By Christian Dominique
“What you can do to make sex fabulous and fulfilling again.” (Brotto, 2018)
Let’s talk about the spice of life, my friend! Sex, the very reason we’re all here, is a captivating and essential aspect of our existence. You see, sexual desire, or as some like to call it, the mysterious libido, is not just a physical urge but a fascinating interplay of mind and body. It’s time to delve into the secrets of this ancient dance and uncover the elements that make our desires burn brighter than ever.
Imagine a world where the spark of passion might flicker or fade, and indeed, this is a reality for many. Research reveals that a significant portion of the population of all genders encounter a decrease in their sexual interest at some point. Shockingly, up to 50% of women and 35% of men find themselves facing this intimate challenge. But fear not, for we are about to embark on a journey to uncover the physical, psychological, and even sociocultural influences that play a role in this intricate game of desire.
The numbers don’t lie, and they tell a story of a growing trend of sexual desire difficulties that knows no geographical boundaries. So, prepare to be enlightened as we explore the factors that can either fuel the flames of healthy lust or leave us searching for that missing spark. Get ready to unlock the secrets to an enjoyable and passionate sex life!
Sexual Arousal vs. Desire
In sex, there is an interplay and intricate dance of desire and arousal. When sexual desire strikes, it can ignite a fiery cascade of physical reactions, from the mighty erection to the subtle lubrification, all preparing the body for the ultimate sensual experience. And let’s not forget the grand finale, the orgasm, as described in the iconic human sexual response cycle by Masters & Johnson (1970). Yet is there more to sex than desire leading to arousal and orgasm?
It turns out that sexual arousal can also ignite the flames of desire, creating a pleasing and potentially powerful feedback loop. As Dr. Setter (2023) reveals, “Arousal precedes desire in many cases, especially for women”. The more tuning of our mind to be receptive to arousal, the more motivation to have more sex in the future. Dr. Basson (2005) summarizes the sex response cycle in this more accurate and detailed representation below.
Figure 1: Sex response cycle, showing responsive desire experienced during the sexual experience as well as variable initial (spontaneous) desire (Basson, 2005).
Responsive sexual desire and spontaneous sexual desire can work together to create an enhanced capacity, disposition, satisfaction and desire to initiate or be receptive to sex. Factors also involve nonsexual rewards like intimacy, sensory, emotional, mental and physical well-being,
Unfortunately, sometimes the positive loop of sexual desire and arousal can be disconnected and many of the factors that affect this ideal feedback loop are mental or psychological. Sexual concordance is the relationship between genital response and subjective sexual arousal. It is found to be higher in men than in women (Sierra et al., 2018). One of the secrets to better sex is to increase this concordance or connection of mind and body. Let’s start with the physical factors that can impact sexual function, arousal and desire.
Physical Factors
Physical factors that can affect sexual desire include many types of medical conditions or interventions that can create chronic fatigue, physical pain during sex, lower lubrification, decreased erection, lower testosterone levels, and more. They may also be directly associated with psychological issues like low self-esteem issues and performance anxiety. The most common ones are urinary tract infections (UTIs), cancer, surgery, obesity, diabetes, heart disease, high blood pressure, high cholesterol and thyroid disease (Gabrielson, 2019). Erectile dysfunction is a common cause for men and can be affected by age, tobacco and heavy alcohol use. Up to 70% of people with poor sexual function have less than average general health (Brotto, 2018). There is no surprise then that good sleep, diet, exercise, hydration and healthy habits can increase sexual desire.
Pharmaceutical Factors
Pharmaceutical (and recreational) drugs can affect sexual desire. We will examine two types of prescription drugs: antidepressants and anticonception medications.
Anticonception or birth control pills have helped women’s sexual health, well-being and expression. However hormonal contraceptives can affect sexual desire, arousal and function, primarily negatively. It can also potentially reduce pair-bonding and increase sexual jealousy (Casado-Espada et al., 2019). If that is your case, or someone you know, one can consider seeking alternative contraceptive methods with their healthcare provider.
