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ask dr-robert ask psychologist todos santos ask psychologist dr robert saltzman

Hi Dr. Robert,

I am a 21 year old male that is really confused about my current involvement with my partner. We have been dating for three years, for the most part of the three years of the relationship sex was great. We did it often and there was no problem. However, now when we have sex it feels like I am pushing her into it to get her to do it about once a week. She has admittedly told me she does not desire sex and would just rather do other things. I am worried because her mother actually has problems with sexual desire as well. Is there something I should be doing or not doing? Any advice is greatly appreciated.


ask dr-robert ask psychologist todos santos ask psychologist dr robert saltzman

Dear Brian--

Hypoactive sexual desire disorder (HSDD), more commonly referred to as low sex drive or low libido, is the most common sexual problem in women, while in men it is extremely uncommon, as even men who suffer from erectile difficulty rarely lack interest in sex. HSDD is defined by the American Psychological Association as a deficiency or absence of sexual fantasies and lack of desire for sexual activity, but this definition is vague because interest in sex varies so greatly among women.

According to a recent survey conducted at the University of Chicago, 37% of women think about sex a few times a month and only 33% think about sex twice a week or more. This means that almost one-third of women think about sex rarely if at all! Another study, conducted at Hebrew University of Jerusalem found that variations in sexual interest and desire have a genetic basis, and those researchers even believe that they have found a particular DNA sequence that seems to be responsible for these variations.

What these studies tell us in the present case is that your girlfriend's lack of interest in sex is neither uncommon, nor can we say that it has a psychological basis since it may be genetic in origin. That said, there are many factors involved in low sex drive, and these vary widely from one individual to the next, so it would not be wise simply to write off her low sex drive as genetic. Many possible psychological causes can lessen a woman's sexual appetite, and certain health conditions and medications also may affect a woman's sexual desire. Stress, depression, or anxiety disorders often interfere with sexual desire, but so can some of the drugs used to treat these conditions. Many antidepressants--in particular Paxil, Prozac, Zoloft--have side effects that often have a negative impact on women's libidos. Wellbutrin is a possible alternative, as it does not seem to cause sexual problems (Remeron, Serzone, and Luvox also may not affect sex drive). In addition, birth control pills, mood stabilizers, tranquilizers and other medications have been shown to decrease libido.

It is harder to write about the psychological causes of HSDD, but a few possibilities are unhealthy sexual attitudes learned in childhood, poor body image, past sexual abuse, rape, latent lesbianism, or relationship problems with the woman's partner. This last factor, which comes up often in psychotherapy, is one that many men fail to understand, since even if upset or angry with their partners, most of them still continue to desire sex, whereas many, if not most, women desire sex only in the context of a satisfactory relationship. In other words, men and women in general seem to experience sexual desire in two completely different ways. Most women see love, emotional intimacy and involvement as a goal, while most men see sexual activity itself as the goal. Perhaps this is one reason why your girlfriend's present lack of interest in sex is so puzzling to you.

Now you say that lack of sexual desire was not a problem at the beginning of your relationship, but I wonder if that was also true for your girlfriend. In other words, perhaps she never had much sexual desire, but was willing to participate in sex with you because, as I said, emotional intimacy was her goal, and sex just a means to achieve that goal. Now that the relationship has gone on for some time now, it may be that she is less intent on establishing that intimacy, and so less interested in being sexual. Please understand that, not knowing your girlfriend, I am just speculating here.

In answer to your question about what you should do, I suggest that you have a talk with your girlfriend about this situation. You must be careful to do this in a loving, and non-judgmental way, and be particularly careful not to blame her in any way. The purpose of this talk would be to find out if your emotional relationship is somehow unsatisfactory to her, which, as I said, is a common psychological cause of low libido. If she seems happy enough with your relationship, the next step would be a complete physical exam to rule out such physical causes as anemia or hormonal disorders. If these are ruled out, your girlfriend might consider speaking with a psychologist. However, if her lack of interest in sex really is genetic (her mother's situation seems suggestive of this), no amount of psychotherapy will be able to increase her libido (although it might help her to accept herself as she is).

I am sorry to say this to you, but if, after following the plan I have suggested, your girlfriend continues to be uninterested in sex, you may have a difficult decision to make.

Be well.

ask dr-robert ask psychologist todos santos ask psychologist dr robert saltzman

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