Sexual aversion; Sexual apathy; Hypoactive sexual desire
Treatment must be targeted to the factors that may be lowering sexual interest. Often, there may be several such factors.
Some couples will need relationship or marital therapy before focusing on enhancing sexual activity. Some couples will need to be taught how to resolve conflicts and work through differences in nonsexual areas.
Communication training helps couples learn how to talk to one another, show empathy, resolve differences with sensitivity and respect for each other's feelings, learn how to express anger in a positive way, reserve time for activities together, and show affection, in order to encourage sexual desire.
Many couples will also need to focus on their sexual relationship. Through education and couple's assignments, they learn to increase the time they devote to sexual activity. Some couples will also need to focus on how they can sexually approach their partner in more interesting and desirable ways, and how to more gently and tactfully decline a sexual invitation.
Problems with sexual arousal or performance that affect sexual drive will need to be directly addressed. Some doctors recommend treating women with either cream or oral testosterone, often combined with estrogen, but there is no clear cut evidence yet. There are studies underway looking at the possible benefit of testosterone supplementation for women with decreased libido.
Disorders of sexual desire are often difficult to treat. They seem to be even more challenging to treat in men. For help, get a referral to someone who specializes in sex and marital therapy.
When both partners have low sexual desire, sexual interest level will not be a problem in the relationship. Low sexual desire, however, may be a sign of the health of the relationship.
In other cases where there is an excellent and loving relationship, low sexual desire may cause a partner to feel hurt and rejected. This can lead to feelings of resentment and make the partners feel emotionally distant.
Sex is something that can either bring a relationship closer together, or slowly drive it apart. When one partner is much less interested in sex than the other partner, and this has become a source of conflict, they should get professional help before the relationship becomes further strained.
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Shafer LC. Sexual disorders and sexual dysfunction. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 36.
Clayton AH, Hamilton DV. Female sexual dysfunction. Psychiatr Clin North Am. 2010;33:323-338.
Heidelbaugh JJ. Management of erectile dysfunction. Am Fam Physician. 2010;81:305-312.
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