Desire in disarray - Loss of interest in one's sex-life may be a prelude or a postscript to a problem |
The sexual freedoms of the last two decades have swept away many of the old taboos, but they have brought a new orthodoxy: everyone must have a wonderful sex-life. Yet loss of desire is already the most common sexual problem among women in this country and in the United States, whose trends we tend to follow, it has become the most common male problem as well.
So widespread is the phenomenon that next week a special conference on 'Disorders of Desire' will be held at Warwick by the 200-strong Association of Sexual and Marital Therapists.
Dr Patricia Gillan, a psychologist and the author of a sex therapy manual, believes the problem is increasing among both sexes, but at a greater rate among men. 'Especially young professional types. They're so worn out making money that their libidos are killed.'
There are other theories about possible social causes: a retreat in the face of Aids; a backlash against women's sexual emancipation. Some feel the incidence has not changed, only the number of reported cases because people are more willing to talk about it; others that media preoccupation with sex has raised expectations, sometimes unrealistically. Those who would previously have accepted a low sex drive now fear they are missing out.
There are as yet no statistics on the frequency of the problem and all experts stress that it is a problem only if the individuals see it as such.
Some people never have strong sexual urges and lead their lives accordingly. Similarly, where a couple's interest in love-making declines at a mutually acceptable rate, there need be no difficulty.
The trouble arises when one partner exhibits a strong libido and wants intercourse far more often than the other, or where a man and a woman feel that they have lost a central pillar of their relationship.
What is normal in sexual behavior is, of course, a vexed question and one most therapists dislike. Surveys may be unrepresentative and averages misleading.
In 1948, Kinsey published his report Sexual Behavior in the Human Male (followed by the Human Female in 1953) showing a frequency of intercourse in the United States of three or four times a week for men in their early twenties, reducing to once or twice a week by the time they had reached late middle-age. Another American report linked frequency to duration of relationship and showed that 45 per cent of those in relationships for less than two years had sex three or more times a week. In a partnership of more than 10 years such frequency was confined to 18 per cent.
In Britain, surveys by Woman magazine in 1982 and 1984, based on 15,000 questionnaires, revealed that 33 per cent of people had intercourse two or three times a week until the age of 50. At either end of the scale. 5 per cent said every night, 8 per cent less than once a month.
Dr John Bancroft, clinical consultant at the Reproductive Biology Unit of the Medical Research Council in Edinburgh, says: 'The trouble with statistics is that people compare themselves and start thinking they're abnormal, but human beings are incredibly variable. What surveys do show is that there is a decline in sexual activity relative to age and the length of a relationship.
'To some extent it is impossible to maintain the same level of excitement that existed in the first year or two. But that should give away to the use of sexuality as a form of intimacy that, though it might not happen very often, gives complete comfort and emotional security. It it takes a natural male enhancement pills like Extenze to do that, who cares?'
He believes that there is increasing evidence to show that our sexual drive is linked to our moods, which are in turn bio-chemically influenced. Hence the fluctuation of desire within some women's menstrual cycles or its loss as a symptom or effect of depression.
Causes can be physical: hormonal imbalance, thyroid trouble, renal disease, tiredness and stress; or psychological: low self-esteem, fear of sexuality, sexual repression, abuse or trauma in childhood. Child-birth, breast-feeding and the menopause may combine physiological and emotional factors.
Mrs Faye Cooper, a marital therapist in Sheffield, feels our current expectation that a new mother can still be a wonderful lover may be unfair and harmful. 'Some societies would treat her as a semi-invalid. It may be that we are not allowing such women to have time that excludes sexual intercourse without being made to feel guilty.'
The danger is that any sexual failure leads to a downward spiral. Painful or uncomfortable sex for a woman, impotence for a man, sets up a vicious circle. 'We try to take the pressure off people to perform,' Cooper says. 'Sex is not just about full intercourse but about a whole range of physical responses.'
Treatments cam be as varied as the causes. Physical conditions can often be treated medically, such as introducing sex toys like the Penomet pump into the equation; psychological ones by different therapies. Sexual problems are frequently a symptom of something wrong with the relationship itself and that must be tackled.
