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Revitalizing Psychiatry
Inhibited Sexual Desire
Alternate Names: Sexual aversion; Sexual apathy; Hypoactive sexual desire
Causes and Risks
Inhibited Sexual Desire (ISD) is a very common sexual disorder. The most common cause of ISD seems
to be relationship problems wherein one partner does not feel emotionally intimate or close to their mate.
Communication problems, lack of affection that is not associated with continuing into sexual
intercourse, power struggles and conflicts, and a lack of time alone together are common factors. ISD
may also be associated with a very restrictive upbringing concerning sex, negative attitudes toward sex,
or negative or traumatic sexual experiences (such as rape, incest, or sexual abuse).
Physical illnesses and some medications may also contribute to ISD, particularly when they produce
fatigue, pain, or general feelings of malaise. Hormone deficiencies may occasionally be implicated.
Psychological conditions such as depression and excessive stress may inhibit sexual interest.
Commonly overlooked factors include insomnia or inadequate amounts of sleep, resulting in fatigue. ISD
may also be associated with other sexual dysfunctions, and sometimes may be caused by them. For
example, the woman who is unable to have orgasm or has pain with intercourse, or the man who has
erection problems (impotence) or retarded ejaculation, may lose interest in sex because it is commonly
associated with failure or is not very pleasurable.
Individuals who were victims of childhood sexual abuse or rape, and persons whose marriages are
lacking in emotional intimacy are particularly at risk of ISD.
Prevention
One major way of preventing ISD is to reserve time for nonsexual intimacy with one’s partner. Couples,
who reserve weekly talk time and time for a weekly date alone without the kids, will maintain a closer
relationship and are more likely to feel sexual interest. Couples should also detach sex and affection, so
that neither one is afraid to be affectionate on a daily basis, fearing that it will be interpreted as an
invitation to proceed to intercourse.
Reading books or taking courses in couple communication, or reading books about massage may also
encourage feelings of closeness. For some individuals, reading novels or viewing movies with romantic
or sexual content may also serve to encourage sexual desire.
For too many couples, sex gets what is left over late at night. Regularly reserving "prime time," before
exhaustion sets in, for both talking and sexual intimacy will encourage closeness and sexual desire.
Symptoms
Lack of sexual interest.
Signs and Tests
The majority of the time, medical evaluation and lab tests will not reveal a physical cause. However,
testosterone is the hormone responsible for creating sexual desire in both men and women. It may be
useful to check testosterone levels, particularly in men who have ISD. Blood for such lab tests in men
should be drawn before 10:00 a.m., when male hormone levels are at their highest. Interviews with a
specialist in sex therapy are more likely to reveal possible causes.
Treatment
Treatment must be individualized to the factors that may be inhibiting sexual interest. Often, there may
be several such factors. Some couples will need relationship enhancement work or marital therapy prior
to focusing directly on enhancing sexual activity.
Declining sex is sometimes one of the few areas where someone who feels dominated in most other
areas of a marriage may still exert control. Some couples will need to be taught skills in conflict
resolution and be helped to work through differences in nonsexual areas.
Communication training in talking on a feeling level, showing empathic understanding, resolving
differences in a manner that reflects sensitivity and respect for the feelings of both parties, learning how
to express anger constructively, and reserving time for couple activities, affection and talking all tend to
encourage sexual desire.
Many couples will also need direct focus on the sexual relationship wherein through education and
couple assignments they expand the variety and time devoted to sexual activity. Some couples will also
need to focus on how they may sexually approach their partner in more interesting and desirable ways,
and in how to more gently and tactfully decline a sexual invitation.
When problems with sexual arousal or performance are factors in decreasing libido, these sexual
dysfunctions will need to be directly addressed.
Prognosis
Disorders of sexual desire are often among the more difficult sexual problems to treat, and seem to be
especially more challenging to treat in men. Consequently, referral should be sought to a specialist in
sex and marital therapy.
Complications
When both partners have low sexual desire, the issue of sexual interest level will not be problematic in
the relationship. Low sexual desire, however, may be a barometer of the emotional health of the
relationship. In other cases where there is an excellent and loving relationship, low sexual desire may
cause a partner to repeatedly feel hurt and rejected, leading to eventual feelings of resentment and
promoting eventual emotional distance.
Sex is something that, for most couples, either bonds their relationship closer together, or something
that becomes a wedge that gradually drives them apart. When one partner is significantly less
interested in sex than their companion, and this has become a source of conflict and friction, it is
recommended that professional help is needed before the relationship becomes further strained.
Alternate Names: Sexual aversion; Sexual apathy; Hypoactive sexual desire
Causes and Risks
Inhibited Sexual Desire (ISD) is a very common sexual disorder. The most common cause of ISD seems
to be relationship problems wherein one partner does not feel emotionally intimate or close to their mate.
Communication problems, lack of affection that is not associated with continuing into sexual
intercourse, power struggles and conflicts, and a lack of time alone together are common factors. ISD
may also be associated with a very restrictive upbringing concerning sex, negative attitudes toward sex,
or negative or traumatic sexual experiences (such as rape, incest, or sexual abuse).
Physical illnesses and some medications may also contribute to ISD, particularly when they produce
fatigue, pain, or general feelings of malaise. Hormone deficiencies may occasionally be implicated.
Psychological conditions such as depression and excessive stress may inhibit sexual interest.
Commonly overlooked factors include insomnia or inadequate amounts of sleep, resulting in fatigue. ISD
may also be associated with other sexual dysfunctions, and sometimes may be caused by them. For
example, the woman who is unable to have orgasm or has pain with intercourse, or the man who has
erection problems (impotence) or retarded ejaculation, may lose interest in sex because it is commonly
associated with failure or is not very pleasurable.
Individuals who were victims of childhood sexual abuse or rape, and persons whose marriages are
lacking in emotional intimacy are particularly at risk of ISD.
Prevention
One major way of preventing ISD is to reserve time for nonsexual intimacy with one’s partner. Couples,
who reserve weekly talk time and time for a weekly date alone without the kids, will maintain a closer
relationship and are more likely to feel sexual interest. Couples should also detach sex and affection, so
that neither one is afraid to be affectionate on a daily basis, fearing that it will be interpreted as an
invitation to proceed to intercourse.
Reading books or taking courses in couple communication, or reading books about massage may also
encourage feelings of closeness. For some individuals, reading novels or viewing movies with romantic
or sexual content may also serve to encourage sexual desire.
For too many couples, sex gets what is left over late at night. Regularly reserving "prime time," before
exhaustion sets in, for both talking and sexual intimacy will encourage closeness and sexual desire.
Symptoms
Lack of sexual interest.
Signs and Tests
The majority of the time, medical evaluation and lab tests will not reveal a physical cause. However,
testosterone is the hormone responsible for creating sexual desire in both men and women. It may be
useful to check testosterone levels, particularly in men who have ISD. Blood for such lab tests in men
should be drawn before 10:00 a.m., when male hormone levels are at their highest. Interviews with a
specialist in sex therapy are more likely to reveal possible causes.
Treatment
Treatment must be individualized to the factors that may be inhibiting sexual interest. Often, there may
be several such factors. Some couples will need relationship enhancement work or marital therapy prior
to focusing directly on enhancing sexual activity.
Declining sex is sometimes one of the few areas where someone who feels dominated in most other
areas of a marriage may still exert control. Some couples will need to be taught skills in conflict
resolution and be helped to work through differences in nonsexual areas.
Communication training in talking on a feeling level, showing empathic understanding, resolving
differences in a manner that reflects sensitivity and respect for the feelings of both parties, learning how
to express anger constructively, and reserving time for couple activities, affection and talking all tend to
encourage sexual desire.
Many couples will also need direct focus on the sexual relationship wherein through education and
couple assignments they expand the variety and time devoted to sexual activity. Some couples will also
need to focus on how they may sexually approach their partner in more interesting and desirable ways,
and in how to more gently and tactfully decline a sexual invitation.
When problems with sexual arousal or performance are factors in decreasing libido, these sexual
dysfunctions will need to be directly addressed.
Prognosis
Disorders of sexual desire are often among the more difficult sexual problems to treat, and seem to be
especially more challenging to treat in men. Consequently, referral should be sought to a specialist in
sex and marital therapy.
Complications
When both partners have low sexual desire, the issue of sexual interest level will not be problematic in
the relationship. Low sexual desire, however, may be a barometer of the emotional health of the
relationship. In other cases where there is an excellent and loving relationship, low sexual desire may
cause a partner to repeatedly feel hurt and rejected, leading to eventual feelings of resentment and
promoting eventual emotional distance.
Sex is something that, for most couples, either bonds their relationship closer together, or something
that becomes a wedge that gradually drives them apart. When one partner is significantly less
interested in sex than their companion, and this has become a source of conflict and friction, it is
recommended that professional help is needed before the relationship becomes further strained.
Desire Disorder