When Desire Declines: Sexuality and Couples Under the Lens of Psychology
Sexual desire is a fundamental component of affective and relational life. However, a decrease or loss of sexual desire is a common experience and often a source of distress for individuals and couples. In psychology, it is important to distinguish between natural fluctuations in desire and persistent situations that may constitute a sexual disorder, in order to offer appropriate interventions.
What Is a Decrease in Sexual Desire?
A decrease or loss of sexual desire (or libido) can manifest as:
- Reduced frequency of sexual thoughts or interest
- Decreased sexual initiative
- Diminished response to sexual stimuli
According to the DSM-5, the corresponding disorder is Hypoactive Sexual Desire Disorder (HSDD) in men and Female Sexual Interest/Arousal Disorder in women. The main criteria include:
- Marked reduction in sexual desire for at least 6 months
- Clinically significant distress
- Not solely explained by other medical, pharmacological, or psychological conditions
Main Causes
A decrease in sexual desire can result from a combination of psychological, relational, and biological factors:
- Stress and lifestyle factors: work pressure, lack of rest, everyday worries
- Anxiety, depression, or other mood disorders: mood alterations directly affect libido
- Relationship conflicts or relational difficulties: poor communication, resentment, lack of intimacy
- Biological and pharmacological factors: hormonal disorders, medication use, post-surgical effects
All clinical examples are fictional and used for illustrative purposes.
Marco, 35: Reports a gradual reduction in sexual desire. As an executive working over 10 hours a day, he experiences chronic stress and difficulty mentally “switching off” from work, leading to reduced sexual interest.
Sara, 32: Experiences decreased desire following the birth of her second child. Psychological assessment reveals depressive symptoms, insomnia, and feelings of inadequacy contributing to lower libido.
Luca and Anna, 40 and 38: Report loss of sexual desire within their relationship. Assessment shows unresolved conflicts, lack of communication, and mutual resentment. Both maintain sexual desire outside the relationship, indicating a significant relational component.
Diagnosis and Clinical Approach
In clinical psychology, evaluating sexual desire involves:
- Sexual and relational history
- Assessment of emotional state: anxiety, depression, stress
- Exploration of life context: lifestyle, habits, stressors
- Medical evaluation: to exclude organic or pharmacological causes
Both the DSM-5 and ICD-11 highlight the importance of distinguishing between generalized or situational disorders and between primary or secondary causes.
Psychological Treatment Pathways
Treatment for decreased sexual desire can follow different pathways depending on individual or couple needs. Individual psychotherapy is often the first step, helping to reduce anxiety, stress, and depressive symptoms, while also addressing self-esteem and body image—factors closely linked to sexual functioning.
When the issue involves the relationship, couple therapy can be essential. This approach focuses on improving communication and intimacy, while addressing conflicts and resentment that may interfere with sexual desire.
Finally, an integrated approach represents the most comprehensive strategy. It involves collaboration between psychologists and physicians to rule out or manage organic or pharmacological causes, alongside combined programs of psychotherapy and sexual education, supporting both individual well-being and the quality of couple life.
Conclusion
A decrease in sexual desire is a common and complex experience involving the mind, body, and relationships. Clinical intervention should consider the whole person, addressing both psychological and relational aspects. Seeking help is not a sign of weakness, but a step toward sexual and relational well-being.
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