Low Libido Treatment in New York City

What causes low libido and loss of sexual desire?

There are hundreds of possible causes for  loss of libido. Stress and exhaustion certainly top the list these days. Then there’s hating your body; feeling angry, worried, or preoccupied; painful intercourse; bad sex in general; or any combination of the above.

Psychiatric conditions like depression can make you lose sexual desire. So can medications such as oral contraceptives and serotonin reuptake inhibitors (SRI’s). Other biological factors probably play a role in loss of libido as well, in ways we don’t yet fully understand.

Trauma from your past can make you not want to have sex—sometimes years or decades later, when you least expect it. So can being abused or mistreated by your current partner. Or knowing there’s no future in the relationship, but not being quite ready to leave.

Often it’s best to think of the question in reverse: What are the sources of desire in my life? Is the sex I’ve been having with my partner really worth desiring? If not, let’s think about what you might do to improve the situation.

How common are low libido and loss of sexual desire?  

Extremely common. One well-known study found that 40% of a representative sample of adult American women reported a significant loss of desire in the previous year.

Sexual desire isn’t automatic. It’s normal to lose desire when the sex you’ve been having just isn’t making you feel good about yourself.

What’s unique about your approach to low libido and loss of sexual desire?

In my book Love Worth Making, I pioneered the idea of asking not only what causes low libido, but also what perpetuates it.  Most couples dealing with low libido and loss of desire are trapped in self-perpetuating cycles of behavior that can be identified and changed.

For example, many people who suffer from low libido eventually start to avoid anything that might turn their partner on. No sexy underwear. No lingering kisses. Nothing that might put them in the uncomfortable position of having to say no.

Many people with low libido and loss of sexual desire start staying up later and later at night, hoping their partner will be asleep by the time they get to bed. Low libido can start out quite innocently and understandably, and then turn into something bigger that involves your whole attitude towards lovemaking.

What’s the first step to resolving low libido and loss of sexual desire?

The first step in resolving low libido and loss of sexual desire is to realize you’re trapped in this kind of self-perpetuating pattern. The next is to get help by consulting with someone who specializes in sexual desire problems. I typically spend 90 minutes or more on a first consultation with an individual or couple with low libido and loss of sexual desire, since libido problems tend to be complex.

How can I learn more about your approach to low libido and loss of sexual desire?

You’ll find many articles on my blog about sexual desire, including “Sexual Desire: Why it Goes Missing, and How to Get it Back” and “Women’s Sexual Desire, and Why Men Often Don’t Recognize It.”

My book, Love Worth Making, has lots of information about what causes low libido and loss of sexual desire in both men and women — and what to do about it.

What are the three biggest mistakes people make when they lose libido or sexual desire?

One, they assume something’s wrong with them. Most often this is not the case. Low libido and loss of sexual desire usually make sense once you understand the situation.

Two, they don’t take action. Low libido and loss of sexual desire tend to get worse, unless you do something about them.

Three, when they eventually seek treatment, they don’t take the time to find a care provider who has specific experience in the evaluation and treatment of low libido.

What’s different about couples today with low libido or loss of sexual desire?

Traditionally women have been seen as more vulnerable to loss of sexual desire. But lately I see more and more heterosexual couples where it’s the man who’s lost desire.   

In couples today with low libido or loss of sexual desire, often one or both partners have neurodevelopmental issues such as ADHD.

What’s the most exciting new development in the treatment of low libido and loss of sexual desire?

The most promising new treatments these days involve mindfulness practice. Mindfulness training can be extremely helpful for individuals and couples with low libido and loss of sexual desire. My book Love Worth Making includes several mindfulness-based sex therapy practices that individuals and couples in my office have found helpful.

Can medication treat low libido and loss of sexual desire?

Medication for libido problems is still in its infancy. In my practice, I more commonly recommend stopping or changing medications, rather than adding them.

Recently, the FDA approved a new non-hormonal medication, flibanserin (“Addyi”), which in, clinical trials, improved desire and reduced distress in about half of pre-menopausal women who’d lost sexual desire and were distressed about it. My review of what’s known about flibanserin so far can be found HERE.  

How long does treatment take for loss of sexual desire?

There’s a wide range. Some sexual desire problems can be solved in just a few sessions. Others, particularly if you or your partner have a background of trauma, can take longer.

What can I expect from a first consultation for low libido or loss of sexual desire?

My goal is for you to leave the office with a better understanding of why you or your partner has lost desire — and what your best strategies and options might be for doing something about it.

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