One of the most frequent sexual complaints for women is low sexual desire (Ellison, 2001).  And one common mistake couples make when trying to fix this or other sexual problems on their own is jumping to solutions without taking time to understand the reasons for the low desire, then putting a band aid on something that needs stitches. This quite often just leaves a scar.

Increasing sexual desire can be very simple but surprisingly low libido is one of the most difficult sex related issues to treat. This is because it is often just the symptom of other more complicated issues within the relationship or individual. Also there is rarely one single thing causing the low sexual desire.  Common causes typically fall into one or more of these four categories: Medical/Biological, Relationship, Emotional, and Societal.  And as you can guess there are many subcategories within these main categories.

This year let’s resolve to see the value of a satisfying sexual relationship. Most long term couples experience mismatched desire at one time or another. It’s common, it’s fixable – it doesn’t need to be a relationship death sentence – but it’s an important piece to maintaining a satisfying long term relationship. Sex is important! Low sexual desire has a negative impact on sexual and relationship satisfaction (Bridges & Horne, 2007; Davies, S., Katz, J., & Jackson, J.L. 1999; Mark 2012; Mark & Murray 2012).  So here are some ideas on where to start.

Doc – just give me a pill!

Sure low sex drive can be medically driven, for example medication, in particular, birth control pills, menopause, pregnancy, childbirth, sexual pain, depression, long-term illness, etc. can all contribute to low sex drive. Seeing a medical doctor to rule out a medical cause to low sex drive is important to do before starting sex therapy. One other obvious reason for low sex drive is a lack of self-care and too much stress. Women in particular are known for sacrificing their self-care for the care of their families. Not paying attention to what our bodies need and letting stress build up to an unmanageable state is not good for our partners or our children and commonly results in lowered libido. 

Also, many people come into sex therapy hoping that their sexual issues are hormonally driven and they are hoping a pill will fix it. In most cases it’s just not as simple as a magic pill. Even magic pills for men haven’t solved erectile dysfunction. This is because our sex drive is primarily psychologically and emotionally driven. Slow down and listen to your body for a minute – it might tell you something. 

When sex isn’t satisfying…duh

First and foremost, if the sex you have been having is boring or unsatisfying then of course your desire for sex is going to decrease. To want sex the sex needs to be worth wanting. Communicating what you want and need in the bedroom is essential to having a satisfying sexual experience and if you are unable to do that, then ultimately your body will stop desiring something in which it experiences no pleasure. Also, the predictability of sex in long term relationship often squashes sexual desire so breaking out of routine and creating new sexual experiences that are fun and creative can be a good place to start when predictable sex is the main cause of the low desire.

Most of us were not raised in families where it is common or comfortable to talk about sex and sexuality so talking about what we want sexually or our turn-ons in the bedroom can be a daunting task. Many couples expect their partners to be able to read their minds when it comes to sex, feelings, and expectations and this is just not possible. Everyone has different desires, turn-ons and turn-offs. If you want sex to be good you have to be an active participant in creating that. Listing your turn-ons and offs and sharing them with your partner can be a good starting point for opening up communication about sex. Sometimes couples are not surprised by what is on the list but in most cases there is something learned and gained from communicating openly about what we want in bed and what turns us on. For detailed instructions on this activity go to www.talksexwithliz.com or click - “here”. 

When relationship problems are to blame

Probably the most common factor contributing to low sexual desire is relationship problems. Time and time again, studies show that if either partner is not getting their needs met outside of the bedroom it is affecting what’s happening inside the bedroom (Mark & Murray 2012).  Sometimes it is related to general relationship issues like communication, empathy, or feeling understood or respected. Sometimes it’s more directly related to feeling wanted, desired, loved in ways that are related to intimacy. Talking about turn-ons and offs is not going to fix this problem. Working out relationship glitches is where to start in these cases. This is where talking to a therapist is highly encouraged. 

Do you even know what you like?

Lack of sexual awareness could also be the problem. We are taught in school how to get a job, go to college, contribute to society, and maybe even how to cook. Most of us are taught by our parents how to have good manners, and act in alignment with our family values. But most of us are not taught the real facts about sex, sexuality, or sexual satisfaction, and some discouraged from exploring our own sexuality.

In therapy having clients share their turn-ons and offs with a partner when they don’t even know them themselves gets us nowhere. Many clients say they’ve never had a sex talk with their parents and that they learned about sex from movies, porn, and their peers. Movies teach us that couples always orgasm at the same time, sexy people have no body fat, and that the most satisfying sex is when the male pushes the woman against the wall and is able to hold her there without his thighs giving up. Porn teaches us that men last 40 minutes or more before they orgasm and women mostly like sex when it’s hard and rough. Peers teach us, well, not much from what I can tell. None of this is accurate and creates unrealistic expectations that often lead to negative sexual experiences. Most of this just makes us feel inferior or confused when it comes to sex. This is also where talking to a sex therapist or becoming sexually literate can help. 

