Why is My Libido Low and How Can I Improve It? Understanding Hypoactive Sexual Desire Disorder in Women

By Tommaso Barba, Neuroscientist

"A major theme among the women I treat is their difficulty in asking men to do this or that, to touch them in a certain way. Women are very tender with the male ego. They're afraid of offending their partner's pride because men like to think they know how to perform.” - Avodah K. Offit, The Sexual Self

Sexuality, a fundamental aspect of our human experience, is a complex interplay of gender identity, sexual orientation, eroticism, pleasure, intimacy, and reproduction. It's more than just the physical act of sex. It's a reflection of our thoughts, fantasies, desires, values, behaviours, roles, and relationships.

At some period or another, most of us suffer from low sex drive and desire. But why does this occur more among women? Is there more at play than we think?

What Is Sexual Activity and What Does Human Sexuality Involve?

Sexual activity involves a complex interaction between the nervous system, the endocrine system, the vascular system, and a variety of structures that are instrumental in sexual excitement, satisfaction, and intercourse.

Though essentially it is meant for procreation, it has also been a source of pleasure, a natural relaxant, and bolsters one’s self-esteem and sense of attractiveness for mutually satisfying relationships.

The World Psychiatric Association has defined sexual health as “a dynamic and harmonious state involving erotic and reproductive experiences and fulfilment, within a broader physical, emotional, interpersonal, and spiritual sense of wellbeing, in a culturally informed, freely and responsibly chosen and ethical framework; not merely the absence of sexual disorders.”

In the dance of human sexuality, there are three fundamental steps: desire, arousal, and orgasm.

Desire is the first whisper of attraction, a mental pull towards sexual activity. This is followed by arousal, a crescendo of physiological changes in the body, manifested by a quickened heart rate and blood pressure, and sex-specific responses like vaginal lubrication in women. The dance reaches its climax with orgasm, a burst of intense pleasure, followed by a soothing sense of relaxation and satisfaction.

"It was Heaven. I was the earth, the mountains, the tigers, the rivers that flowed into the lakes, the lake that became the sea. He was thrusting faster and faster now, and the pain was mingled with pleasure, and I could have said: 'I can't take any more', but that would have been unfair, because, by then, he and I were one person." - Eleven Minutes (Paulo Coelho)

What Is Hypoactive Sexual Desire Disorder (HSDD)?

Despite the natural progression of sexuality, many women often find themselves lost in a maze of sexual disorders.

One of the most prevalent among these is Hypoactive Sexual Desire Disorder (HSDD). Characterized by a persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity, HSDD can cause marked distress or interpersonal difficulty.

It's a condition where feelings of sexual interest or desire, sexual thoughts or fantasies, and responsive desire are absent or diminished, despite the desire to do so. The motivations for attempting to have sexual arousal are scarce or absent.

The Science behind Hypoactive Sexual Desire Disorder (HSDD)

Recent advances in neuroimaging have given us an unprecedented glimpse into the workings of the female brain during sexual activity, particularly in cases of Hypoactive Sexual Desire Disorder (HSDD).

This research has revealed that HSDD is associated with specific patterns of brain activity, particularly in the fronto-limbic-parietal brain network, a set of areas important to support resistance to emotional distraction to promote goal-directed behaviour.

In simpler terms, imagine your brain as a complex network of highways, with different routes leading to different responses and emotions.

In women with HSDD, there seems to be less traffic on the 'sexual desire' route and more traffic on the 'self-referential' route. This self-referential route involves self-inspection, monitoring, and evaluation.

So, what does this mean?

It suggests that in women with HSDD, there's an overactivity in the part of the brain associated with self-monitoring.

Instead of focusing on the sensory experience during sexual activities, the brain is busy inspecting and evaluating oneself or focusing on problems unrelated to the sexual experience such as:

“Have I finished my work tasks?”, “Did I prepare enough food for the kids?” and so on. This overactivity can disrupt sexual desire, making it harder to engage in and enjoy sexual activities.

This finding is crucial because it challenges the common misconception that sexual disorders like HSDD are solely due to hormonal imbalances.

Instead, it highlights the role of brain activity and how our thoughts and perceptions can impact our sexual health. It underscores the fact that our minds and bodies are not two separate entities but are part of a continuum, influencing and being influenced by each other.

The Role of Mindfulness in HSDD and Sexual Wellness

In the context of HSDD, mindfulness can help redirect the traffic on these mental highways. It can help reduce the overactivity in the self-referential brain network, the part of the brain that's busy inspecting, monitoring, and evaluating oneself or focusing on unrelated problems.

By training the mind to focus on the present, mindfulness can help shift this focus to the sensory experience of sexual activities. But how does this work in practice?

Mindfulness-based therapies often involve exercises that help individuals focus on their breath or body sensations. In the context of sexual activity, this could mean focusing on the touch of a partner, the physical sensations of arousal, or the feelings of closeness and intimacy.

The goal is not to force sexual desire but to create a space where it can arise naturally.

Moreover, mindfulness can foster a sense of acceptance and compassion towards oneself, reducing feelings of pressure or anxiety that can often accompany sexual disorders. This can not only enhance sexual desire but also make sexual activities more enjoyable and satisfying.

Breaking Social Stigma: Embracing Female Sexual Wellbeing

In the 21st century, it's time we break the chains of social restrictions and stigma associated with female sexuality.

The first step towards healing is creating factual awareness about sexuality, not just among women, but in society as a whole. Understanding and accepting female sexuality in its entirety is the key to addressing most problems related to it.

Sexual wellness is an integral part of overall health and well-being. It's time we start conversations, spread awareness, and ensure everyone has access to the information and help they need to lead a sexually healthy life.

Let's embrace the beauty of female sexuality and celebrate it in its fullness.