Her eyes, with a mind of their own, lock onto their target. Her partner has just entered the café and wine bar. Light beams radiate in all directions behind them and Donna Summer’s song, ‘Love to Love You’ begins to play. As she watches her beloved saunter through the crowd, a wave of desire washes over her, drenching her in a salty brine of titillation. The wave has also swept them together. Unable to fight the urge, she levitates out of her chair – they embrace and the rest of the patrons dissolve into the receding tide. In her mind, gentle winds blow off their clothes, fireworks explode on the horizon and they are destined for mind-blowing sex… forever.

This may be the way it ends for our fictional friend but in real life, a woman’s sexual desire is much more complex. Human desire is made up of physical and psychological components. Our sex drive, the biological element of desire, includes an interest in having sex as well as our sexual thoughts, fantasies and dreams. Whether we choose to act on our biological urges or not, most of us experience a certain degree of sex drive. There is also a psychological aspect of desire that includes a need for intimacy and closeness. It all seems so effortless for our character in the wine bar but for most of us, desire can ebb and flow causing distress in the best of relationships. If your level of desire is adequate for you and your partner(s) then there is no need to ponder this issue further as there is no standard to live up to. If you are having difficulty due to lack of desire you are not alone. In fact, the prevalence of low sexual desire ranges from 26.7% among premenopausal women to 52.4% among naturally menopausal women (Hildreth & Fellow, 2008).

Some common contributors to a women’s low sexual desire are:


Painful sex – Sex isn’t supposed to be painful unless that is your goal, with safety having been negotiated. Peri-menopausal and post-menopausal women may experience pain due to a decrease in estrogen causing vaginal dryness. Although normal, this is not something that you are resigned to live with. Remedies are available and usually fairly straight forward.

Hormone issues – as we age, men and women do experience a decrease in testosterone and estrogen, our sex hormones. This changes how our bodies respond to sexual desire and arousal.

Medical issues such as thyroid disorders, endometriosis, fibroids or chronic illness

Medications – antidepressants (SSRI’s), blood pressure or heart medications


Mental health issues such as depression, anxiety or trauma-related symptoms

Body image issues

Conflict/confusion surrounding sexual orientation or gender identity


Job and life-related stress

Relational issues – decreased emotional connection and satisfaction in the relationship, trust and safety issues, feelings of obligation to engage in sexual activity, change in life such as having a baby, newly empty nesters or caring for loved ones, partner sexual performance issues, lack of communication, exhaustion

Religious shame around sex, sexuality, or your body


Although there are multiple contributors to low sexual desire, there are also several ways to seek help…

Communicating with your physician or psychiatrist can be helpful. Talking about health issues and medications and their potential contribution to low sexual desire are invaluable.

Making a commitment to see a sex therapist who is also trained as a couple’s therapist will allow you to see someone who can help you in multiple ways. This is true whether you go in as a couple or as an individual. If your primary concern is how your sexuality is affecting your relationship, we suggest you go in together. Being able to explore your relationship dynamics and life issues and communicate about your sexual likes and dislikes can be freeing and enlightening. Learning about your own body and that of your partner and new ways to think about sex and intimacy can recharge your sex life. If your concern is primarily about how your sexuality is bothering you alone, then going in individually is fine. Coming to terms with past hurts or conflict related to religious or family of origin beliefs can be life-changing.

Joining a women’s support group to have a place to voice your distress, wonderings and successes can be helpful. Many women struggle with questions regarding sexual desire – and you would find out you certainly are not alone! If you are interested in learning more about the ‘Understanding Your Libido” women’s support group that will be meeting on Sundays through October, please click here.

It is true, our lives are not those out of a romance novel but it doesn’t hurt to author our own story of sexual desire and fulfillment in the real world.



Kristin Nielsen MS, LMFT, CIIP is a marriage and family therapist in private practice on Lake Union in Seattle.  She visits with teens, individuals and couples desiring change in areas of their life such as relationship conflict, trauma and life transitions.  She is a Certified Integrated Intimacy Professional and sex-positive therapist specializing in sexual health and intimacy.



Hildreth, C. J., M.D., & Fellow, F. (2008). Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. JAMA, 300(10), 1128. Retrieved from http://access-proxy.sno-isle.org/login?url=http://search.proquest.com.access-proxy.sno-isle.org/docview/211400718?accountid=1168




Leave a comment

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.