Negative Sexual Schemes  

Some people have very negative beliefs and views about sex, intimacy, and even their own bodies. Of course this affects their comfort with sex and being sexual. These schemas can be driven by things learned growing up such as, sex is dirty/unsanitary, good girls don’t enjoy sex, or moms/dads aren’t sexy or shouldn’t appear sexual. Or things learned in movies, media, and advertising such as people are only sexy if they look a certain way, loving sex is not as satisfying as new less intimate sex, or sex after marriage is boring. The list goes on and on. 

Sexual trauma can also lead to negative sexual schemas that are complicated and often misunderstood by the general public. While people rarely logically believe the sex negative views they learned growing up, they often still carry those with them and haven’t figured out how to rewrite the schemas to something that is more sex positive. This can take time and direction. Randomly trying to change our negative sexual schemas without guidance can result in more challenges. There are lots of good books out there that I recommend to clients in addition to therapy that can be helpful for this. (See book list below). 

Think Sexy Thoughts

Bottom line – think sexy thoughts. While this is what sexual satisfaction frequently comes down to, it often takes a while and some work. Watching sexy movies, reading erotica or sexy material is a great way to help stimulate fantasy and sexy thoughts. Moving past old negative sexual schemas and creating new positive ones will be part of the work.  Obviously changing our thoughts isn’t easy – if it was, sex and relationship therapy would be unnecessary. Creating a sexual identity that empowers your sexuality is a great place to start. A lot of people have identities related to their careers or family life but few have an identity as a sexual being. What is your sexual identity? If you have no idea, then maybe that’s where you can start.

Often much of the effort that will go into increasing your sexual desire will be overcoming one of the hurdles mentioned above (relationship problems, negative sexual schemas, lack of sexual awareness, boring sex). Because there are usually a number of issues contributing to the unsexy thoughts that people are stuck in. Improving sex drive and relationships is much more complicated than just changing our thoughts. Often times to get to the point of being present and thinking sexy thoughts, behavioral change is needed by both partners. Behavioral change within and outside of the relationship can include getting over past resentments, feeling understood, getting our general needs met, or moving past individual hang ups or trauma. These are different for every couple. Most couples have tried a number of things before they come in to sex therapy. And unfortunately much of what they have tried has made them feel worse about their sex drive or sexual relationship.

So for 2015, take some time to explore the reasons for your low desire. Are you just bored or unsatisfied with your sex life or do you have unreasonable expectations about what it is supposed to look like? Are you ignoring the problems in your relationship that result in a disconnect with your partner or holding onto resentment that you can’t get past when attempting to be intimate? Or do you have some trauma that you have never taken the time to process and heal from that impairs your ability to truly be intimate with your partner? Lastly, have you considered any medical causes and seen a medical doctor to rule it out?

If you don’t know where to begin there are lots of books out there that can be a good starting point. See the reference list below. 

Now go have sex!

Liz Dubé is a Certified Sex Therapist and Licensed Marriage and Family Therapist. At her private practice in Long Beach and Huntington Beach, in Southern California, Liz specializes in helping individuals and couples thrive in their intimate relationships, overcome sexual difficulties, and create empowering sexual identities. Liz also speaks to groups on creating more satisfying sexual relationships and blogs regularly at www.TalkSexWithLiz.com. Liz has two children and has been married for 16 years.

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Bridges, S.K., & Horne, S.G. (2007). Sexual satisfaction and desire discrepancy in same sex women’s relationships. Journal of Sex & Marital Therapy, 33(1), 41–53. 

Davies, S., Katz, J., & Jackson, J.L. (1999). Sexual desire discrepancies: effects on sexual and relationship satisfaction in heterosexual dating couples. Archives of Sexual Behavior, 28(6), 553–567.

Ellison, C.R. (2001). A research inquiry into some American women’s sexual concerns and problems. Women & Therapy, 24(1–2), 147–159. 

Goldstein, A., & Brandon, M. (2004). Reclaiming desire: 4 keys to finding your lost libido. Emmaus, Pa.: Rodale. 

Mark, K.P. (2012). The relative impact of individual sexual desire and couple desire discrepancy on satisfaction in heterosexual couples. Sexual and Relationship Therapy, 27(2), 133–146.

Mark, K.P., & Murray, S.H. (2012). Gender differences in desire discrepancy as a predictor of sexual and relationship satisfaction in a college sample of heterosexual romantic relationships. Journal of Sex & Marital Therapy, 38(2), 198–215. 

McCarthy, B., & McCarthy, E. (2003). Rekindling desire: A step-by-step program to help low-sex and no-sex marriages. New York: Brunner-Routledge.

Mintz, L. (2009). A tired woman's guide to passionate sex: Reclaim your desire and reignite your relationship. Avon, Mass.: Adams Media ;.

Schnarch, D. (2002). Resurrecting sex: Resolving sexual problems and rejuvenating your relationship. New York: HarperCollins.