Two kinds of desire, not one
We imagine desire as a wish that arises on its own, before any contact: that is spontaneous desire, the desire of new relationships, of films and of most young men. There is a second kind, described by research over the last twenty years and far more widespread than people think, especially among women and in established couples: responsive desire, which only appears once arousal has started — through a caress, a situation, a decision to get going. A person with responsive desire does not “feel like it” beforehand, and experiences that as an absence of desire; yet they have pleasure, and desire, as soon as things begin. Many “drops in libido” are really the normal shift from the first mode to the second when novelty fades. It is not a breakdown, it is a change in how things work, and it is very manageable once understood: you no longer wait for the wish in order to start, you start so that the wish comes.
Common, and rarely serious
In large population surveys, about one woman in three and one man in six say they lacked interest in sex for at least three months in the past year. But only a minority suffer from it: low desire is only a problem if it makes the person, or the couple, suffer. Someone who has little desire and is fine with it has nothing to treat; a couple whose wishes differ has something to negotiate, not to cure — and desire discrepancy is, by far, the leading reason for consulting a sex therapist.
The causes to look for first
Desire is a fragile function: it is the first to disappear when something is wrong, and the last to return. Before concluding that the couple is the problem, one goes through the causes that can be corrected.
- Tiredness and lack of sleep, starting with a child’s first year. It is the most banal and most underestimated cause. The page on desire after a birth covers it.
- Medicines. Antidepressants of the SSRI family cut desire or delay orgasm in a large share of the people who take them; some blood-pressure treatments, anti-epileptics, opioids, hormonal treatments for the prostate or for breast cancer do the same. Never stop on your own; talk to the prescriber, who often has an alternative.
- Hormones. In men, low testosterone — with tiredness, fewer morning erections, loss of strength — is measured by a morning blood test. In women, menopause, breastfeeding, sometimes hormonal contraception, and in both the thyroid and high prolactin. The page menopause, andropause and intimate life details what changes with age.
- Depression and anxiety, which switch desire off even before the person knows they are depressed. Treating the depression brings desire back — except when the treatment cuts it, hence the previous point. See mental health and the couple.
- Alcohol, tobacco, cannabis: one drink disinhibits, regular use extinguishes. And chronic illnesses — diabetes, cardiovascular disease, pain — through their own effect and through their treatments.
- Pain or difficulty. One does not desire what hurts or what fails: pain during sex, erectile dysfunction or premature ejaculation end up extinguishing the desire of both partners. Treat the cause, and desire follows.
- Body image: weight gain, a scar, pregnancy, ageing. Feeling desirable is a condition of desire, even more so for women.
When it is the couple
Once body, medicines and sleep have been ruled out, there remains what desire says about the couple, and it says a lot. In women, the quality of the relationship is the first predictor of desire in every study; in men it is too, a little less strongly. The usual drivers: accumulated resentment — one does not desire someone against whom one holds a list of grievances —, the unequal division of chores, which turns one partner into the other’s parent, the absence of any time together outside logistics, the routine of a sex life that is always the same, and silence: in most couples who consult for desire discrepancy, neither partner has ever told the other what they like. Distance, on the contrary — a little separation, a little of the unknown, a little territory of one’s own — feeds desire; fusion smothers it.
Desire discrepancy: it is nobody’s problem
In a couple where one wants more than the other, the temptation is to name a patient: one is “frigid”, the other is “obsessed”. The reality is simpler and more uncomfortable: two normal levels of desire that do not coincide, like two appetites or two needs for sleep. The partner with more desire experiences every refusal as rejection; the one with less ends up dreading any tender gesture, for fear it will “lead to something”, and caresses disappear along with the rest — which finishes off responsive desire. Getting out of that circle means separating tenderness from sex (a kiss is not a request), replacing a flat refusal with an alternative (“not tonight, but Saturday”), and accepting that frequency is a compromise and not the victory of one of the two.
What brings the wish back
- Deciding, rather than waiting. For responsive desire, planning a moment is not sad, it is the condition for it to exist. Couples who “schedule” have more frequent and more satisfying sex than those who wait for spontaneity.
- Sleeping, moving, drinking less. Three boring and effective levers; regular physical activity, in particular, increases desire in both sexes.
- Removing the pressure. The method most used in sex therapy consists of forbidding, for a few weeks, penetration and orgasm, and relearning caresses without a goal. It seems absurd; it works, because it is the obligation to perform that kills desire.
- Introducing the unknown: a place, a moment, a practice, a word never said before. Desire feeds on novelty, not on effort.
- Talking, precisely. Not “we should make love more”, but what each person likes, no longer likes, would like to try. The pages on desire and the female orgasm and female pleasure provide vocabulary.
- Medicines for desire exist, but few: some countries have approved, for women before menopause, treatments with a modest effect and real side effects; testosterone helps men whose deficiency is proven, and some women after menopause under medical supervision; outside these cases no pill replaces sleep, treating a depression or a conversation.
When to seek help
When the lack of desire has lasted more than six months and causes suffering, when it appeared suddenly, when it comes with other signs — tiredness, sadness, weight gain, pain, erectile problems —, or when the couple keeps going round in circles on the subject. The family doctor rules out physical causes, the sex therapist deals with the rest, often in a few sessions, alone or as a couple. The page who to see, and when details the referral.
Frequently asked questions
Is it normal to stop wanting sex after a few years?
The drop in spontaneous desire with the length of the relationship is one of the most consistent findings in the studies, and it is more marked in women. What is not inevitable is the end of sex: couples that last are those that moved to responsive desire without experiencing it as a failure.
Does the pill lower desire?
In a minority of women, yes, and in others it raises it by removing the fear of pregnancy. If the drop coincided with starting hormonal contraception, switching method for a few months is the best test. See contraception.
My partner no longer desires me: does that mean they no longer love me?
Most often, no. Desire and love do not obey the same laws: one can love deeply without desiring, and desire without loving. It is precisely because love is there that desire can fall asleep — security soothes it. That does not mean nothing should be done; it means the question is not “do you love me”.
Do aphrodisiacs work?
No food or supplement has shown an effect on desire in serious studies; the detail is on the page aphrodisiacs. What sometimes works is the ritual around them — a meal prepared for the other, time taken together.