Feasibility study examines relationship therapy to improve sexual desire

Decreased sexual desire is the most common sexual complaint among women, affecting 30% to 40% of adult women. In addition, low libido causes significant distress in 7% to 23% of them. The condition, formally called sexual interest/arousal disorder (SAID), is defined by specific diagnostic criteria established in the DSM-5.

Although low sexual appetite is common and has implications for the mental health, sexual functioning, and relationship quality of women and their partners, evidence-based treatment options have been limited to date.

Recently, a new intervention based on cognitive behavioral therapy for couples (CBCT) was tested and standardized by Sophie Bergeron, professor in the department of psychology at the Université de Montréal and holder of the Canada Research Chair in Intimate Relationships and Sexual Well-Being, in collaboration with Natalie O. Rosen of Dalhousie University and Katrina Bouchard of the University of British Columbia.

They performed a feasibility study who found that the CBCT intervention led to improvements, ranging from moderate to significant, in the core symptoms associated with SAID, namely low dyadic sexual desire and sexual distress. The findings were published in The Journal of Sexual Research.

A randomized clinical trial will start in January 2025 to validate the results.

A problem for both partners

The intervention developed by Dr. Bergeron and her colleagues directly addresses the interpersonal nature of the symptoms associated with decreased sexual desire.

“Desire disorders are heavily influenced by interpersonal factors. They are less about biomedical issues and more about the way couples interact with each other,” she explained. “This means we need to reconceptualize low libido as a couple-based problem, not an individual problem.”

The intervention focuses on communication, acceptance, openness and vulnerability between partners. It starts with creating a sense of intimacy within the couple, as this is a protective factor for sexual desire.

“Women report greater sexual interest when they feel close to their partner, knowing they can share their thoughts and receive empathy and understanding,” said Dr. Bergeron, who also directs the Interdisciplinary Research Center for Problems in Intimate Relationships and Sexual Abuse.

The CBCT intervention encourages couples to talk openly about sexuality, which is often one of the most difficult topics for couples to broach, the researcher said. Couples learn to express their needs, preferences and doubts without fear of hurting each other’s feelings.

The treatment consists mainly of guided conversations with a therapist, but also includes exercises that you can do at home, such as sensory sessions. These sessions are aimed at reintroducing touch in a non-intensive way.

Destigmatization leads to relief

An important part of the intervention is to debunk sexual myths, especially those that evoke feelings of guilt and blame in women with a lack of sexual desire.

“We work to decouple the woman from the disorder, while normalizing and dedramatizing her experience,” Dr. Bergeron said. “And most importantly, we bring the focus back to the pleasure and quality of sexual relationships, rather than the frequency.”

According to her, this psycho-educational component seems to help alleviate the emotional burden that often accompanies SAID, characterized by shame and frustration.