Many women complain of having little sexual desire. Such women tend to feel bad about themselves because of what each may perceive as a personal inadequacy; often just another item added to their list of self-perceived short-comings.  While speaking to an area gynecologist, he voiced that he and other women’s healthcare physicians frequently hear this complaint from their female patients. The following is an exploration of many causes of low sexual desire, lack of desire and outright avoidance of sexual activity all together. This article makes many generalities which may be true for some, but not all women.

    The basis of this article is that sex is a healthy part of the human experience, for both men and women.  This article also is based on the belief that sex is integral to the human experience and need not be linked with shame.  Most relationships include some form of sexual expression and activity, and that an overwhelming majority of healthy partners expect, desire and even need some form of sexual activity to occur for the relationship to remain vital, satisfying and healthy.

    But what causes this phenomenon of low female sexual desire?  It is impossible to pin down what is a normal level of sexual desire, which exists within a broad range. Some healthy women feel that sex is not very important while other healthy women desire some form of sex on a daily basis.  Most women fall into the middle to lower end of this range.

    It is possible that a woman and her partner will have wide and potentially disruptive differences in their levels of sexual desire even while the levels of desire of both partners resides within the “normal” range. The friction between a woman with low sexual desire and her high-desired partner can threaten the very existence of their relationship. It can be the source of much pain and frustration.  A number of distinct factors contribute to women having the subjective experience of having little sexual desire.

Lack of Desire vs. Sexual Opposition

    What seems to be “low desire” may not even be low sexual desire. Having desire for sex is obvious in that it results in clear action of seeking out sexual activity, but the lack of such desire may actually be a wish to avoid sex, but for legitimate reasons.  The two are often confused.  Women may call her inner experience “lack of desire,” rather than distinguishing between these two distinct conditions. Low desire is characterized by devoting little or no effort to make a sexual experience happen, accompanied by little interest in doing so. A woman with low desire may not have an interest in sex, but also may not be strongly opposed to it either. Whereas not wanting sex, is not lack of desire, but instead is about an outright opposition to a sexual experience. Opposition may be expressed as a direct, “No, I don’t want sex,” or less obvious, passive maneuvers to render the possibility of a sexual experience unlikely.

Female Sexuality is Not Male Sexuality

    There may be an assumption by a woman and/or her partner that she should feel sexual desire in the way that a man does.  The temptation to view female sexuality through a lens of male sexuality can be destructive and create inaccurate conclusions as to what is healthy female sexuality, a practice of which at times both men and women are guilty. Just as male genitalia are obvious and “out there,” male sexuality is similar in that it is more openly expressed, direct and advertised.  The result of this is that male sexuality has become the model of sexuality as a whole, in which female sexuality mistakenly included.

    One assumption that exists about female sexual desire is that it should be similar to male patterns of desire.  An example of the male paradigm adopted by or expected of women is displayed in television shows such as Desperate Housewives and Sex in the City where women have high sexual desire and proactively act upon it. For many women this does not accurately reflect how they experience their own sexuality, but may function as a nice fantasy.

    It is not easy for men to understand their female partner’s sexuality. Men are much more likely to view their sexuality and their desire as a distinct part of themselves, whereas for women, it is more usual that her sexuality and desire is a part of herself that is intricately woven into her sense of self and all other aspects of her life.  Different than men who are more likely to use sex as an activity to relieve stress, most women experience sex as something that can be embraced when all else feels right. So a difficult situation, such as stress, problems, feeling overwhelmed or low self-esteem, may cause a man to have increased sexual desire while it can cause a woman to have lower desire.

    Rather than having desire that interrupts her through the day as a strong longing, urging and hunger, the way many men experience it, for many women, this experience is just not present.  And this is not abnormal or an indication of a problem.  Instead, a feeling of well-being, of self-satisfaction or of closeness with her partner, may result in a woman being receptive to a sexual experience.  But unlike a man, many women are not likely to experience anything similar to desire until after the sexual experience is underway and her body has become aroused.  It is then that many women feel desire. The expectations of many have the order of events reversed.  If a woman believes she should be the other way around, just her self-criticism may be enough to cause avoidance of sex.  Being criticized by her partner for not having “his kind of desire,” can be enough to dampen her receptivity.

Reasons For Opposition to Sex

    It makes sense that a woman might not want to be sexual at all if the physical or emotional discomforts outweigh her pleasures. Most of the reasons listed below as to why a woman would be opposed to being sexual fall into that category.  Many are emotionally-based causes for opposition, yet may not be obvious to a woman or her partner.

