This article on low desire (clinical term, hypoactive desire disorder) was written by Cate Lawrence. I agree with much of what she says here, though, I don't think women's sexual position is all that "comfortable". Certainly not in the States, where women's reproductive rights are in dire jeopardy and sex education is nonexistent. Plus, I would argue that heterosexual sex continues to be rigidly defined by a limited set of activities that benefit men more than women. A recent study, conducted by Indiana University gave a glimmer of hope that our sexual definitions have expanded somewhat. So, I am hopeful.
In this article, Lawrence mentions the Intrinsa patch. This transdermal testosterone system is available in Europe but was not approved by the FDA, due to safety concerns regarding breast cancer and cardiovascular risk. The only FDA approved treatment for any form of female sexual dysfunction is the Eros Therapy Device CTD. And this high priced (over 300 bucks) clit pump is available by prescription only. I would say save your money and buy a Hitachi. For those of you looking to find someone who specializes in sexual dysfunction in your area, I suggest AASECT, which gives a state by state listing of therapists who work with sexual disorders.
Beyond Low Desire
by Cate Lawrence
Women are in the most comfortable sexual position in history. Notions of sexual activity have shifted further away from reproduction than any time in history. Women are choosing to have sex on their own terms, whether as part of a relationship, ‘friends with benefits’ or more casually. Sexual pleasure is part of everyday parlance, and models of the sexually satisfied female are everywhere, from burlesque to perfume advertisements.
by Cate Lawrence
Women are in the most comfortable sexual position in history. Notions of sexual activity have shifted further away from reproduction than any time in history. Women are choosing to have sex on their own terms, whether as part of a relationship, ‘friends with benefits’ or more casually. Sexual pleasure is part of everyday parlance, and models of the sexually satisfied female are everywhere, from burlesque to perfume advertisements.
But what if you just don’t feel like having sex, or struggle to enjoy it fully? How do you know if it’s a problem, and if it is, how is it treated?
What low sex drive problems do women have?
Low sex drive is not necessarily a problem. For every woman who wants a higher sex drive, there may be several quite happy not fancying a shag. Only the woman herself can decide whether it is something that she wants to change.
Sexual problems experienced by women commonly involve libido, arousal and orgasmic functioning, and often involve both mental and physiological elements. A woman may be experiencing decreased interest in sex, not feeling ‘turned on’, difficulty achieving orgasms, or something more complex.
‘I didn’t think about sex at all. It was like not being interested it sport — it passed me by completely,’ said Josephine, one woman I spoke to about her sex difficulties. Another, Katy, experienced difficulty orgasming. ‘I would consciously try to get myself aroused. Porn would sometimes get me a bit aroused, and maybe one in ten times I’d have a weak and unsatisfying orgasm. After years of trying, I just gave up.’
Anne had a long history of sexual difficulties. ‘I have a low sex-drive and suffered from vaginismus. Sex during my two-and-a-half-year marriage was bloody awful, to be honest.’ Vaginismus is a condition where a woman is unable to engage in any form of vaginal penetration because of involuntary tightening of the muscles around the vaginal opening.
Naming the demon
Classifying sexual difficulties within a psychiatric framework is problematic and raises as many questions as it answers. The first difficulty is that there is currently no definition of normal sexual functioning for women. Does having an orgasm define ‘functional’ sex for women, as an erection and ejaculation does in men? Some women contend they experience normal, if less pleasurable, sex without orgasm.
Placing sexual difficulties within a psychiatric school of thought is to neglect the role of social and relationship factors, suggesting instead that the difficulties spring from faulty thinking or brain functioning. Then, seeing sexual difficulties through a medical model suggests that treatment will involve medical intervention. Researchers critical of the idea of female sexual dysfunction have pointed to the eagerness of pharmaceutical companies to develop medical treatments for women’s sexual problems because treating men’s sexual problems has been lucrative.
What causes sexual problems?
Dr Lynne Glover, specialist in psychosexual medicine, lists some common causes of sexual problems.
*memories of past events which are perceived in a negative light
*opinions of others, most usually parents and partners
*experiences of pregnancy, giving birth or being a parent
*experience of infertility
*loss, eg, death of a loved one, experience of marital loss or job-loss
*illness or anxiety about the possibility of illness
*religious or cultural beliefs
*anxiety about oneself or others.
