What to Know About Desire Disorders
Everyone may have times when they’re in the mood for sex, and other times when they’d rather not. But if you have a long-lasting or recurring lack of interest in sex and this causes you distress or affects your relationships, you may have a desire disorder.
Doctors call it female sexual interest/arousal disorder or male hypoactive sexual desire disorder (MHSDD), depending on your sex. It’s common, particularly in women. It may be a problem that only happens for a while, or it may be something you’ve dealt with for life. Your doctor or therapist can treat desire disorders and help you have a more satisfying sex life.
Symptoms of Desire Disorders
Symptoms of desire and arousal disorders may include:
- Low or no libido
- No sexual fantasies or sexual thoughts
- Avoiding sex or genital contact with your partner
- Distress at the thought of having sex
- Trouble getting aroused, even during sexual activity
- Vaginal dryness or pain during sex
- Less or no pleasure or orgasms during sex most of the time
Before diagnosing a desire disorder, your doctor will ask you if:
- You were satisfied with your level of desire at one time
- Your desire is lower than it was in the past
- Your lack of desire causes you distress
- Your lack of libido or sexual activity causes problems in your relationships or love life
Distress about the lack of libido and sexual activity is an important symptom. If your lack of interest in sex doesn’t concern you or your partner, then it’s not a disorder.
Men who have MHSDD may first see their doctors for erectile dysfunction (ED), which is trouble getting and keeping an erection. The two conditions aren’t the same, though you can have both at the same time. ED affects only erections, not desire.
Who Gets Desire Disorders?
Desire disorders can affect people of any gender, sexuality, or age. But they're more common in women (including trans women, according to some research). Some estimates say that 1 in 10 women have one, and as many as 32% of women and 15% of men may have a loss of desire lasting several months.
Desire Disorder Causes and Risk Factors
Many common physical or psychological conditions might cause or add to a lack of sexual desire:
Mood disorders. Anxiety, depression, stress, body image issues, or low self-esteem can all affect desire.
Sleep disorders. These can make you feel too tired for sex.
Medication side effects. Loss of desire may be a side effect of antidepressants, anti-anxiety medications, anti-seizure drugs, pain treatments, antipsychotic medications, chemotherapy, blood pressure medicine, medications for some digestive diseases, and hormone-suppressing cancer drugs.
Neurological disorders. Levels of brain chemicals called neurotransmitters may be off, which can disrupt sexual desire and function. This may happen because of multiple sclerosis (MS) or Parkinson's disease.
Digestive illnesses. Inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis (UC) can all affect desire.
Other physical illnesses. Conditions such as diabetes, cancer, urinary incontinence, heart disease, thyroid disease, Addison’s disease, Cushing’s disease, temporal lobe brain lesions, kidney failure, stroke, and HIV can affect sexual desire.
Some life situations also play a role:
Relationship problems. Fighting with your partner or a lack of trust in them can lead to a desire disorder.
Motherhood. Pregnancy, labor and delivery, or breastfeeding can affect sexual desire. But a hysterectomy doesn’t cause desire disorder, according to research. In fact, those who have a hysterectomy may have the same or even better sexual desire and function after the surgery.
Aging. Some people lose their desire to have sex in older age. Studies show that the effect of age on desire is complex in women. Older women may have vaginal dryness and pain during sex, which can affect desire.
Fatigue or stress. These issues can make you less interested in sex.
Desire Disorder Treatments
Talk to your doctor if you think you have desire disorder symptoms. They can suggest or prescribe treatments or refer you to a therapist or counselor. If they suspect your desire issues are a side effect of medication, they can try different drugs or different dosages.
Here are some ways to treat or manage desire and arousal issues:
Therapy
Various types of therapy may treat desire disorders caused by mental health or relationship problems:
Psychotherapy, couples therapy, or sex therapy. These therapies allow you to talk about your symptoms with a professional who can help you address mental health issues. Your therapist may assign sexual foreplay or sexual techniques to help you and your partner have a more satisfying sex life.
Cognitive behavioral therapy (CBT). This may be used to treat desire disorders caused by depression, anxiety, or other mental health conditions. Your therapist helps you focus on negative thoughts related to sex and learn to deal with them.
Medications
Certain drugs and hormone treatments can help treat desire disorder symptoms, increase your libido, or improve sexual function.
Two newer medications are approved by the FDA to treat desire disorder in premenopausal women:
- Flibanserin (Addyi). This is a pill you take once a day. Flibanserin rebalances flibanserin neurotransmitters, or brain chemicals, to restore sexual excitement and desire.
- Bremelanotide (Vyleesi). You inject this medication under your skin at least 45 minutes before you plan to have sex. It improves desire and eases the distress linked to desire disorder.
Other medications. Stimulants like amphetamine or the antidepressant bupropion, a norepinephrine and dopamine reuptake inhibitor (NDRI), could increase sexual desire. A hormonal vaginal insert called prasterone (Intrarosa), and pills called ospemifene (Osphena) may help if vaginal dryness and painful sex affect your desire levels.
Estrogen. If you’ve been through menopause, estrogen creams, rings, or tablets inserted into your vagina can improve muscle tone, flexibility, blood flow, and lubrication for more comfortable or pleasurable intercourse. Estrogen may also make your clitoris or vagina more sensitive and improve arousal.
Testosterone. Men with low testosterone may benefit from testosterone in gel, skin patch, injection, or slow-release tablets. A boost in testosterone may help increase sexual desire or thoughts. Testosterone has also been studied in postmenopausal women, but results are inconclusive. While the FDA hasn’t approved testosterone treatments for lack of desire in women, doctors sometimes prescribe them.
What about supplements?
Some early studies have shown that supplements containing the hormone dehydroepiandrosterone (DHEA) could increase sex drive in older women. But we need much more research into its safety and effectiveness. Some people use herbs like yohimbe and ginseng root to try to improve desire, but there’s no scientific evidence that they work.
Lifestyle changes
Certain home remedies and healthy habits might help boost desire levels, too.
Adopt a healthier lifestyle. Regular exercise can improve your physical fitness, mood, and energy levels. If stress has dampened your desire, find ways to relax, including breathing exercises, meditation, or just getting more sleep. Cut back on alcohol, don’t smoke, and stop taking drugs.
Prioritize communication. Talking openly with your partner, including about sex, helps you feel more connected. That can help improve your relationship as well as sexual desire.
Try sex play, alone or with your partner. Masturbation, experimentation with sex toys or vibrators, trying new positions, watching porn, or reading erotic material may help increase your desire for sex.
Experiment with lubes. Lubricants can help make sex easier and less painful, especially after menopause.
