The sex drive varies greatly from person to person, and a temporary reduction in sexual interest ( decreased libido ) is common. It is often linked to transient problems such as stress . In other cases, however, the decrease in sexual desire represents a symptom of real pathologies.
The reduction of libido can affect both men that the women and can put at risk the personal stability and torque. It is in fact closely connected to arousal and a satisfying sex life.
Symptoms of decreased sexual desire
The decline in libido is manifested by a decrease in the frequency and intensity of the sexual impulse, both spontaneous and evoked by sexual stimuli. The reduction is greater than what might be expected based on the subject’s age and the length of the relationship.
The desire is linked to the health conditions and lifestyle of the subject, to his hormonal levels and to the intake of certain drugs as well as being influenced by various psychological factors (bodily experiences and the presence of sexual images and fantasies, etc.). The libido is a condition characterized by a deficiency or absence of sexual fantasies and desire. It is a situation that creates discomfort and suffering both in those who live it and in the partner and can be specific or generalized to several partners.
The desire decline can manifest itself in two different disorders: The disorder hypoactive sexual desire and sexual aversion disorder. In the first case, the subject has little or no sexual fantasies and little interest in sexual activity. However, it does not reject intimacy as in the case of sexual aversion where the individual experiences a true phobia with avoidance of sexuality.
Causes of decreased libido
The causes of decreased libido can be psychological or organic. It is necessary to take a correct sexual history to understand the nature of the problem.
Organic and pharmacological causes
The most common physiological reasons can be traced back to hormonal imbalances with decreased testosterone production, increased prolactin production and hypothyroidism. The decrease or absence of sexual desire can also depend on numerous chronic diseases, such as uremia, liver failure and various tumors or neurological causes (eg diabetes, multiple sclerosis, spinal cord dysfunction).
Declining sexual interest can also be related to alcohol and drug abuse (eg cocaine , opioids and heroin ). Drugs that affect desire include antihypertensives, neuroleptics , antiepileptics, and some antidepressants (particularly selective serotonin reuptake inhibitors).
Sometimes, even taking oral estrogen therapy and hormonal contraceptives can cause a decrease in libido.
Psychological and physiological causes
Having negative thoughts about intimate relationships (e.g. performance anxiety , fear of unwanted pregnancy or illness) as well as depression and relationship problems and / or unrewarding experiences (for example, due to lack of sexual skills or poor communication of needs) can affect sexual desire .
In women, the decrease in libido can be associated with painful conditions during sexual intercourse (dyspareunia) and inability to penetrate due to involuntary contraction of the vaginal wall ( vaginismus ).
Furthermore, the reduction of sexual desire can be linked to certain circumstances, such as phase of the menstrual cycle, pregnancy, menopause, quality of the couple’s relationship and dissatisfaction with one’s body.
Pregnancy and menopause
In pregnancy, the maintenance of libido is subjective: some women express more desire and continue to have intercourse, while others prefer to reduce or cancel the frequency of intercourse. Often the libido becomes more difficult to recover in postpartum when the new mother needs great support.
Furthermore, with hormonal variations and the new and constant commitment to care for the newborn, the risk of mood disorders and loss of desire increases .
In regards to menopause, systemic estrogen therapy started on time can improve mood and help maintain sexual sensitivity and vaginal lubrication. These benefits can increase sexual desire and arousal.
The man, on the other hand, as a consequence of a drop in libido could manifest a problem of erectile dysfunction . If not addressed, the decrease in desire can negatively affect the psychological environment and the emotional relationship of the couple.
Treatment of reduced sexual desire
It may happen that over time it comes to not cultivate complicity in the couple with consequent relational distancing. This affects intimacy and the lack of stimuli affects desire.
Knowing the reasons for the loss of libido can help you understand what behaviors to adopt to implement the desire. Care must be taken not to neglect mutual feelings and needs in order to maintain pleasure in sexuality as well.
Before the problem worsens and interferes with the quality of life and the couple’s relationship, you should proceed with an evaluation by your doctor. Based on the cause, doctors may suggest psychotherapy, prescribe a different drug, or recommend supplemental testosterone therapy.
Identify the primary causes of the disorder
It is necessary to proceed with a general, sexological and pharmacological anamnesis completed by a careful physical examination and the prescription of some hormonal dosages. It is necessary to frame the patient from an endocrinological point of view and to be able to exclude an organic cause of the lack of libido . Then eventually proceed with an adequate therapy that intervenes on the causes that have determined it.
In some cases, when the problem is a symptom of a relational or psychological disorder, an individual and / or couple psychotherapeutic path is recommended . It is possible that the person experiences a drop in libido, due to emotional and relational conflicts such as:
- Lack of addictive desire and poor sexual skills of the partner (low sexual stimulation and little variety).
- Decreased physical attraction towards the partner.
- Difficulty tolerating psychological and / or physical intimacy in one or both partners.
- Couple conflicts (e.g. power conflicts and passive-aggressive relational dynamics)
- Difficulty combining feelings of love with sexual desire. Some people may be with a partner they love but cannot value sexually.
- Work problems (stress, low gratification, etc.). However, even the lack of a job can lead to this result especially in humans who base their self-esteem on productivity.
Coping with decreased libido
If the cause is of psychological origin, various therapies, including cognitive-behavioral therapies , can help resolve the problem.
If there are elements that limit trust, attraction and emotional intimacy between partners, the couple must be informed that the latter is a physiological need for a woman’s sexual response and must be increased.
Improving the relationship, as well as identifying what sexually stimulates the couple can help with the decrease in libido . It is also helpful to provide instructions on appropriate stimuli. Women may desire non-physical, non-genital physical stimulation and non-penetrative genital stimulation.
It may be necessary to point out to your partner that women appreciate taking time for foreplay and general attention to their needs to be ready for sexual activity.
Some couples come to seek out new techniques or different activities (use of fantasies and the aid of erotic toys) to find more sexual stimuli.
Psychological therapy
A psychological therapy generally involves a psychoeducation phase to increase knowledge of the sexual anatomy and the sexual response cycle. In addition, the therapist can use relaxation techniques to reduce the subject’s anxiety such as, for example, diaphragmatic breathing and Jacobson’s progressive muscle relaxation.
Some people find self-awareness therapy ( mindfulness meditation ) beneficial , which consists of learning to focus on what is happening in the present.
Depending on what emerges from a careful evaluation of the case, in particular according to the causal and maintenance factors of the disorder itself, a treatment plan is set up.
In cognitive-behavioral treatment we proceed with a phase of cognitive therapy that aims to restructure dysfunctional beliefs about sexuality (examination of beliefs and myths about sexuality) and a moment of behavioral therapy that is mainly based on a gradual exposure to sexual stimuli (sensory focus) without a judgmental approach and without setting performance goals.
In general, it is good practice to bring the decrease in sexual desire to the attention of your doctor or a specialist (sex counselor or psychotherapist) before it becomes a problem that can affect individual and couple life.
