Desire:  Wondrous and Misunderstood

The most common complaint in a sex therapist's office is low sex drive, sometimes in one partner, sometimes in both.  Low sex drive causes couples to drift apart, to argue, and sometimes, even to divorce.  This article discusses the physical and non-physical reasons that people experience a low drive. 

Physical Reasons for Low Drive

Hormones

Low sex drive is most commonly associated with a hormonal imbalance.  Testosterone, especially, seems to be the sex hormone most responsible.  Testosterone does a number of things in the body.  For men, it gives them energy, strength, and stamina.  For both sexes, it also seems to be involved in the mind's ability to fantasize about sex.  It also helps men attain and maintain erection.  Testosterone can also help women attain orgasm as it increases sensitivity in the clitoris and nipples.

So if drive is low, it must be testosterone, right?  Wrong.  There are so many other reasons that one's drive is low.  Other hormonal imbalances can also contribute to low drive.  In women, estrogen is required for the production of testosterone.  If estrogen is low, testosterone may also be low.  Thyroid hormones, pituitary hormones, adrenal hormones, and others may also be off balance when one's drive is low.  Of course, there are often other signs that hormones are out of balance particular to each.

Chronic Illness and / or Pain

The wear and tear on the body of chronic illness can take its toll on one's drive.  Diabetes, multiples sclerosis, fibromyalgia, arthritis, and other illnesses are associated with fatigue and lack of stamina.  Managing these illnesses may also require medications that can have an effect on drive and performance, e.g. medications for blood pressure can make it difficult for men to have an erection or for women to come to orgasm.

Chronic pain such as back pain or migraine headaches can also interfere with desire.  Again, medications can cause problems with sleepiness, grogginess, irritability, and so forth.

Pregnancy and Post-Partum

Many hormonal changes occur during pregnancy for women, and for both sexes after the delivery of a child.  Fathers might be surprised to learn that, like mothers, their bodies produce a hormone called vasopressin that promotes bonding.  The bonding chemicals that are so essential between parent and child, though, don't seem to really override the fatigue of staying up with and feeding a new baby.  Although many women will hear that they can have sex after six weeks post partum, a number of them will not be ready to resume sexual activity.

Alcohol

Alcohol is a big culprit when it comes to lack of desire.  While it is true that a glass or two of wine might relax you and loosen you up for sex, some people don't or aren't able to set a reasonable limit.  More alcohol interferes with desire because it is a mood depressant.  There are many alternatives to mood-altering substances for relaxation, so think twice before pouring that cocktail.

Lack of Sleep

Insomnia or just plain staying up too late can rob you of the desire to have sex.  Either one interferes with the manufacture and balancing of hormones that take place in your body while you rest.  If you always complain that you are too tired for sex, perhaps you really are.  Reviewing and adjusting your sleep schedule to get the recommended hours of sleep for an adult--typically 8 hours each night--may really help you to feel sexier.

Lack of Exercise

Surprised?  When you exercise, you help your body to relax and to attain a more restful sleep.  You also increase stamina and strength, which are needed to be a good sexual partner.  For men, exercise can increase the manufacture of testosterone.  Exercise helps the brain to produce endorphins, opioids, serotonin and other "happy chemicals" in the brain.  Many people find that exercise gives them a mood lift, and that help with sex drive.  So get up and move if you've been a couch (or mouse--computer mouse, that is) potato.

Sexual Dysfunction

Problems with ability to attain orgasm, attaining orgasm too quickly, not being able to acquire and maintain an erection--all of these sexual problems lead people to avoid sex.  Another problem that affects millions of women are pelvic pain disorders, also known as vulvodynia.  This set of disorders causes pain to be uncomfortable in many different ways.  Anything that goes wrong when it comes to sex can cause embarrassment and avoidance.

Emotional Reasons

Anxiety

People who worry excessively and who experience rapid heartbeat, pulse, and breathing are said to have generalized anxiety disorder.  But garden-variety worriers and people who tend to ruminate--to think about something over and over again--may be interfering with pleasurable thoughts and fantasies that can lead to sex.

