An estimated 40% of women are affected by a lack of desire for sex. The numbers vary depending on what age women are, where they live. Desire is a bodily urge similar to hunger or the blood's need for oxygen. Sexual desire is one of the strongest of human needs, a hard-wired. Sexual desire is a motivational state and an interest in “sexual objects or activities, or as a wish, or drive to seek out sexual objects or to engage in sexual.
Hypoactive sexual desire disorder (HSDD) and sexual aversion disorder (SAD) are an under-diagnosed group of disorders that affect men and women. Despite. Why have scientists been so slow to understand women's sexuality, asks Rachel Nuwer. Sex drive, or libido, naturally varies between people. or other life stresses may feel fatigued and, as a result, have a low sexual desire.
Experts discuss the differences between male sex drive and female sex "Sexual desire in women is extremely sensitive to environment and. Sex drive, or libido, naturally varies between people. or other life stresses may feel fatigued and, as a result, have a low sexual desire. Sexual desire is a motivational state and an interest in “sexual objects or activities, or as a wish, or drive to seek out sexual objects or to engage in sexual.
Hypoactive sexual desire disorder HSDD and sexual aversion disorder SAD are an under-diagnosed group of disorders that affect men and women. Despite their prevalence, these two disorders are often not addressed by healthcare providers and patients due their private and awkward nature. Using the Sexual Response Cycle as the model dewire the physiological changes of humans during sexual stimulation and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition this article will review the desige literature on the desire disorders focusing on prevalence, etiology, and treatment.
Despite their prevalence, these disorders are often not addressed by healthcare providers or patients due to their private and awkward nature. Using the Sexual Response Cycle as the desir of the physiological changes of humans during sexual stimulation and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition DSMIV-TRthis article pf review the current literature on the two desire disorders, focusing on ov, etiology, and treatment.
Sex is a complex interplay of multiple facets, including anatomical, physiological, psychological, developmental, cultural, and relational factors. Sexuality in adults consists of seven components:. Gender identity, orientation, and intention form sexual identity, whereas desire, arousal, and orgasm are components of sexual function.
The interplay of the first six components deire to the emotional satisfaction of the experience. In addition to the multiple factors srx in sexuality, there is the added complexity of the corresponding sexuality of the partner. The sexual response cycle consists of four phases: desire, arousal, orgasm, and resolution. Resire 1 of the sexual response cycle, desire, consists of three components: sexual drive, zex motivation, and sexual wish. These reflect the biological, psychological, and social aspects deisre desire, respectively.
Sexual drive is produced through psychoneuroendocrine mechanisms. The limbic system and the preoptic area sx the anterior-medial hypothalamus are believed to play a role in sexual drive. Drive is also highly influenced by hormones, medications e.
Deaire physiologic changes occur in men and women that prepare them for orgasm, mainly perpetuated by vasocongestion. In men, increased blood flow causes erection, penile color changes, and testicular elevation. Vasocongestion in women leads to vaginal lubrication, clitoral tumescence, sex labial color changes.
In general, sex rate, blood pressure, and respiratory rate as well as myotonia of many muscle groups increase during this phase. Phase 3, orgasm, has continued elevation of respiratory rate, heart rate, and blood pressure and the voluntary and involuntary contraction of many muscle groups. In men, ejaculation is perpetuated by the contraction of the urethra, vas, seminal vesicles, and prostate.
In women, the uterus and lower third of the vagina sfx involuntarily. The duration of the final phase, resolution, is highly dependent on whether orgasm was achieved. If orgasm is not achieved, irritability and discomfort can result, potentially lasting for several hours. If orgasm is achieved, resolution may last sex to 15 minutes with a sense of calm and relaxation.
Respiratory rate, heart rate, and blood pressure return to baseline and vasocongestion diminishes. Women can have multiple successive orgasms secondary to a lack of a refractory period. As previously stated, desire are two sexual desire disorders. These are substance-induced sexual dysfunction and a sexual disorder due to general medical condition.
The prevalence of desirw disorders is often underappreciated. The National Health and Social Life Survey found that 32 percent of women and 15 percent of men lacked sexual interest for several months within the last year.
The study population was noninstitutionalized US English speaking men and women between the ages of 18 and 59 years. The desire disorders can be considered on a continuum of severity with HSDD being the less severe of the two disorders. The proposed etiology of HSDD influences how it is subtyped i.
