Dr Alverston Bailey, Contributor
This week I will try to shed some light on a most vexing subject - the marked difference in the sex drives of men and women and identify strategies for healing the breach.
Sex drive or libido refers to an individual's urge or desire to engage in sexual activity. On the other hand, inhibited sexual desire (ISD), sometimes called frigidity, sexual aversion, sexual apathy, sexual anorexia or hypoactive sexual desire refers to a low level of sexual desire and interest manifested by absence of sexual fantasies, thoughts, and/or desire for, or receptivity to, sexual activity which causes personal distress.
ISD disorder may be lifelong or acquired, generalised (global) or situational (partner-specific). It occurs in 20 per cent of women and in 10 per cent of men.
ISD may be a primary condition where the person has never felt much sexual desire or interest, or it may have occurred secondarily when the person who formerly had sexual desire no longer has any interest.
Low sexual desire is often the barometer of the emotional health of the relationship and may cause a partner to feel hurt and rejected, resulting in feelings of resentment and disharmony.
It is interesting to note that the opposite of ISD is hypersexuality, which is the desire to engage in human sexual behaviour at a level high enough to be considered clinically significant. It is characterised by a debilitating need for frequent genital stimulation which, once achieved, may fail to result in the expected long-term emotional - or sexual - satisfaction.
Male/female discrepancy in sex drives
A man's libido is greatest during adolescence, but lowers after 50 when his testosterone level drops.
A woman's sexual peak, on the other hand, is between her 30s and 40s, and lowers like that of a man in her 50s.
Richard Driscoll, PhD, a marriage therapist and author of Intimate Masquerades: A Survival Guide for Those Who Know Too Much discovered that the average American couple married for five years has sex only once or twice a week , and that half of all marriages experience some discrepancy in desire at some point, with men consistently having a greater sex drive than women.
Interestingly, about one in five women reported that their husbands had turned them down for sex, while half of all men said their wives had turned them down!
The female sex drive
A woman's arousal is triggered by a network of emotional, intellectual and relationship-based factors, rather than the simple physical response required by a man. Therefore, a woman's sex drive is as much psychological as it is physical.
The male sex drive
Edward O. Laumann, a professor of sociology at the University of Chicago and lead author of The Social Organisation of Sexuality: Sexual Practices in the United States, found: "The majority of males between 18 to 59 in the US report that they think about sex at least once a day - one-third think of it several times a day, but only 25 per cent of females report thinking about it every day."
He also discovered that men, on average, take four minutes from the point of entry until ejaculation while women usually take around 10 to 11 minutes to reach orgasm.
Among men in a stable sexual relationship, 75 per cent report that they always have an orgasm, but only 26 per cent of the women reported having an orgasm with their partners.
What can dampen your sex drive?
Interpersonal relationships
Communication problems
Sexual boredom
Power struggles and conflicts
Lack of quality time together.
Sociocultural influences
ISD may also be associated with a very restrictive upbringing concerning sex, negative attitudes towards sex, traumatic sexual experiences such as incest or sexual abuse, inadequate education and conflict with religious, personal or family values.
Psychological factors:
A number of psychological factors influence the libido such as:
Loss of privacy
Distraction
Environmental stressors, e.g., prolonged exposure to elevated sound levels or bright light
Depression
Stress/fatigue
Paranoia
Body image issues
Sexual performance anxiety
Ageing.
Unhealthy Lifestyles
Unhealthy lifestyles such as obesity, undernutrition, and drug abuse - alcoholism, smoking, etc., can seriously dampen your desire.
Medications
Many medications can affect the libido:
The birth-control pill, antidepressants, tranquillisers and blood-pressure medications.
Medical conditions
A plethora of medical conditions can also influence your libido, namely:
Hypogonadism - a medical term for a defect of the reproductive system which results in impaired function of the gonads (ovaries or testes) with low testosterone output.
Prolactinoma - a tumour of the pituitary gland which secretes prolactin.
Sexual anhedonia - a rare variant of ISD seen in the male, in which the patient experiences erection and ejaculation, but no pleasure from orgasm.
Sexual dysfunction such as:
Painful intercourse (dyspareunia) is more common in women than in men, but may be a deterrent to genital sexual activity in both sexes
Inability to have an orgasm (anorgasmia)
Erection problems (impotence)
Retarded ejaculation
Physical illnesses.
Physical illnesses and some medications may also contribute to ISD, particularly when they produce fatigue, pain, or general feelings of malaise.
Some typical examples are:
The hormonal changes of menopause.
Cardiovascular disease and hypertension.
Endometriosis
Fibroids
Thyroid disorders
Tumours of the pituitary gland (which controls most hormone production, including sex hormones).
Surgery (hysterectomy - removal of the uterus - and oophorectomy - removal of the ovary).
Treatment
Treatment must be individualised to the factors that may be inhibiting sexual interest.
Currently, there is no approved drug or pharmacological treatment for ISD and psychotherapy has proved to be only minimally effective.
If the cause is related to a medical condition, therapy is directed towards the cure or amelioration of that condition such as genitourinary infections, improvement in diabetes control, avoidance of substance abuse and medications that may be potentially responsible.
A recent study has reported that almost a third of non-depressed women with ISD responded favourably to therapy with sustained release tablets of bupropion hydrochloride.
Sex for most couples, either bonds their relationship or creates a wedge that gradually drives them apart. When one partner is significantly less interested in sex than his or her companion, professional help is recommended before the relationship becomes strained.
I hope this article would have provided for you some critical insights into this complex issue and you will now seek help to re-experience the joys of sex.
Dr Alverston Bailey is a medical doctor and immediate past president of the Medical Association of Jamaica. Send comments and questions to: editor@gleanerjm.com or fax:922-6223.
