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Low Sexual Desire for Women

Female Low Sexual Desire (known diagnostically as Female Sexual Interest/Arousal Disorder) involves a significantly reduced or complete lack of sexual interest/arousal.  Sexual interest/arousal encompasses several areas of experience.  Low Sexual Desire for women is defined as the presence of three or more of the following factors:

  1. Absent/reduced interest in sexual activity.
  2. Absent/reduced sexual/erotic thoughts or fantasies.
  3. No/reduced initiation of sexual activity, and typically unreceptive to a partner’s attempts to initiate.
  4. Absent/reduced sexual excitement/pleasure during sexual activity in almost all or all sexual encounters (i.e., more than 75% of the time), in some or all situations.
  5. Absent/reduced sexual interest/arousal in response to any internal or external sexual/erotic cues (e.g., written, verbal, visual).
  6. Absent/reduced genital or non-genital sensations during sexual activity in almost all or all sexual encounters (i.e., more than 75% of the time), in some or all situations.

Female Low Sexual Desire is only considered a psychological problem if it persists for a minimum of 6 months, as many factors can have short-term influences on sexual desire for women.  Such factors can include stress and tiredness from work or raising children, relationship problems or recurrent arguments and sometimes feeling unsure about pregnancy.  Each of these issues can dampen a woman’s sexual desire for short periods, but her enjoyment of sex quickly returns once she is well rested or when problems in the relationship are resolved.  In these cases, a diagnosis of Female Sexual Interest/Arousal Disorder is not warranted because the loss of sexual desire is not long-standing.

Low Sexual Desire for women is also only considered a psychiatric problem if it causes significant distress for the individual.  Some women identify as ‘asexual’, which is defined as a lack of interest in sexual activity or a lack of sexual attraction to any particular gender.  Women who self-identify as asexual are perfectly comfortable with their lack of sexual desire (for sex or any particular gender) and in these instances a diagnosis of Low Sexual Desire is not made.

Female Low Sexual Desire is also only diagnosed as a psychological problem if the difficulties are not better explained by a non-sexual mental disorder or as a consequence of severe relationship problems (e.g., partner violence).  Low Sexual Desire for women is also not considered a psychiatric disorder if the woman is currently prescribed medication known to have effects on sexual functioning or if she is using illicit substances.

Many couples report problems with differences in sexual desire.  For example, a woman may have less strong sexual feelings and may desire sex less often than her partner (and the same can sometimes happen for men).  This ‘desire discrepancy’ can cause arguments and relationship counselling or individual therapy may be necessary to work through the issue, reduce relationship tension and improve the couple’s sex life.  It’s important to note however that just because a woman has a lower sex drive than her partner it does not automatically mean she has a Sexual Interest/Arousal Disorder.  Some women simply have a lower level of sexual desire compared to their partner and this is perfectly normal.  Because it can be difficult to determine if a woman’s difficulties with sexual interest and arousal is a clinical disorder it is important that she speak with a skilled clinician to explore the nature of her difficulties more fully.

It’s also important to note the difference between Sexual Desire and Sexual Arousal.  Sexual desire is the physical and emotional urge for sexual intimacy (what many people simply call “feeling horny” – although this is an oversimplification of sexual desire).  Sexual arousal is the physical changes a person experiences while engaging in sexual activity.  This includes vaginal lubrication for women and an erection for men.  Difficulties feeling aroused physically when intimate with a partner can often occur during periods of low sexual desire as well.  For women, it’s not uncommon to enjoy sex and to become sexually aroused with fore play even though she didn’t feel any initial sexual desire before being approached by her partner for sex.

Like many other psychological problems, Low Sexual Desire for women can result in Mild, Moderate or Severe levels of emotional distress depending on the individual and couple concerned.  Other factors include whether the difficulty is lifelong or acquired.  If the problem has been present since the individual became sexually active it is considered lifelong.  If the problem commenced after some months or years of normal sexual functioning it is considered acquired.  The condition may also be situational or generalised.  If situational, the problem only occurs with specific types of stimulation, situations or partners.  If generalised, the problem is not limited to specific types of stimulation, occurs in different situations and/or with different partners.

What causes Female Low Sexual Desire?

Low Sexual Desire for women can be caused either by psychological or physical factors or a combination of both.  A good place to start if you suspect you’re experiencing abnormally low sexual desire is to speak with your GP or a Sexual health physician to determine if there is a physical basis for the problem.  Female Sexual Interest/Arousal Disorder often occurs at the same time as other female sexual disorders including painful sex (Genito-Pelvic Pain/Penetration Disorder) and Female Orgasmic Disorder.  This is because the causes for each problem can be inter-related.  For example, if a woman experiences painful sex due to Endometriosis or Pelvic Inflammatory Disease then her desire for sex would understandably be dampened due to her expectation of pain during intercourse.  Depression may also be characterised by a reduced ability to enjoy activities such as sex that were once fun and fulfilling.  So low mood may also negatively impact sexual interest.