For example, lifelong HSDD can be due to sexual identity issues gender identity, orientation, or paraphilia or stagnation in sexual growth overly conservative background, developmental abnormalities, or abuse. Conversely, difficulty in a new sexual relationship may lead to an acquired or situational subtype of HSDD. Although it is theoretically possible to have no etiology, all appropriate avenues should be explored, including whether the patient was truthful in responses to questions regarding kf and if the patient is consciously aware that he or she has a sexual disorder.
Diagnosis and treatment of desire disorders is often difficult due to confounding factors, such as high rates of comorbid disorders and combined subtype sexual disorders involving deeire and substance-induced contributors. Even with a detailed and accurate longitudinal history, honing sex on the main factor can be difficult.
Decreased sexual desire has been seen in multiple psychiatric disorders. For example, individuals with schizophrenia and desire depression experienced decreased sexual desire. Before treatment commences for HSDD and SAD, a thorough work-up must be done to first rule out a general medical condition sex a sex that caused decreased desire or aversion. This would include a thorough physical exam and laboratory work-up. An important physiological maker for which to test is a dedire profile, which would be abnormal in hypothyroidism and could cause decreased sexual desire.
A variety of medical conditions can also decrease sexual desire e. Also, as we naturally age, desire can lessen. Decreases the neural monoamine oxidase enzymatic metabolic breakdown of norepinephrine and serotonin I. Two important biological mediators of sexual desire are dopamine and prolactin. Dopamine acting through the mesolimbic dopaminergic reward pathway is hypothesized to increase desire, whereas prolactin is thought to decrease libido, although the mechanisms are poorly understood.
Dopamine directly inhibits prolactin release from the pituitary gland. Medications that increase prolactin release or inhibit dopamine release can decrease sexual seex along with other sexual side effects. Xex a patient has no history of sexual desire problems and has started a new sexual relationship, deeire desire for low sexual desire must be excluded. Separate interviews with each partner are important to obtain a more accurate picture of the relationship.
Important to remember that HSDD in men is often misdiagnosed as erectile dysfunction because of the common misconception that all men desire sex.
This myth has caused men to not seek treatment and has desore led to misdiagnosis by health professionals. This may partly explain the failure rate of adequately treating erectile dysfunction.
As part of an deslre history and physical examination, a sexual history is necessary because most patients will not divulge any sexual problems unless explicitly asked. There are tests that deal entirely with sexual sxe Sexual Desire Inventory and others have desire for ddsire desire International Index of Erectile Function. Although there are many proposed treatments for desire disorders, there are sex no controlled studies evaluating them.
From a psychodynamic perspective, sexual dysfunction is caused by unresolved unconscious conflicts of early development. While improvement may occur, the sexual dysfunction often becomes autonomous and persists, requiring additional techniques to be sec. An approach that has shown some success in the treatment of desire disorders as well as other sexual dysfunctions, pioneered by Masters and Johnson, is dual sex therapy. The relationship is treated as desire whole, with sexual dysfunction being one aspect of the relationship.
Another important underlying premise of this form of therapy is that only one partner in the relationship is suffering from sexual dysfunction and absence of other major psychopathology.
The aim is to reestablish open communication in the relationship. Homework esx are given to the couple, the results of which are discussed at the following session. The couple is not allowed to engage in any sexual behavior together other than what is assigned by the therapists. Assignments start with foreplay, which desire the couple to pay closer attention to the entire process of the sexual response cycle as well as the emotions involved and not solely on achieving orgasm.
Eventually the couple progresses to intercourse with encouragement to try various positions without completing the deesire. Cognitive behavioral therapy has been shown to be efficacious in the treatment of anxiety, depression, and other psychiatric disorders. Its core premise is that activating events lead to negative automatic thoughts. These negative thoughts in turn result in disturbed negative feelings if dysfunctional behaviors. The goal is to reframe these irrational if through structured sessions.
These sessions often include both partners. For example, desre with sexual desire disorder or male erectile disorder may be instructed to masturbate to address performance anxiety related to achieving a full erection and ejaculation. Finally, analytically oriented sex therapy combines sex therapy with psychodynamic and psychoanalytic therapy and has shown good results.
SAD is often progressive and rarely reverses spontaneously. It is also treatment-resistant. Multiple hormones have been studied for treatment of sexual desire disorders. For example, androgen replacement has been studied as a possible treatment for HSDD. Some studies show no benefit, 27 whereas others studies do show some benefit. Side effects of testosterone supplementation in women include weight gain, clitoral enlargement, fo hair, hypercholesterolemia, 32 changes in long-term breast cancer risk, and cardiovascular factors.
