HYPOACTIVE SEXUAL DESIRE DISORDER (HSDD): Conflict in relationships

HYPOACTIVE SEXUAL DESIRE DISORDER (HSDD):

Conflict in relationships

Shellean Jones, 2008 and edited 2014

Not surprisingly, “Problems of hypoactive sexual desire disorder used to be presented as marital rather than sexual difficulties,” (Barlow & Durand, 2005, p348) before it was recognized as a distinct disorder in the late 1980’s. That this should be considered a disorder at all, is controversial. The criteria for diagnosis do not take into account the myriad of other factors that may present in determining both frequency and interest.

Social sexual expectations have changed since the last century and “normal” today means that a person should have a regular, consistent sex drive (Pertot, 2007). There seems to be little recognition of the fact that we are not all the same sexually. Libido can be as individual as different personalities, height, weight or food preferences. There may be just as many definitions of successful sexual relationships, yet society (and psychology) would seek to determine what is normal and what is not in this respect (Pertot, 2005). In a relationship where two individuals have differing libidos, there is thus the potential for assigning judgement and blame around what constitutes a healthy libido as opposed to that which constitutes a disorder or abnormality, resulting in conflict as opposed to acceptance of, and respect for individual libido differences. In such a relationship, there is therefore the expectation to function together sexually in a certain way that is deemed to be healthy and normal.

Interestingly, I have not yet in any of my research, come across a definitive definition of what constitutes normal sexual desire, nor one way to be sexual, nor have I found a term for high sexual desire as a disorder, which one would expect to be on the other end of the continuum if low sexual desire can be classified as a disorder. Pertot (2005) and Ducharme (2008) confirm this observation.

Conflict in a relationship usually arises when one partner is unhappy with their sexual desire not being met. Usually it is the partner who is less interested who is considered to have the ‘problem’, but who is to say who is the ‘abnormal’ one? Moelker (2007) suggests that the person with the lower libido may not be less interested than ‘average’, but is only less interested than the partner. Pertot (2007) states: “Even people with secure, happy personal histories can end up in unsatisfying sexual relationships, because it is how your individual sexuality interacts with your partner’s that defines what is a problem and what isn’t”.

Although sexual desire or libido is commonly thought to be a physical urge for sex Pertot (2007) believes that “in fact it is any motivation that leads to the decision to have sex”. So what motivates us to not feel like sex?

Physical or medical, and psychological factors are seen as predominant reasons for hypoactive sexual disorder. There are hormonal and other gender differences which make for a naturally higher sex drive in men than women. In addition, a woman’s desire for sex is based on far more complex feelings, rather than on a physical drive as with men. Fear, negative emotions, fatigue, beliefs, lifestyle, societal and cultural conditioning and relationship issues may all influence the different individual desires. It is also important to note that these influences may cause low sexual libido in one person, but may not in another.

Ignorance and misunderstandings play an important role in what is considered to be normal and our expectations are gleaned from society’s unrealistic portrayals of sexuality in the media. The messages given in movies, books and the internet, are that sex is hot and passionate and seldom with hiccups. The majority of couples who seek help with distress in their sexual relationships are good people who don’t intend being hurtful to each other, but just don’t know how to bridge the differences in their sexual needs.

An Alternative Approach

For many years, lack of, or low libido as a sexual dysfunction has been defined in terms of specific behavioural shortfalls. Dr Sandra Pertot, a clinical psychologist and sex therapist for 30 years, changed her assessment framework to address the distress using different questions. Using what she describes as the ‘Possibilities Approach’, less importance is put on labeling what the person is actually doing as being the problem, and shifts the focus to why their sexual functioning is a problem in the relationship. A crucial aspect of this approach is to distinguish between judgement and description of the problem, since judgment can lead to feelings of inadequacy and avoidance to improve the situation. During her years of experience as a sex therapist, Dr Pertot started to recognize and group together certain characteristics of sexual desire and developed a method to define different (currently ten) libido types. This concept gives a perspective of our differences and aims to develop understanding one another, thereby eliminating the judgment around one type being “abnormal”. It takes the focus off ‘abnormality’ and creates space to explore other options, reducing the distress in the relationship.

Perhaps it would be better not to specifically classify hypoactive sexual desire as a disorder, but rather look at the individual reasons for low sexual desire with a view to the treatment of that specific problem (for example, hormone imbalances or the affect of past sexual abuse).