Antidepressants and specifically the types known as SSRIs (serotonin-specific reuptake inhibitors) can decrease sexual desire substantially. One can consult appropriate medical professional if this is a suspected culprit. However, one drug originally used as antidepressant was found to increase sexual desire and satisfaction in women. This drug is flibanserin (brand name Addyi) but unfortunately, we found that psychological factors have a greater effect on sexual desire than physical or pharmaceutical ones, and the drug has had little clinical or commercial success.
There is no easy “magic pill” to date for women. For men even with the popularity of erectile dysfunction (ED) medications, like sildenafil (brand name Viagra), tadalafil (brand name Cialis), avanafil (brand name Stendra), vardenafil and testosterone treatments, which have some appreciable levels of effectiveness, they often require prescriptions, monitoring and may have a range of side effects. 14% of US men over 57 years old reported using medication or supplements to improve sexual function and 37% described ED as a problem (Lindau et al., 2007).
“It’s also important to understand that while these medications can help manage the symptoms of ED, they do not generally address the underlying causes,” explains Dr. Linda Khoshaba. These may be health and psychological issues (Cherney & Herbaugh, 2023). There are some studies that suggest that medications did not work when men were too distracted to pay attention to sexual cues or erotic triggers and otherwise worried or preoccupied psychologically (Brotto, 2018).
Psychological Factors
Let’s shed some light on the powerful psychological factors that can influence our sexual desires. Imagine a scenario where the key to unlocking a superb sex life lies not only in the body but also in the state of our minds. Studies show that apart from relationship dynamics, our mood and emotional well-being are the strongest predictors of sexual distress (Brotto, 2018). So, if we want to enhance passion and desire, it’s time to pay attention to our emotional state and ensure we’re in the right mood and mindset.
Here is a list of the six most problematic psychological predictors for sexual desire (Brotto, 2018):
Depression doubles low sexual desire odds and is a major risk factor. Also, close to 50% of people with poor sexual function had symptoms of depression.
Anxiety and low mood increase risks of sexual problem.
Distraction and Rumination: Mind wandering or repetitive thoughts, including preoccupation about chores, work, family, sexual performance or appearance negatively influence sexual desire. To reduce this, one can practice being actively engaged and present in the beauty of the moment.
Trauma: Previous negative sexual experiences, including abuse or assault, can affect perception of sex, dampening or altering sexual desire. Nonsexual traumas can also have a damaging toll on desire.
Stress and multitasking: Busy lives, schedules and trying to do too many things at once decrease the ability to properly respond to, engage in or desire sex.
Belief (negative): People who believe that age diminishes sexual desire and sexual activity are twice as likely to have lower sexual desire than those who don’t have these negative beliefs. Other beliefs such as sinful or immoral activity, fixed gender roles or cultural conformity can severely impede sexual desire and expression.
Reversely, there are psychological factors that positively affect sexual desire. Here are three:
Belief (positive): People who believe that sex can be fun, fulfilling, healthy, a shared leisure activity, a form of communication and unique expression have more sexual desire.
Hope: Women with hope about the future of the relationship were up to three times as likely not to have sexual pain or low sexual desire than women who had lost hope.
Sexual concordance: Alignment between physical and mental sexual arousal is related to positive subjective sexual desire. Concordance is usually higher in men and tends to increase with age which suggests it can be learned. That’s good news!
Socioeconomic and Cultural Factors
Socioeconomic factors can also influence sexual desire. Here are a few interesting ones (Brotto, 2018):
Stable Partner: American married women are more likely to reach orgasm and have less sexual anxiety than unmarried ones.
Education Level: Women who had not graduated from high school were twice as less likely to have low sexual desire than college-educated ones.
Employment: Unemployment is linked with more sexual problems, although both employment and unemployment may lead to psychological stress and anxiety.
Finally, we must consider culture, experience and environment can influence personal beliefs in a significant way. This includes religious beliefs, conservative-liberal spectrum values, income, type of education, legal framework, family, friends, media, social media and societal norms.
The suppression of open sexual discourse and the banning of certain sexual practices can lead to increased individual negative emotions, such as shame and disgust, towards sex within a community. When a culture shuns open conversations about sex and imposes restrictions on sexual behavior, it can foster fear, lower sexual desire and satisfaction. Geographically, North African and Middle East women were significantly less likely to reach orgasm, find sex pleasurable and have healthy sexual desire according to the Global Study of Sexual Attitudes and Behaviours (2002). Worldwide, many cultures, subcultures, communities, and families, risk to have negative sexual outcomes if they allow sexual repression to reign.
