Sexual arousal disorder: No sex doesn′t have to be a problem | Science| In-depth reporting on science and technology | DW | 04.03.2020
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Sexuality

Sexual arousal disorder: No sex doesn't have to be a problem

Franziska could easily do without sex. She suffers from sexual arousal disorder — she hardly ever feels sexual desire. Her marriage has suffered. Because a relationship without sex cannot function — can it?

When Franziska senses that her husband wants sex with her, her body cramps. "Should I allow it or not?" she asks herself. A few times, a situation like that has even turned into a full-blown panic attack.

"Sex is the absolutely worst problem in our relationship," says Franziska. The 37-year-old psychologist has been with her husband for 20 years. The couple has two children and a big problem: He likes to have a lot of sex, but her desire is almost zero.

This is an extreme burden for the relationship. "I'm under constant pressure," says Franziska. If her husband wants to have sex with her, she does him the favor, but at the same time constantly violates her own limits. Sometimes, she also says no. "That's not an intuitive decision, but a rational one. Depending on how long it's been since the last time." If it's been too long, she feels that sex is her duty. Sex — for Franziska and her husband, it means above all distress and quarrels.

Sex? No, thank you!

What Franziska and her relationship suffer from is called sexual arousal disorder, also known as Hypoactive Sexual Desire Disorder (HSDD). 

People who are affected by it have no or few sexual fantasies. They rarely, or never, react to erotic stimulation with sexual desire.

As a psychologist, Franziska became aware that her lack of desire and her reaction to certain ways of being touched could point to traumatic experiences in her past. However, she cannot remember anything. The therapies she has undergone have not been able to shed any light on the cause, either.

Franziska feels inadequate, as if she were not a real woman. She cannot give the man she loves what he wants, even though the couple has tried everything from sex toys and porn to medical drugs. Franziska had her hormone balance checked. Everything was fine. 

Read more: Psychology: A happy partner is the elixir of longer life

Is it a 'disorder' after all?

If Franziska were single, everything would indeed be fine. She could live very well without sex. A lack of sexual desire mostly becomes a problem, "a disorder," only within a relationship.

Many couples with such problems turn to sex therapists like Gertrud Wolf. Wolf is not a big fan of the term "sexual disorder." Focusing on sexual dysfunction, she says, often leads to the real problem being overlooked: the problem of damaged self-esteem.

She has the couples describe a typical situation: In the evening in bed, he touches her. She turns away, gives signals that she doesn't want it. "How does that feel?" Wolf wants to know. Her clients then often describe themselves as feeling inadequate, under pressure or unloved, says the therapist. "These couples usually have no sexual problem at all," she points out. "Nobody says: 'I don't know where to put my sperm.' What makes the partners unhappy is the feeling of being unloved and rejected." 

Read more: A world breaks apart: When parents split up

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Wolf doesn't like the word "disorder" for another reason: It pathologizes refusing intercourse and classifies it as a deviation, while sexual lust is declared the norm. "I would see that as a disorder as little as I can," she says. "That's crazy. It would be like accusing your neighbor of having a disorder because he is too quiet."

No desire? No problem!

That's why Wolf urgently advises people like Franziska to reduce the self-inflicted pressure. "The important message is: 'There's nothing bad about it. We don't have to have sex to feel complete.'" Instead, she says, the focus of a therapy should be on strengthening the patient's self-esteem.

Some couples, Wolf says, find very creative ways of dealing with their disparate degrees of desire. She recalls a couple who barely have sex because the woman feels no desire. That woman therefore allows her partner to sleep with other women. In this way, both do justice to their needs and their love for each other,.

After a serious crisis in their marriage, Franziska and her husband found a new way of coping with the subject of sex. Since then, it has no longer been the biggest problem. Physical approaches on his part are more cautious, and Franziska more often allows herself a "no." Her partner helps her. "My husband pays much more attention to my body signals," she says.

But still, Franziska says that if anyone came up with the idea of completely abolishing sex, she wouldn't complain.

Read more:  Psychology: What are anxiety disorders?

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