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Lack of sexual desire: The causes, the myths, and what to do about it

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The magazine illustrations are of words like desire and arousal. Half of each word is alive with color, swirls and style. The other half of each word fades to black.

Which is exactly how so many women today seem to feel about their sexual lives.

“It’s fine for me not to have sex at all,” said one woman in her 40s to psychologist Lori Brotto at the British Columbia Center for Sexual Medicine in Vancouver. Bratto is well-acquainted with the sentiment, and it also doesn’t surprise her to find out that the woman used to love having sex and, in fact, misses it. “What exactly is turning me off?” she asks Brotto.

At EmpowHer, we get a lot of questions about sexual desire, or the lack of it. Women feel that they somehow are lacking because they suddenly don’t feel a craving for sex. Or they feel that they and their partner are at a crossroads because one person wants sex more than the other. And it doesn’t help that every other commercial on television is for products that enhance a man’s sexual experience, but not a woman’s.

Sunday’s New York Times Magazine printed an article on Brotto, who is studying lack of sexual desire in women and defining the criteria for hypoactive sexual desire disorder that will be used in the next Diagnostic and Statistical Manual of Mental Disorders, commonly called the D.S.M. The 900-page manual is used by medical professionals throughout the United States and Canada.

From the story:

“Judging by what figures exist, Brotto says, between 7 and 15 percent of all young and middle-aged women — an age range that researchers generally set between the neighborhoods of 20 and 60 — feel distressed over the absence of desire. Next to nothing is known, she adds, about a host of basic questions, like whether most women with the condition have been affected from the start of their sexual lives or became afflicted during the course of adulthood. She estimates that the hundreds of cases she has seen are divided about equally between the two categories but laments that there are no studies to supply a solid answer. Little is established, either, about why women may be somewhat more likely to become devoid of desire as they get deeper into middle age — and even this tendency itself is far from proven and is contradicted by some data. In any event, Brotto points out, while menopausal women generally lubricate less, their genitals still respond to with rushings of blood when they sit in front of erotic videos.”

Brotto is exploring numerous possible connections to the loss of desire in women. Remember, her job is to define the disorder, so her emphasis is on links and behaviors, not hormones or environment.
A Psychology Today article last year dealt with some of the biggest myths about low sexual desire. Take a look at the list:

Myth No. 1: A woman’s hormones are the main driver of her desires.

Myth No. 2: Emotional intimacy guarantees a good sex life.

Myth No. 3: If your partner wants sex but you don’t, you can express your love in other ways.

Myth No. 4: Couples should deal with emotional problems before sexual problems.

If you find yourself nodding your head in agreement with any of those statements, stop and look again, because those are the myths. Let’s take their answer to Myth No. 1:

“Many people assume that if a woman rarely wants sex, it means there's something wrong with her libido — and that she needs medical treatment. "The biggest misconception is that low sexual desire is all hormonal," says Juan J. Remos, a doctor with the Miami Institute for Age Management and Intervention. "But libido is a lot more complex than that, and overlaps with every sphere of human experience, including vascular health, mental health, nutrition, body image, stress level, and the quality of your relationship generally." Taking medications like testosterone patches to boost your desire isn't going to work unless the problem is physiological — and low sexual desire in women is rarely the result of physiological causes. In most cases, the problem stems from how she feels about herself, her partner, and her relationship. So when a woman has low sexual desire, the first thing to do is to assess the relationship itself, and how it can be improved.”

The Merck Manual entry on Low Sexual Desire Disorder says this about the causes:

“Depression, anxiety, stress, or problems in a relationship commonly reduce sexual desire. Having a poor sexual self-image also contributes.

“Use of certain drugs, including antidepressants (particularly selective serotonin reuptake inhibitors), chemotherapy drugs, beta-blockers, and oral contraceptives, can reduce sexual desire, as can drinking excessive amounts of alcohol.

“Because levels of sex hormones such as estrogen and testosterone decrease with aging, sexual desire might be expected to similarly decrease with aging. However, overall, low sexual desire disorder is as common among young healthy women as it is among older women.”

Dr. Christiane Northrup, author of “The Wisdom of Menopause” and several other books about women’s health, emphasizes the point that low sexual desire can be a complicated thing.

“Determining the cause of sexual problems can be difficult. Sometimes, menopause-related hormone deficiency is to blame. But sexual function is a complex, integrated phenomenon that reflects the physical health of not only the ovaries and hormone balance, but also the cardiovascular system, the brain, the spinal cord and the peripheral nerves. In addition, there are almost always underlying psychological, sociocultural, interpersonal and biological influences that affect individual sexual function.

“If you think of sexual energy in the largest possible context — as life force, or Source energy — then it is easy to see that the health and vitality of our sexuality is inexorably linked to the health and vitality of our lives.”

So what can be done?

First, make sure there’s no physical cause. See your doctor, talk frankly about the problems, and ask if there could be a hormonal issue at work.

Second, take care of you. Your own health is key. Eat well, exercise, and give yourself time to thrive. No one can feel their best sexually if they feel bad physically.

And do your homework! Yes, that’s what I said. Gail Elizabeth Wyatt, Ph.D. and Lewis Wyatt, M.D, offer “10 Secrets to a Sex Life That Works For Both of You,” including six (fun, we hope!) homework assignments on About.com. The link is below.

Maybe that typography in the New York Times Magazine doesn't have to fade to black after all.

The New York Times Magazine story:

The Psychology Today story:

The Merck Manual entry:

From Dr. Christiane Northrup:

From about.com:

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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