Sexual compatibility, sexual technique and the strength of a relationship may also be contributing factors. Additionally, problems with sex are not always an indication of poor health or wider issues — loss of libido is a healthy response when faced with stress, tiredness or threatening behavior from a partner.
Libido and eating disorders
Extreme weight loss causes changes in hormone levels which are thought to be responsible for lowering sex drive. ‘As soon as body weight plummets below a critical point, the womb shrinks, menstruation stops and your level of sexual interest, fantasy and enjoyment fall. These are all part of the body’s self defence mechanism to prevent a pregnancy when you are physically unable to cope with the increased demands of reproduction,’ explains Sarah Brewer, of London’s Academy of Sex and Relationships.
Medication and low sex drive
What if you are emotionally well and have had a good sex life until recently? What you swallow may be the answer. Consumer feedback motivated researchers to look into whether the contraceptive pill sometimes has a role in reducing libido in women. Results have been inconclusive. Some research however did find that women using The Pill had markedly decreased levels of sexual desire compared with women who did not use it. It also found that women who had stopped using The Pill continued to suffer effects.
It seems that the chemical produced by The Pill to stop ovulation may continue to suppress testosterone, the hormone responsible for arousal, for up to a year after women stop taking it. Australian researchers are currently trialling a new contraceptive pill which uses a natural form of the female sex hormone Estradiol as a means to counteract decreases in libido attributed to oral contraception. Women who think they may be suffering from hormonal contraception-related decreased libido also have the option of non-hormonal contraception, such as the IUD (coil).
Research has also shown that the antidepressant and anti-anxiety medication Selective Serotonin Reuptake Inhibitors (SSRIs) may lead to sexual dysfunction. Dr Glover comments, ‘It is unusual for the effects of medication to be the sole cause of an individual’s low sex drive. It is important to note that depression itself is often associated with diminished libido.’
Katy struggled with sexual difficulties that she felt were related to antidepressants. She changed to another doctor, who changed her antidepressant. ‘The medication I’m on now seems to help my depression and is okay libido-wise so I’m relieved and enjoying it! I’m also a bit angry that I had to endure it for so long.’
Relationship and sexual difficulties
Maintaining a happy relationship with low libido is something the three women I interviewed all struggled with. Josephine recalls, ‘I’d get into bed at night, my husband would have a hopeful look on his face and I’d just tense up. I couldn’t kiss him or hold him without him getting hard and all I wanted was to go to sleep or read a book. It was incredibly frustrating for us both.’
Anne contended with the affect of her sexual difficulties on her partner. ‘He struggled with feeling unloved and unwanted because I want so little sex. He doesn’t want me to engage if I don’t want to, but he wishes I wanted to more often and feels distanced without sex.’ She found it vital to keep talking to her partner about their sex life. ‘We have worked to the point where I’m able to engage in more play and what I call passive sex — where I don’t even attempt to orgasm — to maintain the sense of connection and intimacy between us.’
The impact on self
All the women I interviewed struggle with the idea of having different sexual experiences to other women, given the prevalence of sexual expression in popular culture. Josephine explained, ‘I felt that everyone else was in the most amazing sexual relationships, having sex on the kitchen table every night. I felt boring and restrained — it was terribly lonely.’ Anne struggled with the sense of a partner’s sexual desires. ‘I have experienced again and again hope or expectation in a new potential sexual contact, and watched it slowly die as they turn their intimacy focus elsewhere. The feeling of failing both myself and other people is the hardest.
What treatments are available?
The only approved drug for female sexual dysfunction currently approved in the UK is Intrinsa. These testosterone patches are available only for women who have experienced menopause due to surgery such as hysterectomy. Research has also examined the use of testosterone spray and found that on average, women who used the spray recorded two more satisfactory sexual experiences a month than before taking the hormone.
Whether this is any great improvement is subjective. It is unsurprising, given the lack of medical answers to low sex drive, that some sufferers turn to natural therapies. Naturopath and family therapist Nicole Tracey explained some of the treatments she uses. ‘It is really important for sufferers to have an adequate intake of B vitamins, minerals and trace elements. I also often recommend herbs that support
the reproductive system and act as aphrodisiacs, such as shatavari and damiana.’ It is worth keeping in mind that natural remedies may not have been tested for safety or efficacy.