    The level of a woman’s self-esteem has a direct bearing on her sexuality.  If she does not feel good about herself, it is likely that she will not want to make herself vulnerable by allowing another to experience what she fears is an intrinsic lack of worthiness.

    A woman may hold beliefs that sex is dirty, bad or sinful, but be largely unaware that such beliefs are present.  Such beliefs are often subtly fed to women in their upbringing; since female sexuality remains tinged with societal ambivalence and shame. An early family environment lacking in positive touch, support and encouragement, the modeling of love and affection, and information about the healthiness of sexuality trains a girl to avoid closeness and positive touch; as a woman, she may feel uncomfortable with her body and her sexuality. An early family environment that also included shaming, criticism, and disrespect have an even more profound effect on developing unhealthy attitudes towards or avoidance of sex.

    At the extreme are damaging experiences of emotional, verbal, physical and sexual abuse. Woman who have been abused, which accounts for an estimated one in three, may not have the capacity to trust another or feel safe enough to let a partner as emotionally close as sexual activity demands. If her traumatic experiences remain unremembered, or undisclosed, a partner may incorrectly assume that the woman has no desire for him, whereas emotionally, she is uncomfortable with vulnerability.  

    Many women are unhappy with their bodies, feeling that their bodies do not possess the beauty or sexiness that a woman’s body “should.” Some women are uncomfortable with their vulvas, a possible contributing factor to the overall discomfort of a sexual experience. It is not uncommon that a woman has never viewed her vulva, and holds the belief that her vulva is an ugly, unappealing, even dirty part of her body.  Having discomfort with her vulva, a woman may avoid letting her partner get close, especially for oral or manual stimulation.

    Since a woman’s sexual receptivity may be emotionally and relationally-based, the quality of the relationship between a woman and her mate can have a direct effect on her openness to being sexual. If the relationship is troubled or of poor quality, a woman may not desire sex with herpartner. The accumulation of negative emotions, such as anger and resentment, in a long-term relationship tend to extinguish the flames of sexual desire causing a woman to avoid being sexual.

In general, men seek to build a close connection to their female partner through sex.  Generally women build this connection through non-sexual means, such as sharing, non-sexual touch and affection, spending time together, talking, gaining understanding and mutual support.  In relationships, both partners make the effort to build and maintain connection, but because partners often go about this task in differing ways, tension and conflict can arise.  If the male partner is strong in his efforts to be sexual, but is not attentive to his female partner’s method of building an emotional connection, her interest and desire to participate in his methods, through sex, probably will diminish.

    In general, negative emotions negatively affect the quality of a relationship between a woman and her partner, and negatively affect the sexual relationships between partners.  Conflicts exist in all relationships, whether those conflicts are expressed or remain unexpressed.  All relationships include unresolved differences between partners.  The question as to what degree those unresolved differences contaminate the good will between partners or not is significant both for the health of the relationship, but also for its impact on the partners as lovers.  Especially in long-term relationships, where time has allowed for unresolved conflicts to fester, and for negative emotion, such as anger, resentment, bitterness, etc., to accumulate, these negative emotions can effectively kill sexual desire and eliminate sexual activity from a relationship.

    If there exists any tension between a woman and her partner regarding sex, then the sexual arena can become polluted with negativity.  Included in this is a partner’s request for sexual activities about which the female partner is opposed.  If she worries that her partner will request these unpopular sex acts, she may opt to not be sexual at all so as to avoid facing a situation in which she either says no, or puts herself in a undesirable sexual situation in which she would be selling out her own preferences. A woman pressured to be sexual in ways that are uncomfortable for her may contaminate sex and cause it to lose value for the female partner.

    If the sexual experience is painful for a woman, she may seek to avoid sexual activity.  Not all understand that if a woman is healthy, sex and intercourse need not be painful.  Yet without this understanding, some women think pain is a normal part of sex and subsequently choose to just “grin and bear it.”  Doing so may cause cumulative physical harm and sexual problems for both partners.  Healthy sex need not be painful.

Power Dynamics and Desire

    A facet of relationships can be a competition, battle or negotiation for power.  One place in which a battle for power can be waged is in the sexual relationship between partners.  In a healthy relationship, power is shared and divided in some kind of equitable manner.  In unhealthy ones, power is used in ways that do not benefit both partners. Sex can be one medium of exchange in the relationship or it can be an arena in which power is displayed. If power is unevenly distributed between partners, especially in the extreme, the female partner may lose sexual desire.  If she owns most of the power, she may lose respect for her male partner and subsequently not desire him.  If he has too much power, in her powerlessness she may feel bad about herself, have little self-respect or have resentment towards her male partner; either situation can produce a lack of sexual desire. A woman who feels she has no choice but to be sexual, whether or not she wishes to share herself, will lose desire as her sense of self and sense of her body are not being respected.

The Power to Choose

    Children cannot own power because they do not possess the judgment or cognitive skills to make responsible choices.  In a healthy environment, children are given small amounts of power by their parents so as to practice using power in constructive, successful ways without risking too much harm in the process. Adults, who as children, had not been allowed to practice using power, grow up without developing the capacity to make good choices, to make choices at all or to vocalize their needs.

    Such individuals typically were parented by adults who were controlling or abusive…parentswho were unable to let go of their own needs in order to address their child’s needs.  If a girl’sneeds were never considered, that girl will grow up to become a woman who will also ignore her own needs or be unable to assess or value her own needs including sexual needs.  

    Women who grew up in these kinds of family environments are unlikely to possess the kind of personal power commonly associated with adult maturity, such as emotionally participating in a relationship or sexual partnership as an equal partner. For such a woman and her partner, her behavior may look a lot like lack of sexual desire, but is probably less about lack of desire than it is about sexual avoidance, in which avoiding a sexual encounter is an automatic reaction as an attempt to side-step discomfort.  Such avoidance is not a conscious choice, but a reflexive reaction, much the way a person will duck without thinking if she or he see something flying at her or his face.

    Having power and the power to make a choice, but for a woman who grew up in such a family where she was given little power to make choices, owning this kind of power is not a choice.  Emotionally, for this woman, having power is not an option, and is not considered.  This emotional position, however, significantly affects the woman’s relationship with her partner, and the sexual relationship.  So much of a relationship is determined by how partners negotiate their differences and how each negotiates to get her or his needs met.  A woman who does not own her power cannot be a partner to negotiation. To have a position in a negotiation, a partner must own power. A woman who cannot own power will avoid such negotiation, will not take a stand on an issue, is not likely to speak up for herself, if confronted is likely to either emotionally break down, become silent, or explode in a defensive eruption; all of which prevent negotiation from occurring and a resolution from being reached.

    This lack of power shows up in the sexual arena when the woman cannot voice any choices or preferences for sexual activities.  She may participate passively in sexual play for her partner, but does not experience the interaction as for herself.  Her partner’s request for sex is likely to feel to her like a command, about which she has no choice, and in which she must please her partner or be a bad partner, but the power to voice choice in the matter does not exist.

    Still many women are able to own their power, but still feel they have no choice in the matter of being sexual or not.  Many women, in relationships with high or very high-desired partners feel that they must constantly choose between undesirable options: have sex and feel bad about themselves while avoiding conflict or say no to sex and be saddled with an angry, pouting or abusive partner.  A saying I have heard is: “If she cannot say “no,” then she cannot really say “yes.” Feeing that she does not have choice in being sexual has a high chance of producing in a woman no desire for sex.

    For many women, stress is a large, negative influence that interferes with sexual receptivity.  The feelings of being overwhelmed and exhausted may cause a man to seek sexual release as a way to rid himself of tension, but for many women, it is not sex which nourishes as much as other activities.  This is especially true of mothers of young children.  It is not unusual that the situations which cause stress are also factors which interfere with partners spending time together.  While for most men, sex is the way to reunite and re-establish a connection, the opposite tends to be true for most women; who need to re-establish an emotional connection first before sharing themselves sexually.  So for women living in very stressful environments, the lack of a sense of connectedness may look like a lack of sexual desire.


The emotionally stronger a woman is, the more she can define her boundaries, set limits, assert herself, while also being emotionally open to others and her partner.  A woman who is not emotionally strong may not have her personal boundaries defined at all and routinely allow others to violate what stronger people would experience as poor judgment.  The weakness of boundaries prevents a woman from being able to have the power to assure her own personal, emotional safety. The closer two people emotionally get, such as partners in a love relationship, the more effort and the greater sense of self it takes to keep these boundaries distinct.  If a woman’s sense of self is not strong, she may have the experience of losing her self, and her identity within the relationship.

    Boundary considerations are heightened during sexual encounters between partners because it is during sex that two people have the potential to emotionally and even physically merge. If a woman’s sense of her own self is not well defined or strong, sexual experiences can be anxiety-provoking and uncomfortable, causing such a woman to avoid the potential discomfort by avoiding the sexual experience.

    Partners sometimes make assumptions instead of obtaining the correct information that direct communication provides.  There is no arena within love relationships that is more negatively affected by this tendency than in sex. Because sex is often tainted with shame and embarrassment, partner commonly avoid direct talk about sex.  Yet sex is a team sport.  Just like all other team sports, the chances of victory are increased if the players communicate well.  Assumptions are boundaries that have not been well defined.  If the sexual needs, desires, interests, preference, dislikes and curiosities are never discussed, sex can be an activity complicated with uncertainty; a state which may cause a woman’s lack of interest.