The moral incongruity of sex has been studied and show that people may feel guilty thinking or talking about sex. Same goes for reading, listening, watching or performing, especially sex that is nonnormative. “Abnormal” can range from nonvaginal sex, being nonheteronormative, to kinks, fetishes, BDSM (bondage, domination and sadomasochism), CNM (consensual non-monogamy) and more. It all depends on the environment and changing flavors of the forbidden, illegal or shunned upon. This sometimes-debilitating deep guilt or repulsion may lead to severe psychological effects and decreased sexual desire. It can cause sexual distress and diminish aspects of mental well-being. Sexual minorities are shown to have much higher probability of anxiety and depression. People who have uncommon or unaccepted sexual desires have an all-around tougher time. Hopefully that will change sooner rather than later. Remember, hope is a positive psychological factor.
Sexual Education
A Kenyan medical doctor was arrested because she was researching sex and trying to bring sexual education to Kenya and Eastern African countries. The harsh reality is that sex is still a taboo in many cultures and even a rather liberal and open-minded country like Canada sill have associated stigma. For instance, a recent University of British Columbia study showed that online science-based sexual education tool was both acceptable and appropriate, yet most participants were reluctant to engage with the content and had mixed feelings about letting it impacts their lives (O’Kane et al., 2024).
We know that sexual education directly impacts sexual desire. It also impacts sexual health and well-being. For example, “abstinence-only” sex education produces more sexually transmitted infections (STIs), sexual distress and likelihood of being victims of sexual assaults than evidence-based sex education in Britain.
Ageism
According to a study of over 3000 US adults, the prevalence of sexual activity declined with age from 57 to 85 years of age as follows (Lindau et al., 2007):
-73% among respondents who were 57 to 64
-53% among respondents who were 65 to 74
-26% among respondents who were 75 to 85
Women were significantly less likely than men at all ages to have a spousal or other intimate relationship and to be sexually active. Still, activity is not always linked to desire. We know that many people may harbor desire to have sex with their current or other partner and cannot. We will look at desire discrepancy in couples in the next article. For individuals not in a relationship, incels (for “involuntary celibate”) for example, are a growing number of people of all ages and genders unable to find a romantic or sexual partner despite desiring one. There is growing research on the subject.
Sexual desire does not have to decrease with age and thinking that makes our assumptions a reality, as we saw in the psychological factors section. Biological desire may slightly decrease with age on average (due to decreased hormones), yet sexual satisfaction tends to grow as we get to know ourselves and our partners better. Satisfaction increases desire in the optimum positive cycle of responsive sex. A study showed that older women were twice as likely to find sex pleasurable than younger one (Brotto, 2018). This may also be partially due to learned increased sexual concordance.
I connected with researchers recently who have a yet unpublished study of the elderly population sexual desire, satisfaction and frequency who confirm that sex is still wanted, practiced, rewarding and fun past 80 years of age. This also gives us much hope to be passionate perpetually. Sexual desire boundaries reside in our minds.
Conclusion
We saw that general or specific health issues can severely affect sexual desire. Age, drugs and diet can also play a role, yet the most important factors are almost always psychological. These can be influenced by culture, education and beliefs about sex. It is why being properly informed about sex may lead you to have a healthier and more fulfilling sexual desire and sex life. Thoughts, beliefs, mood and emotions can have a greater effect than even sickness. They are the secret ingredients that can either enhance or hinder our sexual desire and experiences. Lastly, we should focus on the connection to our body, and hopefully our partner!
The next two parts of this series will look at sexual desire more specific for couples. Wishing readers all the libido and sexual satisfaction they “desire”.
Author
Christian Dominique, BSc, MBA
Disclaimer
Please note that this blog article only provides an overview of sexual desire on the current state of the scientific literature. This blog article does not endorse any treatments. If you are dealing with physical, mental or relationship issues, we recommend consulting with an appropriate therapist or healthcare professional. Seeking their guidance will ensure that you make informed decisions regarding your well-being.
References
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