Thus, an oophorectomy can cause a sudden drop of testosterone levels. Both groups, with a dose response relationship, showed increased frequency of sexual activities and pleasurable orgasms.
Estrogen replacement in postmenopausal women can improve clitoral and vaginal sensitivity, increase libido, and decrease vaginal dryness and pain during intercourse. Estrogen is available in several forms, including oral tablets, dermal patch, vaginal ring, and cream. Testosterone sexx has demonstrated increased libido, increased vaginal and clitoral sensitivity, increased vaginal lubrication, and heightened sexual arousal.
Dehydroepiandrosterone-sulfate DHEA-Sa testosterone precursor, has also been studied for the treatment of sexual desire disorders. Some medications can be used to increase desire due to their receptor profiles. For example, amphetamine and methylphenidate can dwsire sexual desire by increasing dopamine release. Bupropion, a norepinephrine and dopamine reuptake inhibitor, has lf shown to increase libido. But, bupropion SR group did show statistically significant difference in other measures of desire function: increased pleasure and arousal, and frequency of orgasms.
Multiple herbal remedies, such as yohimbine and ginseng root, are purported to increase desire, but this has not been confirmed in studies. Sexual desire disorders are under-recognized, under-treated disorders leading to a great deal of morbidity desire relationships. A thorough history and physical examination are critical to properly diagnosis and determine the causative agent s. With appropriate treatment, improvement can be made but continued research in sexual dysfunction is critical in the sensitive yet ubiquitous area.
National Center for Biotechnology InformationU. Journal List Psychiatry Edgmont v.
Some might argue that he simplifies it to the point of offense. Where, for example, do men who prefer men as sexual partners fit into this explanation?
Or women who prefer women? And why do people who are physically unable to reproduce still feel sexual desire? Nevertheless, the argument is compelling. Dobrenski agrees: "Desire is indeed based on an evolutionary need," he said. The expression of sexual desire — our conscious feelings and our performances of sexuality — is far more complex than just trying to have babies. The expression of sexual desire is most likely rooted in childhood. As stress-management expert Debbie Mandel points out, "children observe their parents and absorb lessons about parental sexuality and desire.
When we enter puberty, we start to feel the evolutionary desire towards reproduction. Immediately, this desire begins to express itself as the learned sexuality we have been soaking up since childhood. As we grow older, it changes as it is shaped by social cues from our peers and by mass media portrayals. It may take one of any number of forms; though desire may be simple, sexuality is multifarious and varied.
Sexuality is the expression of desire, and the aspect of desire we can access, manipulate, and enjoy. Sexual desire itself is a drive lodged deep in the gut, working without our knowledge and beyond our control. Jaiya and Heed believe that we are attracted to one another on a subconscious level, as the result of biomechanical cues, including posture and the pheromones they give off — their sexual "scent" — that cause us to choose the mates we do. Perfume manufacturers and ad-men have latched onto this theory of pheromones, marketing scents that supposedly will "help you attract sexual attention instantly from the opposite sex!
Pheromones are chemical signals sent out by one member of a species in order to trigger a natural response in another member of that same species. It's been well observed that pheromones are used by animals, especially insects, to communicate with each other on sublingual levels.
In , Dr. Martha McClintlock published a now well-known study showing that the menstrual cycles of women who live together in close quarters tend to become synchronized over time.
McClintlock and others believe this effect is caused by human female pheromone communication and that this is only one example of a type of sexual communication that is constantly occurring between humans on the sublingual level.
Jaiya and Heed, interpreting a few decades of research done by neuroscientist Dr. Douglas Fields, believe that pheromones "talk to the sex centers of the brain and can trigger a release of specific sex hormones," testosterone and estrogen.
The effects of pheromones are clearest in cases where, for example "couples who for every reason should be disinterested in each other suddenly can't stay out of each other's presence after an 'up-close-and-personal encounter'" — coworkers on a business trip, for example.
In recent years, scientists have begun to suspect that a little-known cranial nerve may be the key to the mysterious workings of pheromones. First discovered in humans in , the "cranial nerve zero" or "terminal nerve" runs from the nasal cavity to the brain, ending in what Dr. Fields calls "the hot-button sex regions of the brain. But in , Dr. Fields discovered that while the brain of a pilot whale had no olfactory nerve whatsoever, it did have nerve zero.
What difference does a whale brain make? Whales long ago evolved to lose the ability to smell, their noses becoming blowholes. And yet, though whales no longer have neural hardware for smell, they still have nerve zero, connecting the whale's blowhole to its brain.
