There are many things that can factor into having a low sexual desire, which is one of the most common conditions I see as a sexuality counselor. That’s because Female Hypoactive Sexual Desire Disorder (FHSDD), defined as diminished or absent sexual desire, is the most common female sexual dysfunction. It represents between 20-40% of women’s sexual problems.
FHSDD differs greatly among women of different ages, reproductive status, culture, religion, ethnicity, and general health status. It can have a significant negative effect on relationships as well as self-esteem.
Women most likely to present with symptoms of FHSDD are those who have:
- Heart disease
- Neurological disorders
- Advanced age
- Painful sex
- Depression or anxiety (or who take certain antidepressants)
- Relationship problems
- Guilt or shame regarding sex associated with religious or cultural beliefs
- Been victims of sexual or emotional abuse
- Low self-esteem or poor body image
There is no clear evidence that hormone levels have any relationship to sexual desire other than at menopause or during pregnancy or while nursing. Yet women with none of these problems can also experience FHSDD.
Daily life stressors such as job, family, finances, fatigue, distraction, and lack of privacy can affect sexual desire. Relationship problems such as desire discrepancy between partners, with regards to frequency or type of sexual activity; having an unskilled, inattentive, or demanding partner; resentment over non-sexual issues within the relationship; poor communication; fear of STDs; and anxiety over failure to perform adequately for one’s partner can all negatively affect sexual desire. It is clearly a problem that can exist on many levels at once, where sexual problems can cause relationship problems which can worsen the sexual problems, or where depression can cause decreased desire which then worsens the depression.
Treating all of these levels requires a thorough physical, mental, social, and relationship evaluation, which can identify or rule out specific causes of FHSDD prior to initiating treatment. The most important thing is to bring up your sexual concerns with your medical provider, so that referral to a trained professional can be initiated. Be assured that this is a common problem, and that there are specific treatments available for all of the problems listed above.
The good news is that there are treatment options for women with HSDD. Next month, we’ll discuss in detail the various treatments. Until then, feel free to post your questions or thoughts in the comments below.
Luigi D’Amato, MD, is a sexuality counselor who completed extensive training in sexuality counseling at the University of Michigan. A former obstetrician/gynecologist, he has more than 35 years of experience practicing medicine. Dr. D’Amato is available for sexuality counseling at the ProMedica Health and Wellness Center at 5700 Monroe St., Sylvania.