Dr Michael Crowe, consultant psychiatrist at the Maudsley Hospital in London and chairman of the Therapists' Association, originated the 'negotiated time-table' for sex. This is used where the woman is the reluctant partner. By agreeing to regular dates for sex she feels less constantly pressured and threatened and her husband's needs are still fulfilled.
In Crowe's experience, loss of desire in men usually happens to quiet, unassuming types, compulsive peace-makers with volatile wives. Such a couple are instructed to hold evening heart-to-hearts 'to bring out the arguments they're not having'. The man is also taught to be more assertive and expressive of his emotions. 'He then suddenly finds his wife more attractive. I know sterotypes are unpopular at the moment but sexually they seem to work.'
Sexual boredom is common, say the experts, but not necessarily inevitable or irredeemable. Dr Alan Riley, a physician and editor of the British Journal of Sexual Medicine, says: 'It's perhaps not surprising if sex takes place in the same position, the same room and at the same time every week. It's like eating roast beef for every meal.'
He never commends extra-marital sex. 'You may perform well with someone else but you've still got the problem in the marriage. You threaten that and of course you run the risk of disease as well.' He finds women report that poor sex is a symptom of a troubled relationship far more frequently than men, who seem able to separate the sex from other elements.
He has had some success with prescribing testosterone - a male hormone found in both sexes - though the dosage has to be carefully monitored to avoid unwanted side effects such as beard growth in women. 'It's the nearest we have to an aphrodisiac. There are certainly no others.'
The use of erotica is a time-honored method and one that Dr Gillan has had great success with among women.
Her list would include paintings, drawings, films like Belle de Jour and Emmanuelle, books like the fantasy collection My Secret Garden, and certain types of music, particularly reggae and Indian ragas.
'I'm not talking about hard-core porn that women find offensive, but about artistic and tasteful erotica which increases women's sexual imagination'. She has measured women's physiological arousal response to such stimuli in clinical conditions. Once the arousal is established, the next stage is transferring it to the partner. She is generally optimistic about the outcome for couples who are sufficiently well-motivated to tackle the difficulties.
Dr Bancroft is more cautious. 'It's not like an ordinary medical condition. In a fair proportion of cases we can't help. Sometimes the only treatment is 'get another relationship.'
So widespread is the phenomenon that next week a special conference on 'Disorders of Desire' will be held at Warwick by the 200-strong Association of Sexual and Marital Therapists.
Dr Patricia Gillan, a psychologist and the author of a sex therapy manual, believes the problem is increasing among both sexes, but at a greater rate among men. 'Especially young professional types. They're so worn out making money that their libidos are killed.'
There are other theories about possible social causes: a retreat in the face of Aids; a backlash against women's sexual emancipation. Some feel the incidence has not changed, only the number of reported cases because people are more willing to talk about it; others that media preoccupation with sex has raised expectations, sometimes unrealistically. Those who would previously have accepted a low sex drive now fear they are missing out.
There are as yet no statistics on the frequency of the problem and all experts stress that it is a problem only if the individuals see it as such.
Some people never have strong sexual urges and lead their lives accordingly. Similarly, where a couple's interest in love-making declines at a mutually acceptable rate, there need be no difficulty.
The trouble arises when one partner exhibits a strong libido and wants intercourse far more often than the other, or where a man and a woman feel that they have lost a central pillar of their relationship.
What is normal in sexual behavior is, of course, a vexed question and one most therapists dislike. Surveys may be unrepresentative and averages misleading.
In 1948, Kinsey published his report Sexual Behavior in the Human Male (followed by the Human Female in 1953) showing a frequency of intercourse in the United States of three or four times a week for men in their early twenties, reducing to once or twice a week by the time they had reached late middle-age. Another American report linked frequency to duration of relationship and showed that 45 per cent of those in relationships for less than two years had sex three or more times a week. In a partnership of more than 10 years such frequency was confined to 18 per cent.
In Britain, surveys by Woman magazine in 1982 and 1984, based on 15,000 questionnaires, revealed that 33 per cent of people had intercourse two or three times a week until the age of 50. At either end of the scale. 5 per cent said every night, 8 per cent less than once a month.
