The difference between desire and arousal.

It happens every few days. A woman comes in and says that she has a problem with “my desire.” Then she goes on to say that she really wants to have sex, but she just doesn’t get turned on or it takes forever to get turned on, “so you see…” she sighs. “I have a desire problem.” Well, actually, not so much.

What you have, my dear, is an arousal problem.


Yeah, I get it. Most women don’t know the difference. But there is a difference and it’s important for you to get it if you want to help solve your problem.

Desire is wanting to have sex.

Arousal is the ability for your body to respond and get turned on.

They can overlap. Sometimes one causes the other, or causes the other to “not work” but they are two different problems and that’s important because they may be treated differently.

Take patient A. She really has a hard time dragging herself to have sex with her partner whom she loves a great deal. He feels like he has to ask 6 times before she’ll finally agree to have sex. Then they have sex and it’s pretty great. She gets turns on, has fun, has an orgasm, enjoys it. But then, a few days later when her husband approaches her for sex again, she really doesn’t want to do it. And she is confused. And he is confused. But the bottom line is that her arousal and orgasm are working fine. Her desire is a problem and believe it or not, it can be an isolated problem. I know it’s counter-intuitive, but it’s true. And realizing that there seem to be specific pathways to the brain for wanting sex can be very helpful in treating it.

Take patient B. She wants to have sex, at least she thinks she wants to have sex. The problem with  her is that once she and her husband get started the experience is disappointing and frustrating. Her body doesn’t respond. She doesn’t get wet. She doesn’t feel “turned on.” Her orgasms are difficult to have,  weak or non-existent. If her body worked well she would want to have sex, but right now it’s not. It’s true that she doesn’t want to have sex, but it’s only a result of the arousal issue.

Understanding the difference is crucial. And sometimes it can be complicated or unclear but if you find yourself not wanting sex, understanding the subtleties may make all the difference!

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