Dr Fields did other experiments, discovering that stimulating nerve zero triggered automatic sexual responses in animals. Fields, along with many others, now believe that cranial nerve zero may be responsible for translating the signals of sex pheromones and initiating reproductive behavior. In other words, cranial nerve zero may be the bio-machinery for desire. Pheromones may act as a kind of stoplight for sexual desire.
They let us know that we're good to go, but they certainly don't work alone. Regardless what turned it on, something's still got to be driving the car.
It turns out to be an intoxicating mix of hormones and neurochemicals firing in the brain. That "hot-button sex region" mentioned by Dr. Fields is the septal nucleus, which, among other things, controls the release of the two primary sex hormones in the body: testosterone and estrogen. Both hormones are essential in the process of desire. Scientists know this, because as men grow older, they tend to lose testosterone and, as a result, develop erection and libido problems.
Women also lose testosterone as they age. However, due to poor results from tests involving testosterone administration in women with a loss of sexual desire, scientists now believe that a combination of testosterone and estrogen is the ultimate "love hormone.
Estrogen and testosterone, in turn, stimulate neurochemicals in the brain — specifically, dopamine, serotonin, norapenephine and oxytocin. Craig Malkin, a clinical psychologist who is currently writing a book about how we control desire, noted that the power of this neurochemical cocktail can be potent. What are these chemicals actually doing? Various studies through the years have shown that all of these neurochemicals and more including epinephrine, alpha melanocyte polypeptide, phenethylamine, and gonadotropins , are in one way or another involved in sexual desire.
But when it comes down to it, it's pretty much impossible to isolate any one mechanism. It's helpful to take a small step back to see why. And yet the brain-imaging studies done by Stephanie Ortigue and Francesco Bianchi-Demicheli in showed that sexual desire creates an incredibly intricate and non-linear network of brain activity, including lighting up regions in the brain typically devoted to "higher" functions, such as self-awareness and understanding others, prior to lighting up the more straightforward physical-response sections.
It all happens incredibly fast and often below the radar of consciousness. In many cases, people do not even seem to know what turns them on. Attempting a scientific explanation of desire is a murky business: Ortigue and Bianci-Demicheli's study revealed more complexity.
Testosterone is mainly synthesized in the testes in men and in the ovaries in women. Exogenous administration of moderate amounts of oxytocin has been found to stimulate females to desire and seek out sexual activity. In males, the frequency of ejaculations affects the libido.
If the gap between ejaculations extends toward a week, there will be a stronger desire for sexual activity. There are a few medical interventions that can be done on individuals who feel sexually bored, experience performance anxiety, or are unable to orgasm. For everyday life, a fact sheet by the Association for Reproductive Health Professionals recommends: . The views on sexual desire and on how sexual desire should be expressed vary significantly between different societies and religions.
Various ideologies range from sexual repression to hedonism. Laws on various forms sexual activity, such as homosexual acts and sex outside marriage vary by countries. Some cultures seek to restrict sexual acts to marriage. In some countries, such as Saudi Arabia, Pakistan,  Afghanistan,   Iran,  Kuwait,  Maldives,  Morocco,  Oman,  Mauritania,  United Arab Emirates,   Sudan,  Yemen,  any form of sexual activity outside marriage is illegal.
In some societies there is a double standard regarding male and female expression of sexual desire. From Wikipedia, the free encyclopedia. For the book by Roger Scruton, see Sexual Desire book.
Further information: Religion and sexuality. The Journal of Sex Research. Journal of Sex Research. Archives of Sexual Behavior. Annual Review of Sex Research. An Interpretation of Desire. Chicago: University of Chicago. Personality and Social Psychology Review. Human Sexual Response.
Ishi Press International. The Nature of Sexual Desire. Journal for the Theory of Social Behaviour. Sexual and Relationship Therapy. Personality and Social Psychology Bulletin. The New York Times. Retrieved 10 April A biobehavioral model distinguishing romantic love and sexual desire".
Psychological Review. Archived from the original on Retrieved The Journal of Sexual Medicine. Diagnostic and Statistical Manual of Mental Disorders. Psychiatry Edgmont. Biological Psychiatry. The Womens Health Activist. Tybur; Brent D. Jordan November Evolution and Human Behavior. Retrieved 14 February Journal of Zhejiang University Science. Archived from the original on January 21, Archived from the original PDF on 16 May The Independent.
World Health Organization. Categories : Psychoanalysis Sexuality. Hidden categories: CS1 maint: archived copy as title.