15 min read
What is sexual desire disorder – and do I have it?
When you step into the office of a sex therapist – it can be daunting. You’re nervous to open up about something you can barely open up about with your partner, let alone a stranger(!).
And worst of all, you worry your therapist will tell you the thing you fear the most. That you actually have a desire disorder.
As a formally trained sex therapist myself, I’ve been on the other side of this conversation more times than I can count. And I feel it’s important to share, even though diagnoses can be helpful – they can also be pretty unhelpful, too.
Because within the diagnosis of a sexual desire disorder itself, lies the very idea that most of us don’t want to be true. That there, in fact, is something wrong with us.
Before we get into the nitty gritty about the pros and cons of diagnoses like these. Let’s first establish what a sexual desire disorder is.
According to the Diagnostic and Statistical Manual of Mental Disorders (also known as the DSM) there are actually several.
In this blog post, we’ll be focusing specifically on desire disorders that center around low or reduced desire (as opposed to feeling like we have too much desire).
Specifically, these are; Female Sexual Interest/Arousal Disorder and Male Hypoactive Sexual Desire Disorder.
It’s important to acknowledge a few things moving forward.
But while the points above are important to discuss and there’s a lot of debate in the field of Sexology about them – you’re (probably) not here (just) for the scientific debate. So let’s get on with it, shall we?
While the male and female desire disorders are separate diagnoses, there are a lot of unifying principles between the disorders. These similarities are:
This means, if you feel totally fine about your lack of desire, and you aren’t worried or anxious about it, you likely won’t be diagnosed with a sexual desire disorder.
Beyond these unifying principles – here are some of the specifics.
In order to get a diagnosis of Female Sexual Interest/Arousal Disorder you need to experience a few different symptoms. Some of them are:
In order to get a diagnosis of Male Hypoactive Sexual Desire Disorder you need to experience:
Looking at the symptoms above, you can probably see that the symptoms are by and large similar. In conclusion, a lack of desire is something that people regardless of gender experience.
Now – let’s dig a little deeper into the question: what is sexual desire disorder.
We’re going to have a look at the way a disorder can both be helpful in order to get your desire back – and how it can also be not so helpful at all.
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.
Well, yes and no. It kind of depends on the therapist you’re seeing and how they like to work.
What a diagnosis essentially does, beyond affirming your very real experiences of low or no sex drive – is it informs your treatment plan.
Because as therapists, we need to know what the problem is in order to offer you a fitting treatment plan. And without a diagnosis – we simply cannot do this.
Diagnoses also ensure that treatment plans are based on sexual science research. And we need research to know what works.
For this research to be conducted – it needs to be funded. And the thing about research is – funding for a research project is often more easily granted if it’s tied to a medical diagnosis, as opposed to a non-diagnosed sexual health issue.
So, if you want treatment to get your sex drive back that is based on evidence and science – and to get this help from a sex therapist – yes, a diagnosis can be tremendously helpful.
However, if you don’t want the label of a sexual desire disorder, and this very label makes you feel hopeless – the diagnosis in and of itself can hamper progress.
There are lots! As previously stated, getting a diagnosis means you can also get treatment, and thus hopefully get your desire back.
And sometimes, this also means your treatment is covered by health insurance – because it’s labelled as a disorder.
However, a lot of times sexual health disorders aren’t covered by insurance. And the only explanation behind this is that they’re kind of seen as champagne problems by insurance providers. But if you’re here reading this, I assume you agree with me that they most definitely are not luxury difficulties.
They have real-world impacts. Impacts on our general self-esteem, the longevity of our relationship or marriage, and our mental health at large.
But beyond the potential treatment perks of a sexual desire disorder, getting a diagnosis can also be incredibly validating.
It can help put into perspective why your feelings surrounding sex are intense in terms of anxiety or stress. But also, in terms of why sex feels like nothing anymore. Or why you barely have any sexual thoughts or fantasies in your day-to-day anymore.
It can be the thing you need to hear that gives you hope you’ll be able to revive your relationship.
This question really does depend on who you ask.
As a sex therapist and coach, my main objective is to help you feel whole again, sexually. This means getting you to a place where we flip the script from something being wrong with you – to something being right with you.
Because when you don’t want sex anymore – it usually makes complete sense.
You just need help to see the sense that it makes. And enlisting the help of a professional can do that for you.
In working with me, I like to come at low desire from lots of angles. But never the angle that something is wrong with you.
We turn over all the stones and do our best to find the deep-seated (often psychological and relational), reasons why you don’t want sex.
This way, we can move forward basing your action plan on real understanding and compassion. Compassion for why your desire is the way it is right now.