What else?
Deciding if there is a problem and what to do about it is ultimately the responsibility of the sufferer, and there is no ‘one size fits all’ solution. These ideas are collated from the experiences of sufferers and the recommendations of medical s from the experiences of sufferers and the recommendations of medical specialists and natural therapists.
1. Talk to your partner
Anne explains, ‘Clearly telling my partner where I’m at is vital. Giving myself permission just to do what I feel like and not feel obliged to achieve either my own or my partner’s orgasm helps relax the anxiety that often, of itself, will interrupt sexual pleasure.’
2. Seek professional help
Ask your doctor to refer you to a sexual and relationship therapy clinic. Look for a therapist who is a member of the Institute of Psychosexual Medicine or the British Association for Sexual and Relationship Therapy. Anne, who undertook extensive treatment for vaginismus, highlighted that talking to a therapist about the emotional sources of her issues had been integral in recovery.
3. Be your own advocate
Think about what’s normal for you and exactly what problems you are having. Research your symptoms and possible causes. If you’re concerned that you cannot speak openly with your doctor, or are not being taken seriously, try another doctor.
4. Embrace the sensual
Touch, good food and engaging music can all help awake the senses. Sensual expression can include writing or reading erotic fiction, or wearing clothing made of fabric that pleases you. Josephine found a sense of sexual self within the BDSM community where dressing up and role play took the focus away from orgasm. Anne commented, ‘Touch helps me feel connected with people and comfortable in my body.’
The three women interviewed are still working through their experiences. Josephine admitted, ‘I still can’t say I’m all that into sex, but I do enjoy the intimacy and the closeness and the kissing. I make sure that we have sex at least once a week, and once we get going I usually enjoy it, even if I don’t orgasm. I consider having sex to be an important part of a relationship.’
Cate Lawrence lives in Melbourne, Australia where she working in education advocacy, and spends her spare time crafting and drinking Earl Grey tea.
What causes sexual problems?
Dr Lynne Glover, specialist in psychosexual medicine, lists some common causes of sexual problems.
*memories of past events which are perceived in a negative light
*opinions of others, most usually parents and partners
*experiences of pregnancy, giving birth or being a parent
*experience of infertility
*loss, eg, death of a loved one, experience of marital loss or job-loss
*illness or anxiety about the possibility of illness
*religious or cultural beliefs
*anxiety about oneself or others.
Sexual compatibility, sexual technique and the strength of a relationship may also be contributing factors. Additionally, problems with sex are not always an indication of poor health or wider issues — loss of libido is a healthy response when faced with stress, tiredness or threatening behavior from a partner.
Libido and eating disorders
Extreme weight loss causes changes in hormone levels which are thought to be responsible for lowering sex drive. ‘As soon as body weight plummets below a critical point, the womb shrinks, menstruation stops and your level of sexual interest, fantasy and enjoyment fall. These are all part of the body’s self defence mechanism to prevent a pregnancy when you are physically unable to cope with the increased demands of reproduction,’ explains Sarah Brewer, of London’s Academy of Sex and Relationships.
Medication and low sex drive
What if you are emotionally well and have had a good sex life until recently? What you swallow may be the answer. Consumer feedback motivated researchers to look into whether the contraceptive pill sometimes has a role in reducing libido in women. Results have been inconclusive. Some research however did find that women using The Pill had markedly decreased levels of sexual desire compared with women who did not use it. It also found that women who had stopped using The Pill continued to suffer effects.
It seems that the chemical produced by The Pill to stop ovulation may continue to suppress testosterone, the hormone responsible for arousal, for up to a year after women stop taking it. Australian researchers are currently trialling a new contraceptive pill which uses a natural form of the female sex hormone Estradiol as a means to counteract decreases in libido attributed to oral contraception. Women who think they may be suffering from hormonal contraception-related decreased libido also have the option of non-hormonal contraception, such as the IUD (coil).
Research has also shown that the antidepressant and anti-anxiety medication Selective Serotonin Reuptake Inhibitors (SSRIs) may lead to sexual dysfunction. Dr Glover comments, ‘It is unusual for the effects of medication to be the sole cause of an individual’s low sex drive. It is important to note that depression itself is often associated with diminished libido.’
