Low sexual desire

Almost one in two people experiences some form of sexual issue. Sometimes the issue is of a biological nature, as is the case when there is a spinal cord injury for example. Other times it can be of a psychological nature such as when we experience high levels of anxiety. The source of the issue can also be of a social nature where perhaps some personal beliefs don’t align with external expectations, such as in the case of a couple with different religious beliefs and therefore expectations when it comes to sexual activity.

One of the most common issues is low sexual desire. To understand what low sexual desire means and its possible causes, we need to explore the biology of sex and the sexual response models. This will help provide the background of why it happens and define what can be done to get help if needed.

The biology of sex

All sexual activity starts in the brain. Our bodies or any part of our bodies, as erogenous as they might be, will not “feel” anything without our brains providing meaning to what is happening. The brain plays a major part in sexual functioning as it controls our cognition. The latter encompasses sensation (signals that we collect through our senses and send to the brain as pieces of information), perception (the process enabling a first level of filtering of the information received by the senses), attention (the process which provides focus on the information that matters) and memory (the process which encodes that information and captures it in our database of knowledge).

Sexual activity, at a biological level starts with our senses picking up information from the external environment and sending them to the brain. This information could be:

• visual cues such as a naked body or an erotic scene in a movie
• auditory cues such as the sound of voice, hearing certain words or listening to music
• touch cues such as a kiss, a hug, a caress
• olfactory cues such as the smell of a particular perfume
• taste cues such as the flavour of a nice chocolate cake

As this information makes its way to be fully understood, perception will give us a first emotional response. This triage stage will give us an indication of whether we like or dislike the information and will associate a first emotional response to it. For example, if we enjoy a kiss, we will feel pleasure or if touch becomes more forceful, we may feel pain.

The sensation process will pick up cues from all sources around us, this includes the location where we are, the lighting, and the various noises in the environment... Because the sensation process isn’t just collecting information relevant to the sexual activity, we need the attention process to focus on that particular topic. In turn, information which has gone through the attention process is sent to memory will form the basis of us being able to recall a pleasurable moment or a painful one when required or wanted.

Once the brain has made meaning of the information received, it will then send signals back to the body in response. If the brain feels pleasure and excitement, it will then release the necessary hormones to prepare our body for the physical response to having sexual activity. For example, and amongst other things, for male bodies individuals, it will get the cardiovascular system to engage to engorge the penis and trigger an erection whereas for female bodies individuals, it will trigger the lubrication process to enable the dilation of the vagina.

Imaging studies have shown the relevance of certain parts of the brain in connection with sexual activity. Sexual desire and orgasm are particularly influenced by the brain and the nervous system activity. For male individuals, achieving orgasm is possible with the shut down of the fear and vigilance centre (amygdala) whereas female individuals will need to silence their thoughts (part of the pre-frontal cortex) and emotion systems (part of the limbic system).

This highlights the complexity of sexual activity without issues. To enjoy sexual activity without issues, we need:

• our bodies to work well and respond as intended to the cues they receive, and
• our minds to be free from distractions or fears/anxiety.

This is clearly not easy to achieve as the factors which will make each person feel well in their bodies and their minds isn’t a standard formula.

Sexual response models

Over the years, studies have tried to understand the complexity of the sexual response, the steps in its cycle and what can cause it to not function as intended. The first model, described by Masters and Johnson in 1966, showed 4 stages: Excitation, Plateau, Orgasm and Resolution. This model was simple and mainly focused on the physical aspects of sexual activity. Although all people may experience these four stages, the intensity and duration of each stage may differ from individual to individual.

Later models introduced the idea of a psychological stage which precedes the Excitation stage originally identified by Masters and Johnson. In 2001, Basson introduced the idea of a circular model, rather than linear. This model acknowledged the complexity of female sexual response as it is affected by multiple psychological factors such as self-image, relationship satisfaction, or even prior sexual experience and their impact, for example. Basson recognised that female individuals may experience spontaneous desire for sexual activity, particularly in the early stages of a relationship, it then leads to a more nurtured form of desire in longer-term relationships where emotional closeness and intimacy are more likely to lead to sexual activity.

In 1985, Loulan introduced another step in the models of sexual responses which was Willingness or Desire for Desire. Willingness to engage in sexual activity is the first barrier to overcome and understand in the drive to bring back sexual activity in someone’s life.

What to do when experiencing low desire

As discussed above, there are various causes possible when experiencing low desire.

The first question to ask is perhaps whether there is a desire for desire, and if not, what could be behind this lack of willingness.

If willingness is not the issue, then exploring desire and what triggers desire through looking at the erotic mind will help identify areas which can be broken down and understood as part of our sexual blueprint.

Identifying any factors which are interfering with the sexual response is also important to explore as it will focus the energy on working on specific and manageable problems.

Psychosexual therapy or couples’ therapy when the issue manifests as part of a relationship, can help both an individual and/or a couple working through this exploration process, where expertise and knowledge will lead the journey of discovery. Sometimes, when the issue isn’t just psychological or social in nature, it may require additional support from other medical professionals.

Sex should be a pleasurable experience and is a fundamental human need, getting help when things aren’t working is a step towards a more fulfilled and happier life.