Welcome to Reader’s Request Fridays. As a reminder, I’ll be addressing one reader email per week, so if you have a specific question you’d like answered or a topic you’d like covered, please email me. If you’re interested in counseling, call (415) 658-5738 or visit my Appointments page to schedule a consultation.

Today’s question comes from Janine*. She writes:

“I have been recently experiencing low sexual desire. What could be the cause? Do I need therapy?”

Thank you for the question Janine! Like most of the questions I have been getting lately, this one is quite complex. Female arousal is influenced by myriad factors, and it can be difficult to ferret out exactly what is causing the dip. Here are some questions to consider:

• Has there been a change in your level of sexual desire, or have you always felt low sexual desire? Everyone has different levels of desire, and some people may have desire that is naturally on the lower end of the spectrum. Having a low sex drive may cause some difficulties in your personal life and in your relationships, but it is possible that it may simply be your body’s natural state.
• Do you want to change your level of sexual desire, or are you content with where it is? One of the main reasons couples come in to see me is because of the difficulties caused by unmatched sex drives. You may be feeling pressure from your partner to want sex more frequently. It is important to consider your own goals and your partner’s goals separately.
• Have you been under stress? Have there been any changes at work, at home, or in your relationship? Stress is typically the culprit behind a sudden dip in sexual desire. Evaluate the level of stress in your life, and see if there are concrete steps you can take to alleviate some of the intensity.
• If you are in a relationship, does your relationship support a healthy and active sex life? Does your partner make you feel secure and desirable? Are you attracted to your partner? Do you and your partner prioritize intimacy and make time to have sex? Are you going through a rut? Are you and your partner able to communicate about sex? Are you comfortable asking for what you want? This one item has enough contributing factors to warrant its’ own blog post!
• Do you feel confident in your sexuality? Do you feel comfortable with your body? Do you know what you like sexually? Do you feel sexy and attractive? Have you been taught that your body is gross, or that “good girls” have specific rules to follow when it comes to sex? If you don’t feel at peace with who you are as a sexual being, it can be difficult to be in touch with true sexual desire.
• Do you have a history of sexual trauma or abuse? Many women think that their sexual trauma was in the past and doesn’t affect them anymore. Unfortunately, sexual trauma is not something that anyone “forgets about”, and it can trigger powerful reactions in surprising situations. Your partner might do something as simple as touch you on a specific part of your body, or startle you, provoking a flood of memories and feelings.
• Have you had a medical evaluation recently? I almost always recommend getting a full medical work-up, if you can afford it. Even if your doctor doesn’t find anything, it can bring you peace of mind to know that the cause isn’t medical.
• How are you doing with sleep, diet and exercise? This one may seem obvious, but many people do not consider the impact that their physical well-being has on their sex drive.

As you can see from the long list, there are many factors to consider when taking a look at your sexual desire. Therapy can be helpful with all of these items aside from the medical and nutritional ones (and even then, therapy can be helpful if you get some bad news from the doctor or find yourself struggling with body issues). If in reading this post you’ve realized that you have gone through a recent stress in your personal life or relationship, even a handful of therapy sessions can significantly improve your situation. If you’re starting to notice that your relationship doesn’t support a healthy sex life, or that you’re not comfortable with your own sexuality, you may be looking for a deeper therapeutic journey. The good news is that sex therapy can help you have some of the most pleasurable, intimate, present, connected, and intense sex of your life!

*Names have been changed for privacy