Imagine you're in a relationship, and everything seems perfect, but over time, you notice a significant decline in your desire to have sex with your partner. You start to wonder, "Is it just me?", or, "Does this happen to other people?"
Low sexual desire, also known as low libido, can be caused by a variety of factors that can be physical (hormonal changes, medical conditions, medications, fatigue, alcohol and substance use, and pain during sex), psychological (stress, mental health difficulties, low self-esteem, a history of trauma) or relational (relationship issues, lack of emotional intimacy, sexual boredom, mismatched libido). While sexual desire can certainly wax and wane throughout life, particularly due to hormonal changes during pregnancy, postpartum, and menopause, some women find themselves particularly distressed by their lack of sexual desire. If this is you, you may meet criteria for FSIAD.
What is FSIAD?
Female Sexual Interest/Arousal Disorder (FSIAD) is a condition characterized by a lack of sexual interest or arousal in women. FSIAD combines what were previously two separate diagnoses: Hypoactive Sexual Desire Disorder and Female Sexual Arousal Disorder. Here are the key features of FSIAD:
1. Absent or reduced sexual desire: A persistent or recurrent deficiency or absence of sexual thoughts or fantasies and desire for sexual activity. This lack of interest can be generalized (occurring in all situations) or situational (specific to certain partners or circumstances).
2. Absent or reduced sexual arousal: Difficulty in achieving or maintaining adequate lubrication or other signs of sexual excitement during sexual activity. This can include a lack of response to sexual stimulation.
3. Duration and frequency: The symptoms must have persisted for at least six months and cause significant distress to the individual.
4. Contextual factors: The diagnosis takes into account various factors that could affect sexual interest and arousal, such as relationship issues, medical conditions, psychological factors, and cultural or religious influences.
5. Impact on quality of life: The disorder can have a significant impact on a woman's quality of life, affecting her self-esteem, relationships, and overall well-being.
Addressing FSIAD involves a multifaceted approach that can include medical, psychological, relational, and lifestyle interventions. One of the main psychological interventions utilized to treat low desire is the implementation of non-demand touch. Non-demand touch is a type of physical contact between partners that is intentionally free from any expectation of sexual activity or reciprocation. In other words, couples are encouraged to touch each other in a non-sexual, non-demanding way, with the goal is to focus on the sensory experience rather than any end goal, thus removing the pressure or expectation of sexual performance or orgasm. This non-demand touch can be seen as a way to relearn how to touch. Non-demand touch is a valuable tool in sex therapy because it helps individuals and couples rediscover the joy of physical touch, reduce anxiety related to sexual performance, and build a deeper, more intimate connection. Relearning how to touch can treat low desire by implementing the following principles:
1. Focus on Sensations: The primary goal is to pay attention to the tactile sensations experienced during touch, rather than thinking about the next step or the end goal. This mindfulness helps individuals become more aware of their bodies and the pleasure that touch can bring.
2. Absence of Sexual Pressure: There is no expectation for the touch to lead to sexual to any outcome; rather, couples are guided to focus on the process of providing and receiving touch from their partner. In other words, the focus is on enjoying the sensations and the experience itself, rather than achieving specific outcomes like orgasm or erection. This helps reduce “performance anxiety” and allows individuals to relax and enjoy the experience.
3. Gradual Exploration: Non-demand touch often starts with non-genital areas and
gradually moves to more intimate parts of the body as comfort and relaxation increase. This gradual approach helps build trust and comfort between partners.
4. Mutual Participation: Both partners participate in giving and receiving touch, fostering a sense of connection and mutual pleasure. It encourages communication about what feels good and what boundaries exist.
By emphasizing touch and physical intimacy without the pressure or expectation of sexual performance or outcomes, non-demand touch can be particularly helpful for women experiencing FSIAD. Indeed, non-demand touch allows them to engage in intimate activities without the anxiety or stress that often accompanies sexual performance expectations. In addition, removing the expectation of “having sex” can help naturally increase sexual desire by fostering emotional
intimacy, reducing stress, and enhancing feelings of safety and connection between partners.