Quality of Sex

    The quality of the sexual activity between a woman and her partner can affect her desire to be sexual.  Certainly men and women are not eager for bad sex.  Because of the tendency for men to not understand female patterns of arousal and the tendency of many women not to voice their own needs while ignoring their own body’s signals, the chances for highly pleasurable sexual experiences are not as high as they could be. Because women respond to stimulation and reach arousal much more slowly than do men, it is not uncommon for couples to engage in intercourse before the female partner is ready, resulting in a sexual disconnect between partners, an occurrence which prevents the female partner from experiencing as much sexual pleasure as is possible.  If this pattern develops, a woman may experience a lack of interest in engaging in a sexual encounter in which her needs and high pleasure are not incorporated into the timing of the sexual play.  This can occur without her conscious knowledge, but instead, she just has a feeling of “I’d rather watch TV.”

Sensuality and Pleasure

    Having lack of desire or lack of interest in sex does not mean that a woman has no interest in pleasure.  When non-sexual pleasures are considered, such as a delicious meal, fragrant perfume or the feel of a skilled massage for example, it may be evident that a woman’s sensuality is very much alive, even if the potential sensual pleasure in sex is nullified by other factors. A woman who lacks sexual desire does not always lack an interest or enjoyment of pleasure.  In fact she may pursue non-sexual pleasures.  The pleasures that are possible in a sexual experience are often discounted by a woman who opposes sexual activity, in that the possibility of pleasure is prevented by emotional or relational factors.

    Having developed a pattern of opposing sex, these tendencies may continue beyond the existence of underlying causes.  In other words, opposition to sex may be its own cause, having gone unchallenged in the pursuit of growth. If the causes have been eliminated or outgrown, acknowledgement of the potential sexual pleasure can be a path towards embracing sex as a healthy and important part of being female.

    While some pleasures may be acceptable to women in many ways, such as enjoying deliciousfood, or making a purchase or spending some enjoyable time with friends, bodily pleasures may be a distinct category of pleasure, which is tarnished by guilt or shame.  Subtle cultural and religious messages have pervaded the sexual development of women which have pronounced bodily pleasures sinful and immoral.  Many women hold themselves back from sexual pleasure for this reason, even if they are not conscious of these subtle learnings.  The only purpose of the clitoris

Having Sex When Desire is Not Present

    Since it is more common that the male partner is the “high-desired partner,” many women share themselves sexually when they have little interest in doing so.  While treating women for sexual difficulties, I hear from my female patients frequently, “I had sex with him just to get him off my back.” The pattern of engaging in sexual activity when no real interest is present potentially buildsresentment, which can deepen a women’s lack of interest in sex.  Also a woman sharing herself when she truly does not wish to, causes an internal disconnect between a woman and her body, her emotions and her self-respect. This is because her fundamental needs during the sexual experience and possibly in the relationship are not being met. In a relationship where there is a large difference in desire between partners, participating in sex, even when there is no desire to do so present, can be an act of generosity and love, that is if the participation is not due to control by the partner, or threat of anger.  The test as to whether sharing oneself sexually even without desire is harmful, is whether or not resentment results.

    Other factors which contribute to low sexual desire are health problems and medications.  Poor health and poor mental health contributes to lack of interest in sex.  Physical problems limit the kinds of activities…making sex more complex and the politics of sex more complex, thus increasing the moments when choosing not to be sexual is easier, especially when tired.

    Among the symptoms associated with depression are low energy, fatigue, lack of interest in the usual desired pleasures, lack of motivation and lack of desire for sex. Depression is not always easily detected, even by the depressed person. Depression can be low-grade and chronic, which has become to a woman just a normal part of her everyday life experience.  

The Ability to Relax

    Relaxing is necessary not only for a high quality of life, but also it is a necessary ingredient to have fun, to laugh and to have good sexual experiences.  The ability to relax is not always easy to come by, especially in our fast-paced high-tech contemporary lives where demands are high and time seems short. Much like a rubber band that has been stretched for a long time and can no longer snap back to its original size, many women maintain fast paced lives for so long that they can no longer relax.  Good sex requires a significant ability to relax.  Many women complain that they feel unable to slow their minds down during sexual experiences. If there is something about sex that is problematic for a woman, she might have trouble concentrating on the sensations provided by her lover’s stimulation in her body, and find herself thinking about non-sexual matters. This may also be true if she is anxious about sex itself. The discrepancy between the pace of daily life and the much slower pace of a sexual experience can cause an internal disconnect. Sometimes women seek to speed up the sexual experience, both to better match her internal pace, but also if she is uncomfortable with being sexual, to get the experience over quickly. If a woman is unable to relax, the sexual experience can produce discomfort simply by heightening her awareness of her inability to relax and of the potential pleasure she is incapable of experiencing at that moment.

