Do I have Low Libido or Sexual Dysfunction?
Randy and Colleen are newlyweds. They can’t seem to get things working in or out of the bedroom. Randy says, “This is so frustrating. You would think at least this would be easy and natural.”
Tammy and her husband just moved to a new town. New house, new job, new everything. “It’s good but it’s stressful,” they say. They feel like they accidentally left their sex life back in the old city.
Brenda is in her 50s. She has been content in her marriage for many years, and everything seems to be fine—except in the bedroom. “I just don’t seem to turn on anymore,” she says.
Sexual Arousal Disorder: Definitions and Key Thoughts
Sexual arousal disorder occurs in women and men. With men, the problem is usually called “erectile dysfunction.” Female sexual arousal disorder is often referred to as “frigidity.”
The symptoms of sexual arousal disorder include:
- Lack of vaginal lubrication or dilation
- Decreased genital tumescence
- Decreased genital or nipple sensation
The DSM-IV diagnostic criteria for female sexual arousal disorders include:
- Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement.
- The disturbance causes marked distress or interpersonal difficulty.
- The sexual dysfunction is not better accounted for by another Axis I disorder (except another sexual dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. [i]
Sexual arousal disorder is often psychological. Present issues such as depression, anxiety, stress, anger, relationship conflict, or a lack of trust in a relationship can lead to sexual arousal problems.
According to information provided by the major pharmaceutical company Merck, regarding female sexual arousal disorder:
“If the disorder has been present since puberty, the woman may not know how the genital organs (particularly the clitoris) function or what arousal techniques are effective. The lack of knowledge leads to anxiety, which worsens the problem. Many women who have sexual arousal disorder associate sex with sinfulness and sexual pleasure with guilt. Fear of intimacy and a negative self-image may also contribute.” [ii]
Sometimes the issue is not emotional, but physiological. Changes in hormones, reduced blood flow in particular regions of the body, diabetes, drug or alcohol use, and nerve damage can effect sexual arousal. In addition, a decreased interest in sex has been found to occur in women as they approach menopause.
It is wise for persons suffering problems with sexual arousal to receive both a medical and psychological evaluation. A medical cause can often be ruled out if one presents sexual arousal problems along with a strong correlation of anxiety or relationship problems.
Both hormone therapy and blood-flow enhancing medications (such as Viagra, for men) have been found to be useful for improving sexual arousal.
Action Steps for Overcoming Sexual Arousal Disorder
1. Get a thorough checkup.
Stated above, problems with sexual arousal, or a decreased interest in sexual activity can be a response to emotional, relational, or physiological factors.
A positive first step includes getting a medical evaluation, as well as addressing any emotional experiences or relationship problems that may be occurring.
2. Improve the relationship.
Once a medical cause is ruled out, talk with your partner about how the two of you can team together in improving the relationship.
Common problems couples face that effect sexual arousal and desire include destructive arguments, current or past affairs, outside stressors, and a lack of quality time together.
3. Face any emotional roadblocks.
An issue, separate from one’s relationship, may be effecting sexual arousal.
Consider that stresses at work, money problems, and any current fears or anger one is harboring can negatively affect sexual arousal.
Also, emotional issues from one’s past—such as pain from past sexual abuse or feelings of betrayal—can effect sexual arousal.
4. Consider medical treatment.
After consulting with a physician, if it is considered likely that decreased sexual arousal has a physiological cause, there are several treatments that have been found to be effective.
Hormone therapy for women, including low doses of testosterone, have been found effective in treating female sexual arousal disorder. For men, medications that increase blood flow including the name brand medications Viagra and Cialis are often effective in eliminating erectile dysfunction.
5. Sex Therapy: The Sensate Focus Technique.
The sensate focus technique is a technique taught in sex therapy that can help couples that are having sexual difficulties due to psychological factors.
The goal of the technique is to reduce the anxiety associated with sexual behavior and sexual performance, while simultaneously teaching the partners what each finds pleasurable. The sensate focused technique is used to treat sexual arousal disorder symptoms as well as orgasmic disorder issues.
The sensate focus technique is a three step series. It is of key importance that both partners are comfortable with the step they are on before moving to the next step.
1. Step one is about touching sensations. It is not about sexual arousal or sexual intercourse. In this first step, each partner takes turns touching the other partner. These are sensual but not sexual touches. Genitals and breasts are off limits in step one.
2. In step two of the sensate focus technique, the partners are allowed to touch any part of the other’s body including the breasts and genitals. However, step two is still similar two step one in that the focus is to remain on the touching sensations, not on sexual arousal. Sexual intercourse is not allowed in step two.
3. In step three of technique, the partners are allowed to forgo taking turns and mutual touching is allowed. Once the couple is comfortable with the process of touching and being touched, this third step also allows sexual intercourse. Still, the focus on the sexual intercourse is to be on mutual enjoyment of sex, rather than orgasm.
Sexual Arousal Stats
According to the International Society for Sexual Medicine, studies investigating the prevalence of sexual arousal disorder find a prevalence of 13% and 24% (across genders). Studies investigating women specifically have produced a range of findings, some claiming 6% and others 28% of women suffer from sexual arousal problems.
When researchers adjust for life distress–which increases sexual problems–the prevalence of sexual arousal problems is reduced to only 3.3% for women aged 18 to 44, and 7.5% for women aged 45 to 64.
Not surprisingly, numerous studies have found that sexual arousal issues, statistically, increase with age.
Sexual arousal issues are not chronic. Duration varies, with one study reporting that 10% of women have problems for one month, 60% have problems lasting 1-6 months, and 30% have problems that persist beyond six months.
Thrive Boston Counseling and Psychotherapy is a Private Counseling Therapy and Coaching Practice in Cambridge, MA. We help couples with a variety of issues including couples communication, fighting, negotiating, and having a plan for the relationship.
For more information on sexual health related issues and to schedule an appointment with a Thrive Boston sex therapist, visit our Boston Sex Therapy page. Appointments scheduled within 24 hours.
[i] American Psychiatric Association, 1994
[ii] http://www.merck.com/mmhe/sec22/ch250/ch250f.html, retrieved 08/2008.