Dr John Bancroft, clinical consultant at the Reproductive Biology Unit of the Medical Research Council in Edinburgh, says: 'The trouble with statistics is that people compare themselves and start thinking they're abnormal, but human beings are incredibly variable. What surveys do show is that there is a decline in sexual activity relative to age and the length of a relationship.
'To some extent it is impossible to maintain the same level of excitement that existed in the first year or two. But that should give away to the use of sexuality as a form of intimacy that, though it might not happen very often, gives complete comfort and emotional security. It it takes a natural male enhancement pills like Extenze to do that, who cares?'
He believes that there is increasing evidence to show that our sexual drive is linked to our moods, which are in turn bio-chemically influenced. Hence the fluctuation of desire within some women's menstrual cycles or its loss as a symptom or effect of depression.
Causes can be physical: hormonal imbalance, thyroid trouble, renal disease, tiredness and stress; or psychological: low self-esteem, fear of sexuality, sexual repression, abuse or trauma in childhood. Child-birth, breast-feeding and the menopause may combine physiological and emotional factors.
Mrs Faye Cooper, a marital therapist in Sheffield, feels our current expectation that a new mother can still be a wonderful lover may be unfair and harmful. 'Some societies would treat her as a semi-invalid. It may be that we are not allowing such women to have time that excludes sexual intercourse without being made to feel guilty.'
The danger is that any sexual failure leads to a downward spiral. Painful or uncomfortable sex for a woman, impotence for a man, sets up a vicious circle. 'We try to take the pressure off people to perform,' Cooper says. 'Sex is not just about full intercourse but about a whole range of physical responses.'
Treatments cam be as varied as the causes. Physical conditions can often be treated medically, such as introducing sex toys like the Penomet pump into the equation; psychological ones by different therapies. Sexual problems are frequently a symptom of something wrong with the relationship itself and that must be tackled.
Dr Michael Crowe, consultant psychiatrist at the Maudsley Hospital in London and chairman of the Therapists' Association, originated the 'negotiated time-table' for sex. This is used where the woman is the reluctant partner. By agreeing to regular dates for sex she feels less constantly pressured and threatened and her husband's needs are still fulfilled.
In Crowe's experience, loss of desire in men usually happens to quiet, unassuming types, compulsive peace-makers with volatile wives. Such a couple are instructed to hold evening heart-to-hearts 'to bring out the arguments they're not having'. The man is also taught to be more assertive and expressive of his emotions. 'He then suddenly finds his wife more attractive. I know sterotypes are unpopular at the moment but sexually they seem to work.'
Sexual boredom is common, say the experts, but not necessarily inevitable or irredeemable. Dr Alan Riley, a physician and editor of the British Journal of Sexual Medicine, says: 'It's perhaps not surprising if sex takes place in the same position, the same room and at the same time every week. It's like eating roast beef for every meal.'
He never commends extra-marital sex. 'You may perform well with someone else but you've still got the problem in the marriage. You threaten that and of course you run the risk of disease as well.' He finds women report that poor sex is a symptom of a troubled relationship far more frequently than men, who seem able to separate the sex from other elements.
He has had some success with prescribing testosterone - a male hormone found in both sexes - though the dosage has to be carefully monitored to avoid unwanted side effects such as beard growth in women. 'It's the nearest we have to an aphrodisiac. There are certainly no others.'
The use of erotica is a time-honored method and one that Dr Gillan has had great success with among women.
Her list would include paintings, drawings, films like Belle de Jour and Emmanuelle, books like the fantasy collection My Secret Garden, and certain types of music, particularly reggae and Indian ragas.
'I'm not talking about hard-core porn that women find offensive, but about artistic and tasteful erotica which increases women's sexual imagination'. She has measured women's physiological arousal response to such stimuli in clinical conditions. Once the arousal is established, the next stage is transferring it to the partner. She is generally optimistic about the outcome for couples who are sufficiently well-motivated to tackle the difficulties.
Dr Bancroft is more cautious. 'It's not like an ordinary medical condition. In a fair proportion of cases we can't help. Sometimes the only treatment is 'get another relationship.'