Women's Sexual Desire and Canadian Medicine

Sexual desire is often described in everyday language as longing or craving, but physicians increasingly describe it as one dimension of general physical and mental health. That framing has been a recurring theme at professional gatherings of Canadian obstetricians, gynaecologists, family physicians, nurses and other health workers, including the annual clinical meetings held by national medical societies.

What was reported

Survey-based estimates suggest that a substantial minority of Canadian women report low sexual desire at some point, though any such figure depends on how low desire is defined and on whether distress is part of the definition. Medical definitions typically distinguish low desire in itself from a condition causing personal distress, known in diagnostic manuals as hypoactive sexual desire disorder.

Clinicians who work in this area commonly note that research links sexual satisfaction with overall wellbeing, though such links are associations. They also note that not wanting sex can be normal for some people, while a person who wants to be sexually active but cannot reach the physical or emotional state that allows enjoyment may be experiencing a problem that merits medical attention.

Stigma and the direction of cause

Specialists often point to a double stigma that falls on women whose libido is judged too low or too high. A chicken-and-egg question also arises: low desire is sometimes attributed to depression or psychological causes, yet the reverse could hold, with an unsatisfying sex life contributing to low mood. Studies have found associations between sexual wellbeing and mental and physical health, but association does not establish which factor drives the other, and researchers continue to debate it.

Factors linked to libido

Several everyday and medical factors have been connected to changes in desire in women.

• Chronic lack of sleep
• Low levels of physical activity
• Diet quality
• Hormonal contraception, in some users
• Life stages that alter hormones, such as pregnancy and menopause

Medical treatments for low desire have been studied for years, and the regulatory status and availability of specific products differ between countries and have changed over time. Health Canada regulates which drugs may be sold in Canada. Lifestyle factors are often presented as potentially simple contributors to the problem.

Training and education gaps

Medical educators have described a shortage of physicians who feel confident discussing sexuality, noting that many avoid raising the subject in appointments. Sexual health content in medical programs and in school curricula varies across provinces and territories, and the extent of formal training for sexologists and sex educators differs by region.

Specialists in the field generally state that a satisfying sex life is possible at many stages of life, and that understanding how the body changes and how physical or environmental factors influence desire is central to maintaining interest. Professional organizations have called for more open discussion of the subject within medicine and in society at large.