Decreased sex drive, impotence or difficulty having an orgasm are three of the most common reasons people seek sex therapy. One thing that’s become clear to me, as a clinical sexologist, is how often people mistake some sexual problems for other sexual problems.
There can be a difference between a presenting sexual difficulty – and the real sexual issue. And in order to work through a problem, you need to understand what’s underpinning it.
If you don’t – you risk trying all sorts of things that have no effect at all – leading to increased worry and anxiety about your sexual difficulties, as well as less motivation to work through them.
The route to better sex and a more intimate relationship starts by understanding the difference between the presenting issue – and the one that’s responsible.
Decreased sex drive, impotence or difficulty having an orgasm are actually three separate diagnoses. And depending on your gender or genitalia, the diagnoses will differ.
If you want to work through your sexual problem, understanding which diagnosis best fits your difficulty, will help you know which steps to take next.
Because low libido doesn’t always stem from a lesser sex drive.
Erectile dysfunction isn’t necessarily only about not getting it up.
And orgasm difficulties aren’t always just about not being able to climax.
Experiencing a decreased sex drive is common. Among those who identify as women, almost one third experience low libido.
For those who identify as male, the number is more like 13-28%. For those who identify as neither male nor female – the statistics are, unfortunately, yet to be researched.
Low libido in those who identify as women:
Low libido encompasses both the the mental and physical aspects of desire (the sexual desire vs. sexual arousal complex). This means that a diagnosis of low libido encompasses less fantasies and thoughts about sex, and not wanting to have sex or masturbate – as well as finding it hard to lubricate or stay wet during sex.
Pro tip:
Sometimes, difficulties with sexual arousal and not feeling in the mood for sex, are a direct result of finding it hard to orgasm. If you’re constantly feeling disappointed by not coming during sex, it can serve as a negative feedback loop – conditioning sex as a disappointment and therefore lowering your libido.
Low libido in those who identify as men:
Low sex drive is characterized by things such as having fewer sexual fantasies, less erotic thoughts, and not feeling like you want to have sex or masturbate.
Finding it difficult to get or sustain an erection – is covered by another diagnosis.
Pro tip:
If you never feel like having sex, it might be the result of having suffered from erectile difficulties for a longer period of time. Just as orgasm difficulties in women can be one of the causes of low libido – inconsistencies with your erection can be one of the main factors decreasing your sex drive.
When trying to understand the difference between a decreased sex drive, impotence or difficulty having an orgasm, it’s also important to understand how the common term impotence can confuse things.
Impotence is a word that refers to men and people with penises both having difficulties either getting an erection or having an orgasm.
Because impotence refers to orgasm and erectile challenges, you need to understand what kind of impotence your problem is referring to.
As erectile challenges in men are their own diagnosis, defining your problem as either an erectile one or a low libido one – is really important.
However, oftentimes, difficulties getting or sustaining an erection go hand in hand with a low sex drive. So it’s not uncommon to find you fulfill criteria for both diagnoses.
Pro tip:
Erectile difficulties aren’t always a question of pure function. In fact, a lot of men I see in my private practice as a sex therapist, seek help for erectile dysfunction when they in actual fact have low libido.
Try and suss out whether you feel in the mood for sex when you’re about to have sex or are in the middle of having it. Chances are, you might not actually feel like it – indicating the possibility of low libido and not only erectile impotency.
My free resource The Desire Test helps you take that first step towards an increased sex drive, by understanding your decreased desire.
Take the 10-page assessment quiz, get the answers you need to understand what’s standing in the way of your desire, and get free sex and relationship tips directly to your inbox. You can unsubscribe at any time.
Orgasms are the culmination of sexual pleasure. When we refer to orgasm difficulties in pop culture, we often talk about women. This is, partly, because of the statistics surrounding these difficulties.
About 11-41% of women or people with vulvas/vaginas never or very seldom climax during sex, compared to 1-4% of men or people with penises.
Orgasm difficulties in those who identify as women:
To be diagnosed with orgasm difficulties, they need to be experienced during both partnered sex and masturbation. If you can reach orgasm during masturbation, your difficulties are usually related to something happening (or not happening enough), for example, the wrong type of stimulation.
Pro tip:
A lot of times, orgasm difficulties are tied to a low sex drive and difficulties getting sexually aroused. If you’re having sex that doesn’t turn you on mentally or physically, your orgasm challenge might actually be caused by low libido.
Orgasm difficulties in those who identify as men:
An orgasm usually contains both the sensation of coming and the physical act of ejaculating. In men and people with penises there is, however, a difference between ejaculation and orgasm.
The two are separate events. This means you can have an orgasm without ejaculating, and ejaculate without feeling like you’re coming.
Pro tip:
If you’re finding it difficult to orgasm – you might want to consider your sex drive as one of the culprits. For some, difficulties orgasming are directly related to not actually feeling in the mood. A low libido might therefore be the actual problem that’s underpinning your orgasm difficulties.
When you’re suffering from sexual difficulties, it’s important to try and understand what these difficulties are all about.
One way of doing this, is trying to identify which diagnosis your difficulty comes from.
Low libido in women is about not feeling mental sexual desire or physical sexual arousal.
Low libido in men is about not wanting sex on a mental level.
Impotence refers to men not being able to get or sustain an erection, or have an orgasm.
Difficulties having an orgasm in women is about not experiencing an explosive culmination during sex.
Trouble orgasming in men refers to not having an orgasm and/or not ejaculating.
My point isn’t that all sexual difficulties are always the result of another one. For example, in the instance of a decreased sex drive – sometimes that’s all it is.
But other times, our low libido stems from other sexual difficulties.
Knowing the difference between a decreased sex drive, impotence or difficulty having an orgasm could be what you need to get started creating a better, more pleasurable sex life.
It really is possible to get past problems of a sexual nature, even if it doesn’t always feel like it.
You’re not alone! Download the 10-page Desire Test to find out why your desire for sex is gone (and what to do about it).
Questions based on a variety of factors proven to negatively affect desire
Find out which factors are responsible for your low or non-existent sex drive
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With 8 years of experience as a sex therapist and coach - Leigh helps her clients create stress-free, shame-free, pressure-free sex lives, through her unique combination of sexological science, & psychotherapeutic & coaching tools.
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