Among couples seeking sex therapy, problems of sexual desire are the most commonly reported dysfunctions, yet have historically been the most difficult to treat successfully.
[3] While higher individual sexual desire discrepancies among married individuals may undermine overall relationship well-being,[4] higher SDD scores for females may be beneficial for romantic relationships, because those females have high levels of passionate love and attachment to their partner.
[6] In married couples, husbands have been found to experience higher sexual desire discrepancies than their wives.
Those who individually experience higher rates of sexual desire discrepancy during their marriage exhibit lower levels of satisfaction in the relationship.
However, researchers propose that low desire in women partnered with men may be influenced by heteronormative structures and gender inequities.
These structures result in an inequitable distribution of household and caregiving labor, which can reduce sexual desire.
[11] Other studies have found men also experience lower relationship satisfaction when desire discrepancy is high.
[1] Furthermore, research by Davies, Katz and Jackson (1999) shows that of the individuals studied, approximately 25% reported believing their personal level of sexual desire to be different from that of their partner's, implying that not all couples who experience SDD label it as such.
[14] To support this notion, a study looked at 1,500 lesbian women who were in a relationship where 78% were initially uninvolved in sexual activities.
Studies show that homosexual women are particularly prone to internalizing negative homophobic societal attitudes which has detrimental affects on their self-esteem and identity.
[19][20] However, research suggests that given the fact that lesbian couples in a relationship are seen to have lower sexual activity, they are likely to be satisfied with their sexual frequency similar to heterosexual women in their relationship[21] highlighting the fact that low desire discrepancies may not necessarily be an issue for women.
[23] It has been proposed that among lesbian couples, SDD or Inhibited Sexual Desire (ISD) masks other underlying emotions, namely anger.
[16] Thus, exercises targeting underlying anger such as creating lists of "grievances" and encouraging the couple to pretend argue during a treatment session can be used to address the issues of underlying feelings of anger in an attempt to alleviate sexual dysfunction.
[16] The following suggested treatment is referrals to lesbian social and education groups for an exposure to positive homosexual role models.
[24] Research by Blumstein and Schwartz depicts that gay men had higher levels of sexual frequencies in comparison to lesbian women throughout all stages of their relationship.
[25] Given that there is a lack of research on sexual desire amongst homosexual male couples, it is difficult to make definitive assumptions.
[35] Sometimes, desire discrepancy may arise when partner A feels repeatedly rejected after their attempts at initiating sex.
[36] Due to its adverse effects on an individual's sexual satisfaction, it has been shown to negatively affect a relationship overall.
[34] The DSM-5 notes that low desire discrepancy, whereby a woman has a lower desire for sex than her partner, is not sufficient for the diagnosis of FSIAD but rather a reduction or absence in: The disorder can be further subdivided as either: It is associated with dyspareunia, mood disorders, problems orgasming and dysfunctional relationships.
Certain medical conditions such as diabetes mellitus and thyroid dysfunction are clinically known to predispose women to FSIAD.
[34] The Sexual Interest and Desire Inventory–Female (SIDI-F)[37] was created as a tool for clinicians to assess FSIAD in female patients.
It is the most credible measurement tool to date and is the most specified tool for assessing FSIAD (formerly known and referred to HSDD in women in the original paper) [37] The DSM 5 has characterised the diagnostic features of MHSDD as males experiencing deficient or no erotic fantasies and desire for sexual activity for a period of at least 6 months.
Approximately half of the men who have experienced psychiatric symptoms in the past are more likely to experience a significant loss in sexual desire relative to those without this history (15%).
Hyperprolactinemia (a disorder of the endocrine system) and hypogonadism has also been associated with affecting men's sexual desire.
For example, female-to-male transgender were administered with testosterone and reportedly experienced higher levels of sexual arousal and desire.
The opposite occurred for male-to-female transgender people who received androgen deprivation (antiandrogens), who reportedly experienced a decrease in sexual desire.
[58] Women ultimately may incur in decreases of sexual desire once they feel they have achieved a connection with their partner.
[59] An important point by McCarthy and McDonald highlighted that there are variations in men's sex drive signifying that solid conclusions should not be made.
This is predominantly due to biological changes, such as testosterone levels [63] and environmental factors, such as cultural influences.
Most research in this domain, and Psychology generally, tends to be conducted on university students and the samples also remain unrepresentative.