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Fear, indifference or other difficult emotions towards sex can sometimes be misinterpreted as lack of sexual desire. However, lack of sexual desire refers to loss or reduction of sexual needs, interest, motivation or libido. It is influenced by mental, physical and external factors, particularly life situation and relationships.

Diagnostic criteria for lack of sexual desire and its main causes

The key criteria are loss or reduction of sexual interest, sexual thoughts and fantasies, sexual receptivity (responsive desire) and/or the desire to feel aroused – and the subjective suffering arising from these. These may be influenced by:

  • Relationship factors and life situation (relationship crises, relationship status, fatigue, stress, traumatic experiences and other unaddressed mental factors related to sexuality)
  • Learnt models, values and attitudes regarding sexual behaviour (what you’re allowed to do/hope/want/express, cultural factors, media, family, mental obstacles or stimuli)
  • Physical, medical and medication-related factors (physical and mental conditions and symptoms, hormonal factors, sex pains, adverse effects of medicines)
  • Emotional obstacles and restrictions (fear of sexual inadequacy and ability, worries about inadequacy of the genitals, difficulty achieving an orgasm, difficulty trusting others)

Self-care of lack of sexual desire

You can think about how important sexuality and sex are to you based on your hopes, needs and experiences: Is the lack of sexual desire always present or does it depend on the situation?

Identifying situation-dependent factors can activate the changes required to revive desire. Would you like to feel more desire but can’t revive it? Or don’t you even want to feel it? If you’d like to feel more desire, reflect on the above criteria and background factors. Which ones do you recognise? Can you influence them? Where can you get help and support if required? If you don’t want to feel desire, it may be because of relationship problems, unprocessed trauma or issues with identifying and accepting your sexual orientation or the forms of sex you like.

Discussing with your partner or others close to you often helps you to abandon assumptions and beliefs that put pressure on sex. Literature and podcasts can provide you with tips, facts and peer support. Key factors of self-care and reviving and maintaining desire include the ability to say NO and to be heard and respected by your partner if the desire is not there, as well as always having voluntary, consent-based sex.

When should you seek treatment?

You should seek treatment especially if the lack of desire significantly impairs your quality of life, causes anxiety, influences your relationships or has developed without an apparent reason.

When assessing your lack of desire, it’s important to examine whether it’s primary or secondary in nature. Was the lack of desire preceded by problems such as depression or a relationship crisis, or did the lack of desire and worry about the situation trigger these problems?

Seeking treatment is important as a lack of sexual desire is often due to an undiagnosed, untreated physical or mental condition or syndrome. After an assessment period, you can receive treatment via the general and mental health services and/or via sex counselling.

FSHS Psychologist / 22 April 2022

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