We tend to mix up the two.
Women say things like “I don’t want to have sex.” And what they mean by that, often, is “it doesn’t feel good when I have sex. I don’t get turned on.”
But, the desire to have sex can — and often is — divorced from the way our body responds to sex. It may be hard to understand. There are women who get turned on fairly easily when they are actually in the throes of passion. They can have satisfying sex and have orgasms easily, but , inexplicably, the next time their partner indicates an interest in sex, they cannot drag themselves to do it. That is a low level of desire, even though, eventually, they can get aroused.
And there are many, many woman who want to have sex — or at least would want to — if it didn’t take 20 minutes to get turned on; if they could have a positive experience, if they could have an orgasm.
So, despite the idea that the elements of wanting sex and enjoying sex are obviously intrinsically linked, they often can exist separately. In treating the problem, we do our patients a great disservice when we link them too closely together and don’t respect each element independently. It’s only when you identify problems correctly that you can help identify a solution.