Written by Emily Lacy, Sex and Relationship Therapist
Emily Lacy is the owner and founder of Aligning Intimacy Therapy where she practices as a Sex and Relationship Therapist. She specializes in sexual trauma, genito-pelvic pain, and low libido and holds a passion for appropriate and accessible sexual education.
One of the most common concerns to present in a sex therapist’s office is mismatched libido or low libido. Also known as desire discrepancy, mismatched libido typically involves one partner having a lower sex drive than the other, which is leading to both personal and relationship distress. This is an incredibly common issue among many relationships, but that doesn’t mean it has to be the norm. From establishing emotional safety to exploring erotic imagery, this article will offer some strategies to create a desire that feels easier and lasts longer.
What is low libido?
Low libido is usually described as a decreased interest or desire for sexual activity. The clinical diagnoses detailed in the Diagnostic and Statistical Manual (DSM-5-TR) include female sexual interest/arousal disorder and male hypoactive sexual desire disorder. However, you don’t need to meet all the criteria for a clinical diagnosis to experience distress with libido concerns. Most of the time, one’s relationship with libido is such a personal experience that it’s difficult to generalize symptoms. One person may be completely unaffected by low libido while another may experience great distress in all areas of functioning.
What causes low libido?
This section could be an entire research paper on its own. There are a plethora of potentials for why your libido level fluctuates or stays consistently low. Physical health, mental health, lifestyle, relationship dynamics, stage of life, and psychological influences are just a starting point for you to explore. For example, as a sex and relationship therapist, some of the first things I suggest clients investigate are their hormone levels. Libido levels are also often impacted by medications, chronic illnesses, stress, relationship conflicts, poor communication, past experiences of trauma, low self-esteem, body image concerns, and so much more. It’s very rarely just one thing being labeled the culprit. Rather, all of the above mentioned factors have likely created an intricate and complex system that influences many of our body’s natural responses to the world around us.
6 strategies for creating and boosting desire
1. Build emotional safety to grow physical intimacy
Typically, but certainly not always, couples enter my office after several years in a committed relationship telling me how they just don’t understand what happened.
“When did the spark go out?”
“How do we have more sex?”
And my personal favorite…”What’s wrong with me?”
I almost always start this journey with my clients by establishing a foundation of emotional safety and trust. If we aren’t feeling safe enough to show vulnerability, how can we feel excited about sharing our body? If we’ve been made to feel like we aren’t enough for our partner or are constantly disappointing them, desire isn’t likely to make an appearance. Partners can start creating an emotionally safe environment by having a respectful, compassionate, and curious conversation. Asking questions without blame, acknowledging our role in the relationship, embracing accountability for our behavior, and showing empathy for one another. I’m not, by any means, saying this is easy but I am saying this is necessary. Feeling affection for our partner can be a powerful precursor to feeling desire.
2. Manage your stress cycles
We probably already know what stress feels like, right? If you don’t, there might be a general idea of what it is and I’m confident you or someone you know has said “I’m just stressed out!” Well, yeah, we live in a world that thrives on cultivating stressful environments to increase productivity, earn more money, or become a “better” spouse, parent, employee, leader, etc. . What that environment does not do, is create a space for sexual desire that fuels a fulfilling and satisfying sex life.
Stress is not only mentally, but physiologically, the antithesis of desire. What does that mean? Stress will almost always dominate libido if left unchecked. In her book Come as You Are, Emily Nagoski describes the impact of stress on sex. Nagoski illustrates how people who are stressed are more likely to interpret any stimuli as a threat and are also likely experiencing information overload. When stress is driving our mind and body, many things are placed lower on the priority list or even blatantly ignored, which includes your sex drive. This drives the need to manage our stress cycles as efficiently as we can, because avoiding them is practically impossible.
3. Explore foreplay
When I ask clients how they understand or describe foreplay, I’m typically hearing activities involving their genitals or the more “obvious” erogenous zones (i.e. breasts, butt, neck, etc.). I also hear a lot about making out, kissing, and back rubs. That’s great, and definitely some enjoyable and fun sexual activities that are part of many individuals’ foreplay experience. However, I’m almost always telling clients to start their foreplay in the morning if they are wanting to work toward having sex in the evening.
Foreplay can and most often should last much longer than two to ten minutes because it involves so much more than only physically arousing the female identifying partner in the hopes of having sex. It’s time to redefine foreplay as something for both partners to actively engage in, explore, and mindfully experience. Start cuddling earlier in the evening, hugging while leaving for work, texting throughout the day about new things you want to try, holding hands in the car. Foreplay can be words as much as touch. There really are endless possibilities for growing your foreplay menu so why limit yourself to one or two options? The takeaway…start affectionately touching each other and communicating when intercourse isn’t an option so that you are ready to go for it when it is.