Because once you get to a place of understanding and knowing nothing is wrong if you don’t desire sex anymore – you can
When asking yourself: what is sexual desire disorder, it can be helpful to know there are some very real backsides to the diagnosis.
While I generally tend to veer away from sharing my opinions on these matters in my articles (because my work is based on science and not my opinions), I need to get personal here for a moment.
Part of why I do sex coaching nowadays is because I’m tired of the stigmatizing diagnoses surrounding sexuality. I didn’t like the rhetoric that is used so often in psychotherapy where we talk about disorders.
As with everything, there is, of course, a place and time for them. And they do truly legitimize conditions that have previously gone underlooked and therefore untreated, causing massive amounts of psychological pain. And as with all matters, the way therapists use language like disorders, varies.
But there is still so much to uncover and learn in the burgeoning field of Sexology. So much nuance to discover. Things that tell a different story than the one we’ve been sold about sexual desire to date.
Because libido isn’t a linear, hormonal reaction that occurs in precisely the same way for everyone. Especially not when we take into account the other factors in life that make our experience of desire so diverse.
Sometimes, the diagnosis of a sexual desire disorder can make us feel like we’re broken.
Because to receive a diagnosis is to be told there’s actually something wrong with us.
And these negative-sounding titles (that are often needed in order for us sex therapists to actually get paid to help you) have a backside.
They have real-world negative effects that create specific, cookie-cutter models of how sexuality and desire “should” work.
They tell us how our bodies and minds are “meant” to function in very specific ways. And that if they don’t, well, Houston, we have a problem.
Being in this field for many years now, I’ve come to be humbled by how multi-faceted desire difficulties are. And have learned just how rooted they are in the very fabrics of our lives.
And this means experiencing desire in ways that don’t mimic the stories we’ve been told about desire (that it’s always spontaneous, and hungry) can sometimes be misconstrued as diagnostic criteria for a sexual desire disorder.
One that we might not actually have. Whatever “have” means here.
Because how much sexual desire is actually normal? It, again, depends on who you ask. And that, in and of itself, says a lot about how careful we should be in labelling people as either having a disorder or not.
All of this being said though – when discussing the question of; “what is sexual desire disorder, really?”, this isn’t a black-and-white discussion. At least not from my perspective.
I’m grateful Sexology is a legitimate field. And to continue researching and unearthing more knowledge, we kind of need these labels. Because that’s, unfortunately, the way the system works.
However, in my work with my clients, I find it important not to label.
This means you won’t find me telling you something is wrong with you, because there likely isn’t.
You won’t find me saying you should experience desire or arousal X number of times a week, because you shouldn’t.
And you most certainly won’t find me telling you that you’re broken.
I will tell you how much sense it makes that you don’t want sex anymore.
How understandable it is you can’t get aroused when you’re brimming with performance anxiety.
That everything you’re telling me are experiences you share with millions of people. Because you’re not alone – and you’re not damaged goods.
And – change is possible, too. If you want it.
If you’re currently in a relationship or marriage – you will likely have noticed your lack of desire (unfortunately) doesn’t only affect you. In fact, for most of my clients, sexual desire disorder only becomes a problem once it affects their relationship as a whole.
This means while you may not want sex and maybe you’re okay with it for the time being (or don’t have the energy to work on it right now) – chances are your partner isn’t alright with it.
And when they notice you start pulling back from their sexual advances – it quite quickly turns into an infected pattern. One where your partner might get angry and lash out, saying hurtful things because they also feel hurt deep down, too. Perhaps they’re worried you’ve fallen out of love with them. Or you no longer find them sexually attractive.
But as with all emotional situations in life – it’s always okay to feel how we feel – but, it’s not okay to take our feelings out on someone else.
Granted, none of us are perfect, but it’s always possible to deal with mismatched libidos in better ways than hurtling insults or putting pressure on your partner. This way you can move away from the feeling of having a sexually demanding husband, wife or partner – and into one another’s arms again.
Sex isn’t something we give to others – it’s an experience we share.
And once the experience of having no sex drive and your husband or wife is mad at you, has been going on for a while – it’s easy to fall into a pattern where you give into the pressure from your partner.
We do this in order to keep our partner happy. However, this reaction to their pressure quickly becomes a slippery slope. One where you might start to experience sex as non-consensual. For this reason alone it’s important to talk with your partner about what’s going on and what you would like to do about it.
Furthermore, while having sex for your partner’s sake, may solve things temporarily (in that they stop pestering you for sex) – in the long term, it only further cements low desire.
Because when our bodies and minds get used to sex not being positive – there’s no reason for desire to show up again. Because desire knows it’s not going to be a good time.
