If one-third of women don’t fantasize and rarely feel sexual desire, does that mean they’re all sexually dysfunctional? (Actually, the term is “hypoactive sexual desire disorder.”)
Or does it mean that the medical community needs a better understanding of how women get turned on, why we want to have sex, and why we might not want to have sex?
The research is clear and consistent: A lot of us simply don’t feel much sexual desire. We don’t think about sex much “in between,” and we aren’t particularly motivated to initiate sex. We do, however, enjoy it once the ball gets rolling, and we feel pretty good about our sex lives overall. “Research confirms that women report sexually satisfying lives despite rarely or never sensing desire,” writes Dr. Rosemary Basson in an editorial in Menopause: the Journal of the North American Menopause Society.
Basson is a champion for less labeling and a more open-minded understanding of female sexual arousal and response. (That’s why we love Rosemary!) She and others hypothesize that women have a different arousal mechanism than men, less straightforward and linear, more subtle and complex. Maybe desire and arousal overlap and reinforce each other in women. Maybe we need to light the kindling—a little nibble on the earlobe, a little stroke along the thigh—before desire and arousal begin to smolder. And sometimes life experiences affect our sexual appetite and responses. Longstanding personal issues, like childhood abuse or problems with our partner, for example, or recent developments, such as illness or depression.
Basson advocates careful consideration of all the variables when it comes to labeling one-third of women as sexually dysfunctional because sexual desire in women is subtle and many-faceted. Is a physical illness the impediment, or is it the financial worry that accompanies the illness? Or is it depression brought on by the medication for the illness?
Basson encourages a more “detailed, careful interview” to establish causation. And she is hesitant about blaming hormonal or neurochemical imbalances, which she says there is lack of evidence for.
When women are carefully examined, she feels that only a “theoretical sub-fraction… would merit a diagnosis of intrinsic sexual disorder.”
The bottom line, ladies? Lots of us don’t think about sex much in the course of daily life, but light the match, and we warm up nicely. For most of us, this isn’t a problem. So why consider it a sexual disorder?
And if it is a problem in our relationship, try to find a medical professional who’s willing to perform the kind of “detailed, careful” examination that Basson recommends.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.