Katy struggled with sexual difficulties that she felt were related to antidepressants. She changed to another doctor, who changed her antidepressant. ‘The medication I’m on now seems to help my depression and is okay libido-wise so I’m relieved and enjoying it! I’m also a bit angry that I had to endure it for so long.’
Relationship and sexual difficulties
Maintaining a happy relationship with low libido is something the three women I interviewed all struggled with. Josephine recalls, ‘I’d get into bed at night, my husband would have a hopeful look on his face and I’d just tense up. I couldn’t kiss him or hold him without him getting hard and all I wanted was to go to sleep or read a book. It was incredibly frustrating for us both.’
Anne contended with the affect of her sexual difficulties on her partner. ‘He struggled with feeling unloved and unwanted because I want so little sex. He doesn’t want me to engage if I don’t want to, but he wishes I wanted to more often and feels distanced without sex.’ She found it vital to keep talking to her partner about their sex life. ‘We have worked to the point where I’m able to engage in more play and what I call passive sex — where I don’t even attempt to orgasm — to maintain the sense of connection and intimacy between us.’
The impact on self
All the women I interviewed struggle with the idea of having different sexual experiences to other women, given the prevalence of sexual expression in popular culture. Josephine explained, ‘I felt that everyone else was in the most amazing sexual relationships, having sex on the kitchen table every night. I felt boring and restrained — it was terribly lonely.’ Anne struggled with the sense of a partner’s sexual desires. ‘I have experienced again and again hope or expectation in a new potential sexual contact, and watched it slowly die as they turn their intimacy focus elsewhere. The feeling of failing both myself and other people is the hardest.
What treatments are available?
The only approved drug for female sexual dysfunction currently approved in the UK is Intrinsa. These testosterone patches are available only for women who have experienced menopause due to surgery such as hysterectomy. Research has also examined the use of testosterone spray and found that on average, women who used the spray recorded two more satisfactory sexual experiences a month than before taking the hormone.
Whether this is any great improvement is subjective. It is unsurprising, given the lack of medical answers to low sex drive, that some sufferers turn to natural therapies. Naturopath and family therapist Nicole Tracey explained some of the treatments she uses. ‘It is really important for sufferers to have an adequate intake of B vitamins, minerals and trace elements. I also often recommend herbs that support
the reproductive system and act as aphrodisiacs, such as shatavari and damiana.’ It is worth keeping in mind that natural remedies may not have been tested for safety or efficacy.
What else?
Deciding if there is a problem and what to do about it is ultimately the responsibility of the sufferer, and there is no ‘one size fits all’ solution. These ideas are collated from the experiences of sufferers and the recommendations of medical s from the experiences of sufferers and the recommendations of medical specialists and natural therapists.
1. Talk to your partner
Anne explains, ‘Clearly telling my partner where I’m at is vital. Giving myself permission just to do what I feel like and not feel obliged to achieve either my own or my partner’s orgasm helps relax the anxiety that often, of itself, will interrupt sexual pleasure.’
2. Seek professional help
Ask your doctor to refer you to a sexual and relationship therapy clinic. Look for a therapist who is a member of the Institute of Psychosexual Medicine or the British Association for Sexual and Relationship Therapy. Anne, who undertook extensive treatment for vaginismus, highlighted that talking to a therapist about the emotional sources of her issues had been integral in recovery.
3. Be your own advocate
Think about what’s normal for you and exactly what problems you are having. Research your symptoms and possible causes. If you’re concerned that you cannot speak openly with your doctor, or are not being taken seriously, try another doctor.
4. Embrace the sensual
Touch, good food and engaging music can all help awake the senses. Sensual expression can include writing or reading erotic fiction, or wearing clothing made of fabric that pleases you. Josephine found a sense of sexual self within the BDSM community where dressing up and role play took the focus away from orgasm. Anne commented, ‘Touch helps me feel connected with people and comfortable in my body.’
The three women interviewed are still working through their experiences. Josephine admitted, ‘I still can’t say I’m all that into sex, but I do enjoy the intimacy and the closeness and the kissing. I make sure that we have sex at least once a week, and once we get going I usually enjoy it, even if I don’t orgasm. I consider having sex to be an important part of a relationship.’
Cate Lawrence lives in Melbourne, Australia where she working in education advocacy, and spends her spare time crafting and drinking Earl Grey tea.
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