Lack of Information and Unrealistic Expectations

Even in this age of great availability of information, women and their partners still may lack the right information and knowledge about sex and female sexual functioning.  Male partners do not always the understanding the importance of clitoral stimulation for a woman’s sexual pleasure and its importance in the achievement of the female partner’s orgasm.  A woman, even if she is aware of this, may not tell her partner. Many couples are uncomfortable speaking about sex and avoid doing so to minimize the risk of hurting the partner’s feelings or to avoid feelings of embarrassment.  Both men and women may expect that female orgasms should occur during intercourse, an activity during which direct clitoral stimulation does not occur. Statistics reveal that most women do not reach orgasm through intercourse.  Unrealistic expectations can make a sexual experience disappointing. They may contribute to the female partner not desiring the kind of sexual experience she and her partner routinely have.


At its best, sex is an interaction between partners that is both natural and simple.  The more that negative differences between partners pollute the essential simplicity, the more undesirable the sexual experience can be for both partners.  If sex is complicated by negative emotions, sexually-related conflicts, a high frequency of problems, dissatisfactions and risks of disappointment, then sex becomes overly complex and loses its allure.  A woman may react to this state of affairs before her male partner, especially is she is the lower-desired partner. To her partner, she may seem to have lack of sexual desire.

Sexual Problems

Sexual problems are unfortunately common and tend to be more common as women age.  Among them are difficulties of becoming aroused and difficulties at achieving orgasm.  Both of these problems, if not attended to, could be an obstacle to a woman having sexual desire.  Some of the previously-mentioned factors, such as anxiety, or being sexual without desire can interfere with arousal. Medications also can inhibit arousal.  But if a woman engages in intercourse prior to being fully aroused, the experience may be uncomfortable and ultimately painful…potentially forming a vicious cycle including decreasing sexual desire.

    Orgasm, too, if problematic can be one element in a negative cycle that includes or causes low sexual desire.  Some women have never achieved an orgasm and are unsure about what it is. Many other women have routine difficulty achieving orgasm.  Roughly one-third of women have never experienced orgasm at all and approximately two-thirds rarely experience orgasm through intercourse, when direct clitoral stimulation is not present. Most women can learn to experience orgasm. Neither many women nor their partners are aware of the reality that these statistics bear out.  Unrealistic expectations regarding orgasms can lead to frustrations, disappointments and even accusations. Reaching orgasm can be nearly impossible for most women if strong negative emotions, such as anger, depression or anxiety are present.  It is an unusual woman who is eager to enter into a sexual experience in which disappointment is assured.

    Medications can reduce the possibility of orgasm.  In situations where a woman knows that orgasm is unlikely, and/or if there is pressure from her partner because her orgasm is important to him or her, it may result in the woman having very little desire to have a sexual experience at all.

    Most medications have a negative impact upon sexual response, such as interfering with arousal, evidenced by lack of lubrication, but also interfering with the ability to experience orgasm, thereby reducing the quality of, and can indirectly resulting in lack of desire for what may be perceived as a less-than-satisfying sexual experience. Many women are not aware that birth control pills have a negative side effect of lowering a woman’s sexual desire in that birth-control pills cause testosterone levels to fall. If unaware of this truth a woman may needlessly blame herself for her lack of sexual interest. Anti-depressant medications are notorious for reducing sexual desire.  Most medications have a negative effect of sexual functioning and response.

     Among the health considerations are hormone levels.  Just as for men, the hormone testosterone also plays an important role in female sexual desire, especially a factor for menopausal women.  If a woman has a low level of this vital hormone, she may then have a lack of desire for sex.  For general well-being, including a healthy level of sexual desire, proper balancing of the levels of all hormones, estrogen, progesterone and testosterone is optimal.    

    While not being the largest component in a love relationship, sex is an essential ingredient in most love relationships.  Low female sexual desire interrupts that essential ingredient, and if uncorrected can and does create great damage to many marriages and love relationships.  This article has detailed many of the factors which contribute to a woman’s opposition to and/or lack of desire for sex, but by no means has it explored all of them or in the most detailed manner.  Female sexuality is highly complex. The attempt to understand why a woman has lack of desire, or avoids sexual activity, must start with respect for and consideration of her uniqueness.

Andrew Aaron, LICSW

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