Physical causes of Female Low Sexual Desire:

Physical causes of Low Sexual Desire can include the same physical causes of other female sexual disorders including genito-pelvic pain disorder and difficulties achieving orgasm.  These factors include Diabetes, Thyroid Dysfunction, Irritable Bowel Disease, central nervous system disorders and the prescription some medications (particularly some anti-depressants known as Selective Serotonin Re-uptake Inhibitors).  Vaginal dryness in older women is related to age and menopause and may make sex uncomfortable, which in turn negatively affects a woman’s desire for sex.

Psychological causes of Female Low Sexual Desire:

Many couples report a fulfilling love life that includes a regular desire for sex on behalf of the woman in the early years of their relationship.  However if the couple experiences regular arguments in which key issues remain unresolved then a reduction in a woman’s sexual desire and enjoyment of sex often results.  Women typically report the need to feel close to their partner and safe from tension to desire and enjoy sex.  Counselling is often necessary to address those unresolved issues (which might for example include conflict resolution and negotiation) and once this is done a woman’s natural desire for sex and intimacy returns.  This unfortunately conflicts with men’s tendency to use sex as a way to create a sense of being close to their partner and to create a sense of security from the effects of relationship tension.  Relationship problems and dissatisfaction can play a big role in a woman’s loss of desire for sex.

Unrealistic expectations on behalf of the woman or her partner can also negatively affect a woman’s sexual desire.  Generally, most men report stronger sexual urges than women and this is quite normal.  If a man assumes his partner should ‘always’ feel sexual desire towards him then this creates an unrealistic expectation.  These unrealistic expectations then create arguments and tension that further erodes a woman’s desire for sex and intimacy.  Most women also report that to enjoy sex they need substantial foreplay (which might include sexual activity such as kissing or cuddling, or non-sexual courting, such as a romantic dinner).  Some men assume a few kisses and some groping will get their partner ‘in the mood’, but this is just not enough enticement for many women to feel sexy and to enjoy intimacy.

Another common unrealistic expectation is if either partner assumes a woman should be able to achieve orgasm every time she has sex.  In reality, a woman’s ability to climax is dependent on a vast array of factors (for example, her stage of menstrual cycle) and sometimes it’s impossible for her to achieve orgasm regardless of what sexual activity she engages in.  Sex at these times can still be fun, intimate and greatly enjoyable for women, however if she or her partner assumes she ‘should’ be able to climax then this sets the couple up for failure and possibly arguments that only reinforce the problem.  Misunderstandings between men and women regarding what’s needed for sexual enjoyment play a big role in dampening sexual desire for women.

Cultural expectations may also dampen women’s sexual desire, or her felt ability to express it.  For example, some conservative and traditional religious attitudes toward women’s sexuality include assumptions that ‘only men want and enjoy sex’ or ‘women should never initiate sex’.  If a woman holds these expectations her ability to enjoy and pursue sexual intimacy may be impacted.

How common is Female Low sexual Desire?

It’s extremely difficult to determine how common Female Sexual Interest/Arousal Disorder is.  Some studies have shown higher rates of this condition for East Asian women compared to European and North American women.  A key factor considered is whether Low Sexual Desire is distressing for the woman.  Many women have a limited need for sexual intimacy and aren’t bothered by this at all, in these instances a diagnosis of Female Sexual Interest/Arousal Disorder is not made.  However, whether Low Sexual Desire is distressing for women is influenced by age, cultural and relationship expectations.  Arguably, women are the ones best placed to decide if their level of sexual desire is causing them or their relationship problems.  If Low Sexual Desire is causing problems such as recurrent arguments then relationship counselling or individual counselling may be useful to manage this tension.

What are the steps in treatment for Female Low Sexual Desire?

Managing Low Sexual Desire for women involves similar areas as managing Low Desire for men.  It may be as simple as changing the type of medication you’re prescribed (if this applies).  Individual counselling for women and/or relationship counselling are important to identify the causes of low libido for women when physical factors have been ruled out.  Once psychological factors such as recurrent arguments or unresolved issues within the relationship are worked through, a desire for more frequent sex often results.

Counselling may also involve managing the impact of low sexual desire on the couple in those cases in which it cannot be fully reversed.  This can include focussing on what you enjoy that leads to sexual excitement, modifying unrealistic expectations, or sharing satisfying and enjoyable intimate time together that may not involve intercourse or the woman climaxing during sex.  Effective communication in relationships plays an important role for couples managing the effects of differences in sexual desire.  Counselling will focus to a large extent on communication, as well as on misunderstandings or a lack of knowledge about sexual functioning to help the couple achieve a more satisfying sex life.

Disclaimer:  The information covered on this website is for educational purposes only.  A diagnosis of any psychiatric or medical condition must only be made by a medical or mental health specialist.  Diagnosing a psychiatric concern is a complex process that involves formal training, do not ‘diagnose’ yourself.  If you have concerns that a particular disorder or condition applies to you, please speak with your General Practitioner for further assessment and medical/psychological care.

Individual counselling appointments are 50 minutes long.
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