We asked registered sex therapist Emma Waring about what causes a low sex drive in women; what affects her desire and how to deal with the causes of low sexual desire, so that couples can face any issues together.
What is considered a low sex drive and how is it diagnosed?
I prefer to talk about it as low sexual desire or interest in sex, which is probably the most complex condition sex therapists work with. When I meet a woman with low desire I consider a number of different ‘jigsaw pieces’ – biological, relationship, social, and sexual enjoyment factors, things that feed into how we feel about sex and how we function sexually.
Female sexual interest/arousal disorder (FSIAD) is the medical term for low desire and sexual interest in women. For a diagnosis to be made, a specialist would be looking for absent or reduced:
- - interest in sexual activity,
- - erotic thoughts or fantasies,
- - initiation of sexual activity and typically being non-responsive to the partner’s attempts to initiate sexual activity,
- - and absent or reduced sexual excitement or pleasure during sexual activity.
What are some biological factors, which can affect a woman’s sexual desire?
Biological factors, which reduce sexual desire, are one of the main ‘jigsaw pieces’ to consider. These include: hormone deficiency, menopausal changes and infertility. Medical conditions including diabetes and thyroid problems can reduce sexual desire. Sexually transmitted infections, such as herpes and warts can also impact physical functioning and significantly reduce sexual desire.
Some medication, for example antidepressants, and cancer treatments, such as chemotherapy can reduce a woman’s interest in sex.
It is not uncommon for a patient to be referred to me with “low desire” and the problem is actually sexual dysfunction – that the woman’s partner has a sexual problem such as erectile dysfunction or they are experiencing dyspareunia (sexual pain).
How do social factors, sexual enjoyment and the relationship affect desire?
There may be social issues affecting desire, these are issues that are not directly related to sex, but may indirectly affect the relationship such as a couple’s ability to have quality, undisturbed and intimate time together. Examples include: living with parents or in-laws, having small children, working unsocial hours, etc.
For a women to want to engage in sex, she needs to enjoy it or at least believe there is hope she might enjoy it. It makes complete sense that if sex is not enjoyable, disappointing or boring she is not going to feel aroused, and she will not be sending messages to her brain that this is a good activity, which she regularly wants to repeat.
It is also important to consider how the relationship functions as a whole, especially as we know that women are more likely to want to have sex if they feel positive about their relationship. Lack of deeper and satisfying communication, unresolved disagreements and low levels of trust are just some of the things that can reduce her desire for sex.
What can you do to increase desire?
If you are struggling with low desire a really helpful exercise is to arrange to have a night or weekend away with your partner. If you find that your desire improves and you enjoy sexual intimacy together then this suggests that the low desire is likely to be linked with social factors, tiredness, busyness, rather than physical, relational or sexual enjoyment factors.
It’s also worth asking yourself how you feel about the relationship at the moment and taking positive steps to improve any areas where you feel you’re less than happy. Toucan Together is an app to grow and strengthen your relationship. The app enables you to take the ‘Pulse’ of your relationship through their research based quiz, which gives you a map of your relationship in seven key areas plus personalised recommendations. Toucan Together empowers you to explore lots of areas of your relationship: communication, resolving disagreements, growing friendship and intimacy and much more.
Esther Perel has written a great book ‘Mating in Captivity’ which considers the challenges of keeping desire alive in committed relationships, something that all couples have to work at. We know that domesticity kills passion and so couples need to look at ways to nurture this part of the relationship.
How to deal with biological factors…
If you decide to seek help for low desire, then your first port of call should be your GP, to rule out any obvious things like recurrent thrush or urinay symptoms which could make sex painful, and to consider hormonal factors. If you are approaching menopause and you have reduced levels of the hormones oestrogen and testosterone, and you may benefit from hormone replacement therapy (HRT).
If your GP rules out any physical factors they may suggest seeing a sex therapist and this can be helpful in exploring the relational, social and sexual enjoyment factors. It may be that you have never had much interest or enjoyed sex and this would be considered ‘primary’ desire disorder. A therapist would be interested in the type of up-bringing you had, how was sex talked about in your family, and your early sexual experiences both positive and negative. If you have enjoyed sex historically but this has changed then this would be considered ‘secondary’ desire disorder and a therapist would then be interested in when your desire had changed and possible triggers for this. The arrival of a baby, trying to come to terms with an affair, illness or depression are some possible triggers.
Putting things in perspective…
It’s good to remind ourselves that a relationship isn’t just about good sex. Intimacy in a relationship has many dimensions, including: the way a couple communicates, feelings are shared and levels of trust; also, how arguments are worked through and friendship is built; as well as romance and sexual intimacy. It’s normal to experience good times and times that feel more of a struggle. Dealing with problems together, sexual or anything else, and working on all aspects of intimacy will build a great relationship and better sex.
Toucan Together can help you improve many aspects of your relationship: discover deeper ways to communicate; find positive approaches for resolving arguments; learn to speak each other’s Love Languages®️; build friendship, intimacy and a great sex-life. Get started by taking the‘Pulse’ of your relationship with our short research-based quiz and see the health of your relationship across seven key indicators. GET STARTED NOW