Stress

Stress is a big problem in our culture.  We work more hours and take fewer vacations that people in most industrialized nations.  The gadgets and electronics that were supposed to save us time have actually made it possible for us to work more.  Whereas everyone, it seemed, had a secretary at one time, we are now expected to do our jobs, plus be administrators.  All of this wears heavily on many people.  By the time bedtime rolls around, couples tend to flop onto the pill and call it a day. 

Depression

Depression can mean being in a deep, dark mood most of the time.  It can also mean the so-called blues, or a low-grade depression that is ever-present.  If you are someone who frequently complains, you may be depressed and not recognize it.  In fact, many people do not recognize the symptoms of depression and do not seek treatment, even though depression can be fatal.  Some of the symptoms of depression include social withdrawal and not finding fun things that you may have formerly enjoyed.  Both of these may relate to a low sex drive. 

Sexual Trauma

Sadly, sexual trauma is somewhat common.  One out of four women and one out of three men have been sexually abused.  For some people, having been sexually traumatized creates the impulse to act out sexually--to sleep with other people indiscriminately, or do other self-destructive behaviors.  For others, it means turning off to sex.  A sexually traumatized person may feel that sex is "dirty" or not for them. 

Poor Body Image

In general, women have a long history of worry over the shape and size of one's body.  There is a lot of pressure to conform to an "ideal" that seems to change with every decade.  With more and more exposure to images on TV and the Internet, men are finding that they, too, worry about a belly that comes from drinking a six-pack rather than having one from exercise.  Concerns about one's body can cause embarrassment and avoidance of physical intimacy.

Your Relationship

Perhaps the most complex reason for low drive has to do with the interactions you have with your sexual partner.  Unspoken resentments can build over time, and one place that they tend to be expressed is in the bedroom, where the party who perceives themselves as hurt may withhold sex.  Sometimes one partner feels pressured to have sex because the other needs it to feel loved and validated, and this can cause withdrawal, too.  Also, sometimes one partner simply has a stronger sex drive than the other, causing misunderstandings and fighting about sex.

Your Upbringing

The way in which you learned about sex, the messages you got from your parents, the teachings of your church or school, all contribute to your sexuality.  If you were taught not to express your sexuality, you may be obedient and never show sexual interest.  You may find being nude uncomfortable, or touching and bodily fluids to be disgusting.  You may simply feel inadequate about sex because you never learned much about it.

What Can You Do About Low Sex Drive?

If you haven't done so already, please consider signing up for The Buehler Institute newsletter so that you can receive Dr. Buehler's free report, "Hot Sex at Any Age."  The download includes ten basic but critical things you can do to improve your drive and make sex better.  Also do the following:

1.  Have a physical examination.  There is research that shows that sexual dysfunction can be an indicator of serious physical problems, like cardiovascular disease.  Also, you may have a low thyroid or other imbalance.

2.  Keep a journal for a few weeks.  Notice what is happening in your life in terms of self-care, your mood, your worries, and your relationships.  How might these be affecting the way you feel about yourself?  Your sexuality is an expression of a part of who you are.  If you are troubled and upset, chances are that you aren't going to be feeling very sexy.

3.  Talk to your partner.  Let your partner know that you are struggling with low drive.  Don't blame your partner; it may not be his or her problem at all, except to the extent that your low drive affects their emotional and sexual well-being.  Take responsibility for your drive and sexuality.  Ask your partner to help you figure out why you have lost interest in sex.

4.  Have a psychological assessment.  Whether you come to The Buehler Institute or seek help elsewhere, a trained, objective professional may be able to pinpoint something you are too close to be able to see.  Desire is very complex, so it may take a few sessions to figure out what factors are causing a problem.  But rather than letting things drag for years and even threatening your marriage or relationship, invest some time and money in your sexual happiness.  Just as you deserve physical and emotional health, you also deserve sexual health.