Beckoned by ads on the radio and in newspapers and on Craigslist, in the fall of 2011 women across America began applying to be among the 420 subjects in the Lybrido and Lybridos studies. Plenty were turned away when the trials filled. Lack of lust, when it creates emotional distress, meets the psychiatric profession’s clinical criteria for H.S.D.D., or hypoactive sexual-desire disorder. Researchers have set its prevalence among women between the ages of about 20 and 60 at between 10 and 15 percent. When you count the women who don’t quite meet the elaborate clinical threshold, the rate rises to around 30 percent. For a minor fraction of all the sexually indifferent (or repelled), the condition has been lifelong, regardless of whom they’re with or how long they’ve been with them. For middle-aged or older women, menopause and its aftermath may play a role, though its importance is much debated. For a sizable segment of the undesiring, the most common antidepressants, the selective serotonin reuptake inhibitors, can be the culprit. Millions of American women are on S.S.R.I.'s, and many of them would have good use for a pill to revive the libido that has been chemically dulled as a side effect of the pill they take to buoy their mood.
But for many women, the cause of their sexual malaise appears to be monogamy itself. It is women much more than men who have H.S.D.D., who don’t feel heat for their steady partners. Evolutionary psychologists argue that this comes down to innate biology, that men are just made with stronger sex drives — so men will settle for the woman who’s always near. But the evidence for an inborn disparity in sexual motivation is debatable. A meta-analysis done by the psychologists Janet Hyde and Jennifer L. Petersen at the University of Wisconsin, Madison, incorporates more than 800 studies conducted between 1993 and 2007. It suggests that the very statistics evolutionary psychologists use to prove innate difference — like number of sexual partners or rates of masturbation — are heavily influenced by culture. All scientists really know is that the disparity in desire exists, at least after a relationship has lasted a while.
Dietrich Klusmann, a psychologist at the University of Hamburg-Eppendorf in Germany, has provided a glimpse into the bedrooms of longtime couples. His surveys, involving a total of almost 2,500 subjects, comprise one of the few systematic comparisons of female and male desire at progressive stages of committed relationships. He shows women and men in new relationships reporting, on average, more or less equal lust for each other. But for women who’ve been with their partners between one and four years, a dive begins — and continues, leaving male desire far higher. (Within this plunge, there is a notable pattern: over time, women who don’t live with their partners retain their desire much more than women who do.)
Lesbian couples seem to fare no better, and maybe worse, in keeping their sexual ardor for each other. The term “lesbian bed death,” coined by the University of Washington sociologist Pepper Schwartz in the ‘80s, has been critiqued as overstatement but not quite as fiction. “In the lesbian community, the monogamy problem is being aired more and more,” Lisa Diamond, a professor of psychology and gender studies at the University of Utah, told me. “For years, gay men have been making open arrangements for sex outside the couple. Now, increasingly, gay women are doing it.”
Klusmann’s results are echoed by Lori Brotto, a psychologist at the University of British Columbia who has worked clinically with scores of H.S.D.D. patients and who recently led the American Psychiatric Association’s attempt to better delineate the condition in The Diagnostic and Statistical Manual of Mental Disorders. (H.S.D.D. is being reconceived as sexual interest/arousal disorder, S.I.A.D.) “The impact of relationship duration is something that comes up constantly,” she told me about her therapy sessions. “Sometimes I wonder whether it” — H.S.D.D. — “isn’t so much about libido as it is about boredom.”
But desire resists comprehension. Whether it is mainly a raw drive or a complex emotion is a question that has bedeviled psychiatry for decades. And the fading of desire can seem impossibly intricate. Is it a result of a lack of intimacy or its cause? One theory holds that it’s a challenge for both sexes to maintain passion over the long-term because it’s threatening to desire the same person from whom we seek security and true understanding. It leaves us feeling too vulnerable. As Stephen A. Mitchell, one of the leaders of relational psychoanalysis, described it: “Sustaining desire for something important from someone important is the central danger of emotional life. What is so dangerous about desiring someone you have is that you can lose him or her.” Mitchell argued that ultimately the emotional meshing and vulnerability of committed relationships can become the most rewarding source of eros. Esther Perel, a couples therapist and author of “Mating in Captivity,” emphasizes a separateness at the heart of longstanding passion. “Many couples confuse love with merging,” she writes. “This mix-up is a bad omen for sex. To sustain élan toward the other, there must be a synapse to cross. Eroticism requires distance.”
“What protects desire in monogamous partnerships is a great empirical question,” Brotto said. “I don’t think there have been any good studies.”
Brotto, who is married and has three children, went on: “I’m a woman in a long-term monogamous relationship. I myself have felt firsthand very high passionate desire, which then wanes. I can relate to my patients completely.” Sometimes she discusses the option of open relationships. But even to contemplate this alternative is to ignite fears in both women and men, and those override the pining for lust.
How much easier it would be if we could solve the insoluble by getting a prescription, stopping off at the drugstore and swallowing a pill.
by Daniel Bergner, NY Times | Read more:
Image: Jake Chessum for The New York Times