To be clear – responding to pressure from your partner to have sex isn’t necessarily a conscious choice. Nor are you choosing to do something because you want a negative outcome. It’s a perfectly understandable response to a high-pressure situation in your relationship.
However – it’s one that’s important to change, especially if you want to enjoy sex again and relish in intimate pleasure together. Like you used to.
Ideally, having a conversation with your partner about your low sex drive should take place at a time when emotions aren’t running too high. This will significantly reduce the risk of a full-blown conflict as you both won’t be flooded with stress and anger.
Sometimes it may even be helpful to follow up a conversation by showing your partner a blog post or an article (like this one) that shares how complex low desire is and how it doesn’t have to do with falling out of love.
It is possible to turn things around even if your partner is angry and you feel hopeless right now. And it often starts by having a conversation about what’s going on and how you would like things to change.
Because it takes two to tango – and the dynamic between the two of you isn’t one you’re solely responsible for.
When answering the question of what is sexual desire disorder (and do I have it), it’s important to expand the conversation.
Because for all of the good that disorders do; validate our lived experiences, enable treatment funded by insurance, and quality research – there’s another side. One that can make disorders less appealing.
That the very diagnosis can be the thing that makes us feel broken. That we risk boxing in human sexuality and desire into very standardized ways of functioning. Ways that actually hamper our desire and our self-esteem.
There’s lots you can do to get your desire back. Stuff that doesn’t hinge on treatment plans – because you likely don’t need treatment. You need to be seen and heard.
And this can be done, sexual desire disorder – or not.
If you want help getting your sex drive back and turning that dread and pressure into a stress-free sex life (without labels of disorder or something being wrong with you) – I’d love to work with you in Re:Desire.
Re:Desire is a 5-phase, 1:1 online program all about reducing pressure and stress surrounding sex, as well as increasing desire and intimacy.
You can read more and take your first step towards stress-free sex.
In order to overcome your loss of sexual desire you want to start by addressing the situation from a bio-psycho-social lens. This means having a look at all of the possible factors involved and what might need to be changed.
For instance, from a biological perspective this could mean asking yourself questions that uncover whether biological or medical factors are responsible for your decreased sex drive:
Are you currently on hormonal birth control?
Are you in menopause?
Are you experiencing health challenges such as diabetes or thyroid issues?
From a psychological perspective this could mean asking yourself:
Are you struggling to be present during sex and find yourself worrying and thinking about everything but sex while you’re having it?
Are you feeling stressed and overwhelmed in life currently?
Are you struggling with negative body image and feeling unattractive?
From a social perspective this could mean asking yourself:
Are you and your partner emotionally disconnected?
Are you struggling to talk about your sexual differences in your relationship?
Are you feeling shame surrounding sex that stems from your upbringing?
If you’d like a full list of all possible factors that create hypoactive desire disorder you can download my free resource The Desire Test. It’s a 10-page assessment that will help you understand what’s going on and what to do about it.
Once you know the factors involved – the next step is to work on those most responsible – this could look like:
Seeing your doctor to switch up medications
Seeing a sex therapist or sex coach to work on body image, relationship issues, shame surrounding sex, increasing presence during sex and finding out what turns you on (and off)
Seeing a physiotherapist to help you strengthen your pelvic floor (or relax it)
Hypoactive sexual desire disorder can show up in many different ways. For some, it’s most noticeable in that you no longer think about sex, let alone fantasize about it.
For others, it’s the combination of a lack of sexual thoughts and an onslaught of negative, worrying thoughts about sex such as “I’m broken” or “what’s wrong with my relationship?”.
For a third, it might be that you no longer think of yourself as a sexual being and find sex to feel like nothing anymore. All sensation is dulled and it feels more like an act you perform for your partner’s sake more than your own.
No matter how you experience it, there are lots of things you can do to start to want sex again and truly enjoy it (if that’s what you want!).
There are many different reasons why you’re experiencing low or no sex drive. Oftentimes, low desire doesn’t just come down to one factor or two – rather it has to do with a broad spectrum of concerns. These range from the biological and medical factors, like medications or health conditions that naturally reduce sex drive, to other factors such as psychological, relational and social.
Psychological reasons for low libido may be negative body image, low sexual self-esteem and shame, even mental health struggles such as anxiety and depression can negatively impact desire.
Relationship factors include struggling with emotional intimacy in your relationship or increased conflict. Even worrying about your relationship and questioning it can lead to low desire, especially if you crave safety and closeness in order to want sex.
Social reasons such as not experiencing desire the way society tells us we should or feeling like you get off to the wrong things sexually, can cause low desire.
This article was first published on October 4th, 2022. Updated August 16th, 2023.
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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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