Article: Robyn Von Geusau from SHAPE
Image: Ablestock

Yet women have had a torrid time of it: too little enthusiasm, and we were labelled "frigid"; too much, and we were "nymphomaniacs".

The media and movies haven't been much help. If you grew up on a diet of Barbara Cartland, you could hardly be blamed for wondering why you didn't hear cymbals clashing every time your bodice was ripped from your heaving bosom and the flag was planted on Smoky Mountain. Hollywood has perfected the "meet-n-mate" recipe. Your eyes lock across a crowded room, cut to next scene where perfectly matched underwear is peeled from gleaming torsos followed by a bout of utter ecstasy on silken sheets.

"We are given a distorted view of sexual interactions between people," says Sapire. "In real life, one needs security and trust to find a sexual relationship fulfilling. Most people want to feel cherished, otherwise they feel vulnerable and it is difficult to let go."

If things aren't working
The medical community has separated FSD into four categories: desire disorders, arousal disorders, orgasmic disorders and sexual pain disorders. The first, hypoactive sexual desire or low libido, is rated as the most common.

There is a vast array of factors affecting libido, including stress, illness, menopause, surgery, low self-image, relationship problems, exhaustion, childbirth, depression or trauma. The simple popping of a prescription pill is certainly not going to help here.

"A reduction in libido is universally experienced by both men and women at some stage in their life, even if it is only transitory and occurring at times of physical illness," states Sexual Health Geddes & Grosset).

But does this make it a dysfunction? Absolutely not, says Dr John Bancroft, director of the Kinsey Institute, who says the term "dysfunction" is misleading. He says lack of desire is a healthy response for women faced with stress, exhaustion or threatening behaviour from their partners, and he urges that attention be paid to other aspects of women's lives. Sapire agrees: "So many women are simply not in the mood. It is becoming more common and is not surprising when you consider the stresses of holding down a job, running a house, dealing with a family," she said.

It is not this aspect of FSD that the industry is targeting. Drugs companies have set their sights on the so-called arousal disorders, which they believe can be relieved by increasing blood flow, which will enhance the ability to lubricate.

Shere Hite, author and researcher into female sexuality, isn't convinced. Writing in The New Scientist, she said the pharmaceutical industry had "misunderstood the basics of female sexuality". "It is not women who need to change, or be made different through drugs, but the drug industry's own outdated notion of how women should have sex," she charged. None of the "disorder" categories are independent of each other. If pain during intercourse is a major factor, one cannot just target the arousal factor, she points out. Anticipating pain will kill off desire. An arousal pill may be a costly waste of time if the root cause of that lack of arousal is addressed."

What to do?
If we are talking lack of sexual desire – with its wide-ranging base of possible causes – the pressure created by a medical "cure" will be extremely unhelpful. The non-physiological aspects of sexuality have to be addressed, and this is where therapy can play an important role. Here's how to address them: