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 persistent loss of interest in sex, and low or no libido, you may have desire disorder.
Also called a hypoactive sexual desire disorder (HSDD), this condition is very common. 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 help you treat desire disorder and have a more satisfying sex life.
What’s a Desire Disorder?
Desire disorder is a persistent lack of physical desire for sex and a lack of sexual activity, or even sexual thoughts or fantasies that causes you distress. For men, desire disorder symptoms must persist for at least 6 months.
Some people may also have sexual aversion disorder (SAD), where they feel an aversion to any sexual contact with their partner.
How Do You Know if You Have a Desire Disorder?
Your doctor can diagnose your desire disorder based on your symptoms. They’ll ask you if:
- 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 relationship or love life
Symptoms of desire disorder may include:
- Low libido
- No sexual fantasies or sexual thoughts
- Avoiding sex or genital contact with your partner
- Distress at the thought of having sex
Distress about the lack of libido and sexual activity is the most important sign. If your lack of interest in sex doesn’t concern you or your partner, then it’s not a disorder.
Your doctor will rule out any medical or substance-use causes. They may also determine if your lack of desire is due to mental health problems or a new sexual relationship.
Men who have desire disorder may see their doctor because they have erectile dysfunction (ED). Your doctor can test you for low testosterone (low T), which can cause a drop in sexual desire. Men may feel more comfortable talking to their doctor about ED than a loss of libido, because of the common stereotype that men never lose their desire for sex.
Who Gets Desire Disorder?
Desire disorder affects both women and men, and people of any gender, sexuality, or age. However, it’s more common in women than men.
Some estimates say that 1 in 10 women have HSDD, and as many as 32% of women and 15% of men may experience a loss of desire lasting several months. SAD is much rarer.
What Causes Desire Disorder?
Many common physical or emotional conditions could cause desire disorder:
- Chemical imbalance: Levels of brain chemicals called neurotransmitters may be off, which disrupts sexual desire and function.
- Mental health: Anxiety, depression, stress, body image issues, low self-esteem, or past sexual or physical abuse
- Relationship problems: Fighting with your partner, lack of trust in your partner
- Sleep problems: You’re too tired for sex
- Hormonal: Low levels of sex hormones like testosterone or thyroid hormone, or menopause in women
- Medication side effects: Antidepressants, anti-anxiety medications, pain treatments, antipsychotic medications, chemotherapy, blood pressure medicine, hormone-suppressing cancer drugs
- GI illnesses: Inflammatory bowel disease (IBD), Crohn’s disease, ulcerative colitis (UC), or the medications used to treat these diseases
- Other physical illnesses: Diabetes, cancer, urinary incontinence, multiple sclerosis (MS), heart disease, thyroid disease, Addison’s disease, Cushing’s disease, temporal lobe brain lesions, kidney failure, stroke, HIV
- Motherhood: Pregnancy, labor, and delivery, or breastfeeding
- Aging: Some people lose their libido or desire to have sex in older age
Hysterectomy doesn’t cause desire disorder in women, according to research. In fact, women who have a hysterectomy may have the same or even better sexual desire and function after their surgery.
What Can You Do to Treat Desire Disorder?
Talk to your doctor if you think you have desire disorder symptoms. They can suggest or prescribe treatments or refer you to sex therapist or relationship counselor.
Here are some possible treatments for desire disorder:
Kegel exercises. Both women and men can improve blood flow, sensation, and sexual function in their genitals with kegels or pelvic floor exercises. Your health care provider can teach you how to locate the right muscles, then squeeze and relax them in repetition. Aim to do sets of 10-15 kegel exercises three times each day.
Healthy lifestyle. 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.
Try sex play alone or with your partner. Masturbation, experimentation with sex toys or vibrators, watching porn, or reading erotic material may help you increase your desire for sex.
Therapy may treat desire disorder caused by mental health or relationship problems:
- Psychotherapy, couples therapy, or sex therapyallow you to talk about your desire disorder 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) can treat desire disorder 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. CBT may also include masturbation to help men maintain an erection until ejaculation.
Medications may 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) is a pill taken once a day. Flibanserin rebalances neurotransmitters, or brain chemicals, to restore sexual excitement and desire.
- Bremelanotide (Vyleesi) is self-injected under the skin at least 45 minutes before you plan to have sex. It improves sexual desire and eases the distress associated with desire disorder.
Hormone treatments may improve libido and sexual function in women and men:
Estrogen. For post-menopausal women, estrogen creams, rings, or tablets inserted into the 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 desire disorder may benefit from testosterone in gel, skin patch, injection, or slow-release tablets (Testorel). Extra testosterone may help men increase sexual desire or thoughts. Testosterone has been studied in post-menopausal women, and it’s been shown to improve desire, fantasy, orgasm, and sexual satisfaction.
Other medications. Stimulants like amphetamine or the antidepressant buproprion, a norepinephrine and dopamine reuptake inhibitor (NDRI), could increase sexual desire.