As a relationship counselor I work with individuals and couples on a number of sex and intimacy related issues. By far the most common one in monogamous partnership is a low or no sex relationship, a relationship in which there are one or fewer shared sexual experiences per month. Low sex relationships tend to signal to the couple that something is wrong; that they have lost their love or attraction for one another or that someone is having an affair. In such partnerships, one person is often identified as having the higher sex drive and one as having a low or nonexistent libido. This lower-libido partner is usually addressed as the one with the problem and the reduction on sex is blamed on their lack of interest or effort. After speaking with countless couples about this, I have come to believe that a reduction in positive sexual encounters between partners is rarely the fault or responsibility of one person. In my practice, it is most commonly the female in heterosexual partnerships that reports having a lower interest in sex thought that is certainly not always the case. And it is indeed not necessarily the case in a larger and broader sample. My caseload happens to be mostly couples under 50. In older couples, I believe the gender split is more even or potentially flipped with the men reporting a significantly decreased interest in sex. The primary reason for this is that when men lose interest in sex as a generalization, it is for performance based reasons. Specifically, they are experiencing more sexual encounters in which they are unable to get or maintain an erection. This then results in anxiety around sex, which makes this so-called “erectile dysfunction” likely to happen again. Thus they start to become avoidant when it comes to sex. The reasons women lose interest in sex however are far more complex.

I could not possibly count the number of women in heterosexual relationships who have come to see me because their male partners are angry because they are not having sex with them. It’s understandable of course; most people consider sexual intimacy an important part of their romantic relationships.

A healthy sex life is one that allows couples to reconnect in a way that is pleasurable, fun, and close. But when one person starts to want sex less frequently or not at all, it can feel frightening to their partner.

Most report feeing rejected, scared, and frustrated. This frustration often translates are pressure and blame. And it is safe to say that pressure and blame do little to increase one’s interest in sex. So the couple enters a lock-down of sorts. A space in which the potential for resentment for one partner and withdrawal for the other is high. In order to reach a place in which the couple is able to return to a happier and closer baseline, this cannot go on. What though, to do when their is an incompatibility that seems insurmountable? Most men in these partnerships have expressed an initial patience and understanding which becomes lost when it does not result in a rather rapid turn around by their female partners. Some women do attempt to have sex but it is more of a means to reduce tension associated with the topic of sex than because of a physical or emotional desire to connect in that way. When this happens it tends to feel worse for both people; the partner with the lower interest feeling checked out and their lover sensing the disinterest. Most report that they would prefer not having sex at all over having it with someone that does not appear to be enjoying it.

While in the past women’s sexuality was in many ways invisible and misunderstood, women’s liberation started garnering awareness in the ways in which women’s arousal and response cycles differed from men’s. In most progressive relationships today, partners will report placing high level of importance on female sexual enjoyment and satisfaction. These seem like undeniably positive improvements. But they are not coming without a price. That price is that when women now cannot achieve orgasm or have a lower than average sex drive, they are pathologized. With the recent FDA approval of Addyi, the pill developed to increase female libido, there has been increased attention to the so-called problem of Hypoactive Sexual Desire Disorder, or more recently in the DSM 5; Female Sexual Interest/Arousal Disorder and as a result, an increased focus on fixing women who experience it. Interestingly, far from the commonly held belief that men think about sex every 7 seconds on average (which would be around 8,000 times!), men actually think about sex around 19 times a day (Dr. Terri Fisher, Ohio Sate University) . Women think about sex on average 10 times a day. A difference certainly, but not as dramatic of one that one might expect. Also noted in this study was that men think about food and sleep just as often as sex. So if women are still thinking many times a day about sex, why are they less inclined to want it?

So, then. Why is the loss of female libido such a common experience for women in our culture of younger generations? To start with, think about what puts you in the mood for sex. What factors generally contribute to wanting it? For many it is a sense of relaxation, freedom, choice, confidence, playfulness, spontaneity, closeness. Thus when we look at why those things are lacking, we must look at a number of facts. In my practice I see the following reasons.

