 

Symptoms for Male Hypoactive Sexual Desire Disorder include the following:

  • Reduced or absent sexual thoughts or fantasies
  • Reduced or absent desire for sexual activity

Similar to Female Sexual Interest/Arousal Disorder, the symptoms must also be present for at least six months and cause significant distress to the individual.  

Causes of Low Sexual Desire: 

  • Medication side effects (e.g., SSRI's, oral contraceptives, benzodiazepines, opioids).
  • Negative attitudes about sexuality
  • Low self-esteem/poor body image
  • Relationship difficulties (e.g., poor communication, mistrust, relationship violence/abuse)
  • Partner's sexual functioning 
  • Medical conditions (e.g., diabetes mellitus, high blood pressure, endocrine disorders)
  • Erectile dysfunction
  • History of emotional or physical abuse
  • Other psychiatric diagnosis (e.g., depression, anxiety, PTSD)
  • Life stressors (e.g., parenting, job loss, bereavement) 
  • Alcohol use

Treatments:

Psychotherapy: Psychotherapy (aka: "talk therapy") can be helpful for individuals with low sexual desire.  A thorough assessment will be conducted to rule out physical/medical factors and narrow down psychological contributors.  Once defined, individuals will be provided with a number of tools to address these contributing factors and strategies to increase desire. 

Cognitive Behavioral Therapy: CBT is a type of psychotherapy that teaches individuals different ways of thinking, behaving, and reacting to maladaptive thoughts (e.g., "Things are never going to get better," "My partner thinks that I am inadequate").  Cognitive restructuring helps the individual learn how to identify, challenge, and neutralize unhelpful/maladaptive thoughts related to low sexual desire.

Mindfulness: Research has shown that mindfulness can help individuals with sexual dysfunction increase their sexual desire by helping them to become more attuned to their body’s sexual response and learning to accept their body’s physical limitations.  Mindfulness can also decrease stress and alleviate depression, allowing individuals to feel better and enjoy sex more. 

Medications: The jury is still out on the efficacy of medications specifically aimed at treating low sexual desire.  Medications can be helpful in treating some of the contributing causes of low desire, including depression and anxiety, while other medications only add to the problem.