Decreased sexual desire is the most common sexual complaint among women, affecting 30% to 40% of female adults. What’s more, low drive causes significant distress for 7% to 23% of them. The condition, formally called sexual interest/arousal disorder (SAID), is defined by specific diagnostic criteria set out in the DSM-5.
Even though low sexual appetite is highly prevalent and has consequences on mental health, sexual functioning and relationship quality for women and their partners, evidence-based treatment options have been limited-until now.
A new cognitive-behavioral couple therapy (CBCT) intervention was recently tested and standardized by Sophie Bergeron , who is a full professor in the Department of Psychology at the Université de Montréal and holds the Canada Research Chair in Intimate Relationships and Sexual Well-Being, in collaboration with Natalie O. Rosen from Dalhousie University and Katrina Bouchard from the University of British Columbia.
They conducted a feasibility study that found the CBCT intervention led to improvements, ranging from moderate to significant, in the main symptoms associated with SAID, namely low dyadic sexual desire and sexual distress. A randomized clinical trial will begin in January 2025 to validate the results.
A problem for both partners
The intervention that Dr. Bergeron and her colleagues developed directly addresses the interpersonal nature of the distress associated with reduced sexual desire."Desire disorders are strongly influenced by interpersonal factors. They’re less about biomedical issues and have more to do with the way couples interact," she explained. "This means we need to re-conceptualize low sex drive as a couple-based issue, not an individual one."
The intervention focuses on communication, acceptance, openness and vulnerability between partners. It starts by establishing a sense of intimacy within the couple, since this is a protective factor for sexual desire. "Women report improved sexual interest when they feel close to their partner, knowing they can share their thoughts and be met with empathy and understanding," said Dr. Bergeron, who also directs the Interdisciplinary Research Centre on Intimate Relationship Problems and Sexual Abuse.
The CBCT intervention encourages couples to discuss sexuality openly, which is often one of the hardest topics for couples to address, according to the researcher. Couples learn to express their needs, preferences and misgivings without fear of hurting the other person’s feelings.
The treatment primarily involves guided discussions with a therapist, but it also includes exercises to be completed at home, such as sensate focus sessions, which aim to re-introduce touch in a non-demanding way.
Destigmatization leads to relief
A major part of the intervention is debunking sexual myths, particularly those that trigger culpability and guilt in women experiencing low sexual appetite."We work on de-coupling the woman from the disorder, while normalizing and de-dramatizing her experience." shared Dr. Bergeron. "And, above all’else, we bring the focus back to the pleasure and quality of sexual relations, rather than the frequency."
In her view, this psycho-educational component seems to help ease the emotional burden-characterized by shame and frustration-that often accompanies SAID.