1. Relationship Problems

Probably the leading cause described by women in my practice of a loss in libido traces back to relationship issues. Tension, conflict, and resentment certainly do little to create a desire for closeness, intimacy, vulnerability, and playfulness. But it is more than these less subtle problems that can decrease desire for sex. Most women I talk to describe feeling as if sex is the only time their partners show them affection. The lack of non sexual physical touch, thoughtfulness, curiosity, and kindness, leads many women to feel unseen, unappreciated, unloved. Therefor when affection is introduced by their partner as a way to initiate sex, they are unable or unwilling to respond to it. When there are problems with a relationship, many women withdraw from it as a means of self protection and self preservation. It’s not because they are trying to withhold, it is because they feel as if they have no other choice and simply cannot give more of themselves or give such a personal part of themselves. This tends however, to make their male partners feeling disconnected which tends to make them outwardly more angry and resentful. Many report not understanding why their partners cannot just put more effort in because it will benefit the relationship. And it can be true that while for many men sex can create closeness and warmth, for many women sex can only happen when those qualities already feel present and strong. What I try to help the partners of these women understand is that it is no easy task being generous with your body when you feel like it is all you have for yourself.

2. Responsibilities, Stress and Exhaustion

There is no question that since women’s liberation there is a more equal balance in most homes when it comes to income, cleaning, and childcare. Now that most women work, they are simply unable to also be responsible for all other domestic matters. More and more, women have learned over the past few decades to find their voices and to speak up about their feelings, needs and wants. Men have been able to grow as caretakers and emotional beings as well, though there is still often shame and stigma about this “softness” in the same way their can be a stigma around women who care about and pursue careers. However, while I do see some logistical and practical changes in gendered relationship dynamics, I see less change when it comes to assumptions and perceptions about responsibility. What I mean by that is that while in many homes there is a more equal division of labor, most women report still feeling like the greater responsibility lies on them when it comes to knowing how to care for a sick child or enroll them in soccer, preparing the meals, seeing when something needs to be cleaned and taking the time to do so. Perhaps even a stronger sentiment expressed by most women I see is that when it comes to relationship maintenance, i.e. who is paying attention to and communicating about the quality of the relationship, they are almost exclusively responsible. The result of this is that many women report feeling overwhelmed, overburdened, and exhausted. And while they may be able to keep their families, homes, and jobs together, they certainly don’t feel like they are growing and thriving. Self care falls to the bottom of the list of priorities and accordingly, they feel disconnected from themselves.

3. Children and the Loss of Physical Autonomy

There is nothing that changes a relationship more dramatically then the introduction of children. For women who carry their children biologically, the change is physical as well. During pregnancy, a women’s body is, in every sense, shared. Once a child has been born, she must adjust to a level of physical connectedness and near constant touch never before experienced. If she is nursing, her breasts become a part of her body that may no longer be associated with sexuality and instead a source of nourishment and sustenance for her child. Breastfeeding is tremendously time consuming and though it is often a time of wonderful bonding, it can also be uncomfortable and challenging. Prolactin, hormone released during nursing to stimulate milk production, simultaneously lowers sex drive. Additionally, many women suffer from postpartum depression. All of these factors combined with a lack of sleep and the overwhelming love and sense of responsibility for your child, makes sex for many mothers far from appealing. As our children grow, the physical demands decrease but the sense of autonomy and freedom that you had prior to children rarely returns. John Gottman and Julie Schwartz Gottman present some strategies to increase a couple’s chances of maintaining intimacy in their book; “And Baby Makes Three; The Six Step Plan for Maintaining Marital Intimacy and Rekindling Romance After Baby Arrives” for those struggling with these factors.

4. Sexual Trauma and Shame

It is hard to enjoy something that has caused you pain, fear, or discomfort. And it is sadly the reality that the majority of women have at some point experienced some form of sexual abuse or trauma. This could be rape or molestation, coersion and pressure, shame, or any other experience in which a women felt like her right to control what was happening to her body and how she felt about it was taken from her or disrespected. These wounds take time and effort to heal. Dissociation, or a sense of “not being in your body” is a very good coping strategy in the face of sexual abuse. But without wanting or trying to, many women automatically dissociate during sexual experiences even with safe and loving partners if they have experienced sexual trauma. Having sex while not feeling present in your body makes sex a not particularly pleasurable thing. Also frequently the case for many women is the experience of being in a sexual relationship in which they felt as if their sexuality was a commodity and that their pleasure was not a priority. If you are one of many women whose sexual development was impacted by trauma, I highly recommend reading “Healing Sex; A Mind-Body Approach to Healing Sexual Trauma” by Staci Haines.