4. Know your desire type
First, it is imperative to know that desire and arousal are not the same thing. Yes, they can often present concurrently however, that’s not always the case. We can absolutely produce arousal when desire hasn’t been invited to the party and that paves the way for incredibly mixed messages for both yourself and your partners. On that same thought, desire can be raging but arousal is just not happening. It’s a totally normal experience called arousal non concordance. Dr. Noam Shpancer goes into detail explaining this phenomenon in his article “Sexual Arousal is Not a Reliable Sign of Sexual Desire.”
So how are they different? Arousal is our body’s physiological response. It’s the feeling of being “turned on.” For example, an erection, vaginal lubrication, increased heart rate, rapid breathing, and/or tingling in the nipples or genitals can all be arousal responses. Desire is the wanting to engage in sexual experiences. Desire can be described as “being in the mood,” or “wanting to want.” Basically, our brain is leading our body into our sexual feelings. Desire can be triggered by sexual imagery, thoughts, touches, or really whatever works for you personally, which gives it so much potential to explore!
Emily Nagoski, Ph.D. explains three main types of desire in her book Come As You Are. Spontaneous desire is what most people commonly think of and the overarching theme in media, romance novels, and movies. Spontaneous desire is exactly what it sounds like, zero to one hundred with little to no lead up necessary. People with this desire type are ready for sex almost immediately if the opportunity presents itself. On the other end of the spectrum is responsive desire. This desire type wants a bit more of a warm up before coming fully online. This is where foreplay, both emotional and physical, is very important. There might be a need to provide sexual stimulus to build desire gradually rather than expecting it to appear out of nowhere. Finally, context dependent desire relies heavily on the who, what, when, where of a situation. In this type, desire is dependent upon an individual’s likes and dislikes as well as their environment. Nagoski has a variety of free resources and worksheets on her website to begin exploring sexual temperaments and desire.
All of these desire types are entirely normal and healthy! You may even experience more than one over the course of your sexual encounters and that’s absolutely normal as well. There is not one ideal type, even when societal norms and expectations are screaming the opposite. How an individual feels desire is a personal experience and doesn’t have to be a sign of dysfunction. Exploring within your desire type can be a game changer when trying to boost libido. People are expending a vast amount of energy in the effort to become something they think they “should” be and feeling shame and disappointment when it doesn’t work out. It’s time to stop fighting what we can naturally embrace and nurture from within ourselves.
5. Embrace play
For many people, sex isn’t fun anymore. Intimacy has been clouded by expectations, obligations, and insecurities. Somewhere along the way, sex became a task rather than an experience. It became a checkbox on the never ending to-do list. For others, sex became something to fear and avoid. Whichever way we look at it, sex doesn’t feel joyful. This happens at different times for everyone, so look to the past and try to notice when it stopped feeling fun. Maybe that answer is that it has never felt fun and exciting and it’s okay to acknowledge that.
According to a 2021 study exploring laughter as a form of therapy for depressive symptoms, the act of laughing produces an increase in dopamine activity. An increase in dopamine, “the feel good hormone,” plays an important role in how we experience pleasure and increases our desire to repeat the action. So make sex playful! Introduce a new game, explore ticklish areas of the body, try a new position, and don’t be afraid to giggle when things feel awkward.
6. Talk to someone
The short answer, if you're experiencing low libido and you want to make a change, talk to someone! A sex therapist is a wonderful place to start, and not just because a sex therapist happens to be writing this, but because they should be able to point you in the right direction and provide a space to just talk about it. Sometimes talking about it in an accepting and validating environment is all you need. However, some big indicators that you speak with a professional sooner rather than later include any experiences with pelvic pain, relationship conflict, a history of sexual trauma, taking long-term medications, or chronic medical conditions.
When clients come in for their first session describing issues or distress related to their libido, I’m already getting together a list of our referral partners. For example, some of the first things I suggest clients investigate are their hormone levels. The Cleveland Clinic lists testosterone and/or estrogen as two of the key players in a low or absent sex drive. I have watched clients go from absolutely no interest in sex to a consistent and fulfilling desire after balancing their hormones. Also, if a client is describing intercourse as painful or uncomfortable, there’s no hesitation in recommending a consultation with a pelvic floor physical therapist and sex medicine provider. These professionals can explore the body’s symptoms and offer exercises, supplements, medications, and lifestyle changes to assist in meeting personal goals.
Read more from Emily Lacy
Emily Lacy, Sex and Relationship Therapist
Emily Lacy is an emerging leader in the research and treatment of female sexual dysfunction, trauma therapy, and sex education. She has personally deconstructed harmful and shame-filled messages surrounding sex and intimacy to create an empowered approach to assist others who wish to do the same. She has since developed a group therapy practice where she and her team work diligently to promote a sex-positive and inclusive environment for all to embrace their journal toward sexual wellness.