Furthermore, it seems beneficial to do away with the perspective that a person with a lower sexual desire has a problem and to rather see the couple’s inability to lovingly deal with individual differences as the challenge that needs to be addressed. Educating couples in understanding differences in sexuality, fostering respect for individual desires and facilitating understanding and support for each other in dealing with the contributing factors that are a result of physical, hormonal and psychological issues, could conceivably result in fewer people presenting with problems of low sexual desire. At the end of the day, it would seem to boil down to love, understanding and a genuine interest in each other.

The debate around what is considered “normal” sexual desire and the controversy around classifying low sexual desire as a disorder, seems widespread. Neither take into consideration the obvious gender differences in sexuality, nor the differences and responsibility of both partners in a loving relationship, but instead serves to create judgement which may contribute to further distress . Sexual desire is not just a physical urge, but a complicated interaction between partners which is influenced by many different factors, and can change at any given point in time.

Reference List

Angier, N. 3 May 1994, ‘Male Hormone Molds Women, Too, In Mind and Body’, New York Times, Science [Online]. Available: http://query.nytimes.com/gst/fullpage.html?res=9907E3DF1130F930A35756C0A962958260 [Accessed : 27 Feb. 2008].

Harvey, J.H. & Wenzel, A. & Sprecher, S. (2004) ‘The Handbook of Sexuality in Close Relationships’ [Online]. Available: https://books.google.co.za/books?id=LohEE9kwRxUC&pg=PA456&lpg=PA456&dq=low+sex+drives+conflict+in+relationships&source=web&ots=X_uzAy1kFP&sig=U-Ckvn8jfJxFjyiySo-LrD0AEmM&hl=en [Accessed 26 Feb. 2008].

MayoClinic.com, Female Sexual Dysfunction [Online], 2006. Available: http://health.msn.com/health-topics/sexual-healthy/womens-sexual-health. [Accessed 28 Feb.2008].

MayoClinic.com, Low Sex Drive in Women – Comprehensive overview covers diagnosis, treatment of this common problem [Online], 2007. Available: http://health.msn.com/health-topics/sexual-healthy/womens-sexual-health/articlepage.aspx?cp-documentid=100186622. [Accessed 28 Feb.2008].

Moelker, W 5 Jun. 2007, ‘Psychological Problems Related to Women with Low or No Sex Drive, Questions’ [Online]. Available: http://web4health.info/en/answers/sex-no-desire-psy-f.htm [Accessed 26 Feb. 2008].

Pertot, S. (2005) Except from ‘The Illusion Of Sexual Individuality’ [Online]. Available: http://www.power-surge.com/educate/sexual_individuality.htm [Accessed 26 Feb. 2008]

Pertot, S (2007) When Your Sex Drives Don’t Match: Discover You Libido Types to Create A Mutually Satisfying Sex Life. New York: Marlowe & Company.

Stanley Ducharme, Ph.D [Homepage of clinical psychologist and consultant Dr Stanley Ducharme] [Online]. Available: http://www.stanleyducharme.com/resources/low_sex_desire.html [Accessed 27 Feb. 08] Other Related Readings

Gawain, S (1986) ‘Living In The Light’ (2nd ed). Great Britain (1988): Eden Grove Editions.

Love, T. (no date) ‘Relationships & Love – Nine Sex Drive Killers’ [Online]. Available: www.thirdage.com/news/articles/ALT03/05/0517-01.html [Accessed 24 Feb. 2008]

O’Neill, N and O’Neill, G (1984) ‘Open Marriage’ (3rd ed). New York: M Evans and Company, Inc.

Pertot, S. (2005) Except from ‘Perfectly Normal: Living and Loving with Low Libido’ [Online]. Available: http://www.power-surge.com/educate/lowlibido.htm [Accessed 26 Feb. 2008]

Quasha, D.R. (2006) ‘An Inquiry into Female Sexual Dysfunction and Testosterone’ [Online]. Available: http//leda.law.harvard.edu/leda/data/786/Quasha06.rtf [Accessed 25 Feb. 2008]

Redmond, G (2007) The Hormone Help Centre, ‘Hormones & Sex: When Sex Does Not Seem Right’ [Online]. Available: http://www.hormonehelpny.com/column/sex.htm [Accessed 27 Feb. 2008]

Author: Shellean Jones from Divorce Resource.
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