5. Lack of Self Awareness Regarding Personal Sexuality

Culturally, we are not raised to talk about sexuality in a healthy way. Most of us had a fear based preventative sex ed class that explained the basics of intercourse and how to avoid getting pregnant and maybe had a conversation with a parent or were given a book about what sex was and when you should do it. Our other main avenue of learning tends to be from the media. Because women are sexualized in media, their bodies objectified and used, and because sex itself is often portrayed as being generally the same for everyone, i.e. passionate, easy, and satisfying, we are left feeling like their is a model we should aspire to and, if not met, that there is something wrong with us. This does not set the tone for healthy sexual exploration or development or open and honest conversations down the line with our partners. But we are, as humans, sexual beings so we try to make our way with little to guide us. If we are lucky, our early experiences are safe, respectful, and enjoyable. If so, we might be able to move forward on our sexual journey not feeling shame as we learn and communicate about what we like and don’t like when it comes to all manner of sexuality.

But many women have partners that do not put in the time and energy necessary in getting to know how their bodies work and what they like and because of this, may not be able to give them pleasure or bring them to orgasm. Sex is, when it results, in orgasm, a positively reinforcing act. If it feels good, we will want more of it. Thus a women is more like to want more sex if she knows her body and what brings her pleasure and her partner takes the time to learn it. A point to note here; sometimes a woman may discover that her sexual curiosities are a bit different than the dynamics she wants in other areas of her life. For example, some women who strive to have egalitarian partnerships enjoy being dominated in the bedroom. This can result in some personal conflict and may not be an easy change for a partner to adapt to when in the bedroom.A great book to read to get started on understanding your sexuality is “Come As You Are; The Surprising New Science That Will Transform Your Sex Life” by Emily Nagoaki.

In addition to these factors, there are some basic reasons that sex decreases over time in many long term relationships and that interest declines for both men and women and these reasons are as common in queer relationships as they are in heteronormative ones. As we age, our bodies change and don’t always respond in the way we would like or expected them to when we were flooded with youthful hormones, we feel more burdened with obligations and responsibilities, we generally have less energy. In intimate partnerships, many changes also take place over time.

Things that contribute to high levels of sexual desire such as newness, risk, and excitement are directly incompatible with the things we gain from long term partnership; things such as stability, comfort, predictability, something that Esther Perel writes about extensively in her groundbreaking book “Mating in Captivity”.

These challenges can be disheartening but if both partners remain committed to maintaining a healthy and satisfying sex life, they can be navigated because they don’t usually involve the same blame and contention that results when only one partner loses their interest in sex. In these partnerships, a mutual desire to improve intimacy and work as a team allows couples to create a new definition and vision of what a mutually fulfilling sex life would look like taking the realities of their present circumstances into consideration.

You can understand now I hope, why taking a pill does little to remedy a women’s lack of desire. It is not as simple as increasing blood flow to the genitals, which is how Viagra works. First and foremost, a woman must want a higher sex drive. And for a number of valid reasons, she may not. It’s important that this is an authentic desire and not one created only because it is the need of a partner or because she feels like she has to for someone else down the line. Of course those can be factors, but without a motivation that is more personal in nature, changes will be harder to make. The task is not always an easy one and it does tend to take some time. For some women, some fairy significant increases in sex drive can be seen once they start learning about it through reading and conversation. Lifting the secrecy and shame can increase comfort and confidence. Beginning to think about who she wants to become as a sexual person is a first step in the process and through counseling or readings, she can consider possible steps to move towards that goal that will work for her.

Remember too my very first point, that in order for a woman to want to have sex with her partner, the relationship must provide the appropriate nurturing environment for growth and intimacy. While partners cannot control a woman’s personal sexual development, they can either hurt or help the process. Finally, finding a path towards increased sexual desire requires a balance, a balance between time together and time alone. Both of these factors are necessary and without one again, change will be hard. If this all sounds a bit overwhelming, please don’t be discouraged. I have seen countless women connect with their sexual selves and discover their sexual power over time. Try to remember, this is about taking steps. Don’t worry about getting to some predetermined finish line because there isn’t one. One of the great things about sexuality is that it is always evolving. And the evolution can in fact, be quite fun and liberating.