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Inhibited sexual desire (ISD) is a medical condition with only one symptom: low sexual desire. A person with ISD seldom, if ever, engages in sexual activities. He or she does not initiate or respond to a partner’s sexual overtures. This condition is also called hypoactive sexual desire disorder, sexual aversion, or sexual apathy.
ISD is one of the most common problems couples face today.
ISD can be seen as either a primary or a secondary condition. For treatment purposes, this is an important distinction.
Primary: The person with ISD has never had sexual desire.
Secondary: The person with ISD began a relationship with normal sexual desire, but later became disinterested.
ISD can also be understood as a relationship issue, which helps to guide medical or psychological treatment. This includes:
Situational: The person with ISD has sexual desire for others, but not for his or her partner.
General: The person with ISD has no sexual desire for anyone.
There is no true normal range for sexual desire because it naturally fluctuates throughout life.
Major life changes can affect our sexual desire. These include:
People seek help when ISD puts stress on their relationships. However, the problem is not always a case of ISD. One partner may have an overactive sexual desire. When this happens, it can:
ISD is often an intimacy issue. Common relationship factors that can reduce sexual desire include:
People who are most at risk of developing ISD have experienced trauma (incest, rape, or sexual abuse), or were taught negative attitudes about sex by their families while growing up.
There are many medical and psychological factors that can also hamper sexual desire, including:
Certain diseases can affect libido (sexual desire). The most common of these are:
Women who have had breast or vaginal surgery may experience sexual dysfunction, poor body image, and inhibited sexual desire.
Erectile dysfunction (ED) is a man’s inability to achieve an erection. This can cause ISD in the man, who may feel he is a failure sexually. Perceived failure in both men and women (failure to orgasm, for example) can cause the individual experiencing the dysfunction to have ISD.
Erectile dysfunction is not caused by aging. It can be a sign of medical problems, including:
In the majority of ISD cases, medical conditions are less important than each partner’s attitude about sexual intimacy.
You may be diagnosed with ISD if you experience low sexual desire and it causes you distress personally or in your relationship.
Your doctor can look for causes of ISD and recommend strategies that may help. After questioning you about your medical history, the doctor may prescribe some or all of the following tests:
After treating any medical conditions, your doctor may recommend evaluation by a sex therapist or psychiatrist, either individually or as a couple.
Psychological and sexual counseling are the primary treatments for ISD. Many couples first need marriage counseling to improve their nonsexual relationship before addressing the sexual component directly.
Communication training is one option that teaches couples how to:
Sexual counseling will help couples learn how to:
Some people may need individual counseling if their ISD stems from sexual trauma or sexual negativity learned as a child.
Male problems, such as impotence or delayed ejaculation, can be treated in private counseling or with drug therapy. Drugs such as Viagra can help with ED. But it is important to keep in mind that these drugs only permit erections; they do not cause them.
A woman’s sex drive is greatly influenced by the hormones testosterone and estrogen. Small doses of estrogen delivered via a vaginal cream or a skin patch can increase blood flow to the vagina. However, long-term estrogen therapy has increased risks of breast cancer and heart disease. Female testosterone therapy may also help, but it is not yet approved by the Food and Drug Administration for treatment of female sexual dysfunction.
Testosterone side effects include:
Certain lifestyle changes can have a positive effect on sexual desire while also improving overall health.
ISD is often successfully treated through couples’ therapy. However, treatment can be more challenging for men—both in counseling and drug therapy.
Counseling can be a lengthy process, but it can enhance a couple’s attitude towards each other and improve their general outlook on life.
Written by: Sandy Calhoun Rice
Published on Jul 27, 2012
Updated on Feb 15, 2013
Medically reviewed by George Krucik, MD
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