Low Sexual Desire in Relationships: When It's Time to Consider Sex Therapy
Almost every long-term couple experiences a stretch where sex feels less frequent, less exciting, or harder to want. For some couples this passes on its own. For others, it settles in and starts to feel like a wall between partners — one person wanting more connection, the other feeling pressured, guilty, or disconnected from their own body. This gap is called desire discrepancy, and it's one of the most common reasons people seek out a sex therapist.
What Counts as "Low" Sexual Desire?
Desire exists on a spectrum, and there's no universal "normal" frequency or intensity that applies to everyone. Low desire becomes a clinical concern when it causes distress — either for the person experiencing it or for their relationship — not simply because it falls below some external benchmark. A person or couple might benefit from support if:
Desire has dropped noticeably from what it used to be for that person
One partner consistently wants sex much more or less than the other
Sex feels obligatory, anxiety-provoking, or disconnected from actual want
Avoidance of intimacy is creating distance, resentment, or conflict
The change is unexplained by an obvious factor like illness or medication
Common Causes of Low or Mismatched Desire
Desire is shaped by biological, psychological, and relational factors, often all at once. Some of the most common contributors include:
Stress and mental load — chronic stress, anxiety, or depression can flatten desire long before someone notices the connection
Life transitions — pregnancy, postpartum recovery, infertility treatment, or major career and life changes
Relationship dynamics — unresolved conflict, emotional distance, or a breakdown in communication
Medical and hormonal factors — certain medications, hormonal shifts, chronic illness, or pain conditions
Body image and self-acceptance — difficulty feeling present or safe in one's own body
Mismatched expectations — partners operating from different, often unspoken, assumptions about how desire "should" work
Trauma history — past sexual or relational trauma shaping present-day responses to intimacy
Importantly, desire discrepancy isn't usually a sign that a relationship is failing. In many couples, it's simply two people with different baseline levels of desire — a difference that becomes a problem only when it isn't talked about openly.
How Sex Therapy Helps
A sex therapist is a mental health clinician with specialized training in sexual health, intimacy, and relationship dynamics. AASECT certification is awarded by the American Association of Sexuality Educators, Counselors and Therapists to clinicians who complete rigorous coursework, supervision, and clinical hours specifically in sex therapy.
Sex therapy is talk therapy — it does not involve physical exams, nudity, or sexual activity in session. A typical course of treatment might include:
Assessment — understanding each partner's history, expectations, and the specific pattern of the concern
Identifying underlying factors — separating out what's medical, psychological, and relational
Improving communication — building the vocabulary and safety to talk about sex without shame or defensiveness
Addressing individual factors — anxiety, trauma, body image, or stress that may be dampening desire
Rebuilding connection — structured exercises and conversations that help couples reconnect physically and emotionally at a pace that feels safe
Sex therapy can be done individually or as a couple, and it's just as relevant for people not currently partnered who want to understand their own patterns around desire and intimacy.
Frequently Asked Questions
Is low desire always a sign something is wrong? No. Desire naturally fluctuates with stress, life stage, and relationship length. It becomes worth addressing when it causes distress or conflict, not simply when it changes.
Do both partners need to attend sex therapy? Not necessarily. Desire discrepancy can be addressed in couples sessions, individual sessions, or a combination of both, depending on what's driving the concern and what each person is ready for.
Is sex therapy only for married couples? No. Sex therapy is inclusive of unmarried partners, long-term relationships, and diverse relationship structures, including non-monogamous and polyamorous partnerships.
How is sex therapy different from couples counseling? Couples counseling addresses the relationship broadly — communication, conflict, and connection. Sex therapy focuses specifically on sexual health and intimacy, often alongside those broader relational themes, and requires additional specialized training.
When should I see a sex therapist instead of waiting it out? If low or mismatched desire has lasted more than a few months, is causing distress, or is creating distance between partners, it's reasonable to seek support rather than wait for it to resolve on its own.
Getting Support in Ann Arbor
Working through desire discrepancy takes patience, and it helps to have a therapist trained specifically in this area. Sarah Cissell, LMSW and AASECT-Certified Sex Therapist, works with individuals and couples in Ann Arbor and via telehealth across Michigan and Florida on concerns related to low desire, intimacy, and relationship communication, using a sex-positive, LGBTQIA+ and poly-affirming approach.
If this is something you or your relationship are navigating, you can schedule a free consultation with Sarah Cissell or learn more on her therapist profile.
