Sexual Health and Wellness

DYSFUNCTIONS: INHIBITED SEXUAL DESIRE DISORDER

Sexuality is a complex process, co-ordinated by the neurologic, vascular and endocrine systems. Individually, sexuality incorporates familial, societal, and religious beliefs, and is altered with aging, health status and personal experience. In addition, sexual activity incorporates interpersonal relationships, each partner bringing unique attitudes, needs and responses into the coupling. A breakdown in any of these areas may lead to sexual dysfunction. Features Inhibited Sexual Desire Disorder (ISDD) refers to persistent or recurrent low levels of sexual interest, desire or fantasies. ISDD is also referred to as sexual apathy or hypoactive sexual desire. An individual with ISDD is often considered asexual because of their apparent lack of interest. As such, there is no desire to initiate or participate in sex. ISDD can be primary, where the person has never felt much sexual desire or interest.

  • ISDD can be secondary, where the person used to feel sexual desire, but no longer does.
  • ISDD can be partner related, in that the person is interested in other people, but not in their primary partner.
  • ISDD can be general, in that the person isn’t sexually interested in anyone. In the extreme form, the person not only lacks sexual desire, but may find sex repulsive.
  • Sometimes, the sexual desire is not inhibited per se. The two partners have different sexual interest levels, even though both of their interest levels are within the normal range.
  • In some cases a partner can claim that their partner has ISDD, when in fact they have overactive sexual desire and are very demanding sexually.

Epidemiology Approximately 30% of women report having little or no sex drives. Studies have found that complaints of low sexual desire increase with age, relationship duration, number of small children, relationship discord and symptoms of anxiety and depression. If the problem occurs after a period of normal sexual activity, the cause can be related to a partner (because of the situation or if there is something lacking in the relationship) or might be due to some trauma or to pain caused during intercourse. Causes Many things can cause a sexual aversion; it can be a psychological problem, or a combination of a physical and psychological problem. Some physical reasons that may result in a loss of desire are medical or surgical interventions, hormone disorders and certain medical conditions such as diabetes, heart disease, multiple sclerosis, Parkinson’s disease and depression. Other physical factors include changes in contraceptive methods, tiredness, insomnia, chronic pain, obesity, and excessive alcohol or drug use. Certain medications can also lead to a loss of desire (such as antidepressants or antihypertensive medications). Some psychological reasons may include poor body image, stress, anxiety, poor relationship satisfaction, and past traumatic experiences (including incest, sexual abuse or rape). It often occurs when one partner does not feel intimate or close to the other. Communication problems, lack of affection, power struggles and conflicts, and not having enough time alone together are common factors. It may also be attributed to something related to the partner (e.g., bad body odor or poor hygiene) or to the context of over-familiarization or boredom with sexual routine. A repressive family attitude concerning sex and rigid religious beliefs have also been found to play a role. Treatment Every woman will have a unique set of circumstances causing her loss of desire, and likewise the treatment plan should be individually tailored to meet her special needs. A detailed medical, sexual and social history should be obtained and certain blood tests carried out. This may uncover any underlying medical or psychological condition. Based on the information uncovered the treatment plan will target at the factors that may be lowering sexual interest. When an underlying medical condition is found, this will be treated first. In the context of relationship difficulties or sexual boredom, couples may need relationship or marital therapy to enhance sexual activity. Some couples will need to be taught how to resolve conflicts and work through differences in nonsexual areas. Communication training will help couples learn how to talk to one another, show empathy, resolve differences with sensitivity and respect for each other’s feelings, learn how to express anger in a positive way, reserve time for activities together, and show affection, in order to encourage sexual desire. Many couples will also need to focus on their sexual relationship. Through education and couple’s assignments, they learn to increase the time they devote to sexual activity. Some couples will also need to focus on how they can sexually approach their partner in more interesting and desirable ways, and how to more gently and tactfully decline a sexual invitation.