Women experiencing Sexual Interest/Arousal Disorder (SIAD) might find sex unappealing, struggle with their physical arousal, and feel disconnected from their partners. And it’s not a once-in-a-while thing – these feelings need to be present for at least 6 months to be considered SIAD.
Sound familiar? If it does, you’re not alone! In fact, “30-40% of adult women have experienced this concern in the past year.”
Having sex without sexual desire can be draining. Mindfulness and pharmaceutical options may help, but what about support for couples?
This is exactly what “Feasibility of a Cognitive-Behavioral Couple Therapy Intervention for Sexual Interest/Arousal Disorder” wants to address.
Done by Dr. Katrina N. Bouchard, Dr. Sophie Bergeron, and Dr. Natalie O. Rose, this research explores a couples-based approach to addressing sexual interest/arousal disorder (SIAD) in women. Their goal is to show how SIAD symptoms impact both partners.
It’s not “just about low libido; it’s about the way couples interact, communicate, and connect.”
What is Distressing Sexual Interest/Arousal Disorder?
Sexual Interest/Arousal Disorder (SIAD) isn’t simply ‘not being in the mood’ – it’s a persistent lack of desire or arousal that leaves many women feeling frustrated and distressed. It’s characterized by “low sexual desire, few or no sexual thoughts, no initiation of sexual behavior, or lack of receptivity to partner invitations.”
But it’s not only affecting the female partners, it’s affecting their relationships, too. It leads to “lower sexual and relationship satisfaction, poorer sexual communication, and higher sexual distress” for both partners.
Pills, Therapy & Mindfulness
We have various options to combat SIAD, but they may not always be effective, especially for the relationship component. On the pharmaceutical side, medications like flibanserin have been approved, but as the doctors point out, they come with “unwanted side effects and minimal benefits compared to placebo.”
Then, mindfulness-based therapies are in the mix, offering moderate improvements by helping women focus on the present moment and reduce stress. Lastly, there’s cognitive-behavioral therapy (CBT), which allows individuals and couples to “target unhelpful cognitions and behaviors” that could be contributing to the sexual ‘blahs.’
While these remedies are being used IRL, none of them are a one-size-fits-all fix, and many overlook the importance of treating SIAD as a couple’s issue.
“Distressing low sexual desire often occurs for women in partnered relationships,” so maybe it’s time we start treating it that way.
Learning from Real-Life Couples
Dr. Bouchard and colleagues set out to explore whether a manualized cognitive-behavioral couple therapy (CBCT) intervention could fill this gap in SIAD remedies. It’s a look at how couples could work together to overcome sexual difficulties. The researchers wanted to find out the following questions:
- How easy was it for therapists and the couples to do the therapy?
- How committed were the participants to the treatment?
- Were there noticeable improvements in sexual desire and distress?
Four therapists, all with PhD-level education in clinical psychology and sex therapy, led the sessions. They learned the therapy manual, having been through 12 hours of training. Throughout the study, the therapists received weekly supervision from experienced psychologists who helped develop the treatment approach. This ensured the therapy was consistently delivered across all sessions.
Nineteen cisgender women diagnosed with SIAD, along with their partners, participated in the study. They were recruited from two Canadian cities, with some coming from a psychology practice waitlist and others responding to a French news article about couples-based sex therapy. The research team only included those who met strict criteria, like having a DSM-5 diagnosis for SIAD, being in a committed relationship for at least a year, and being physically healthy enough to participate.
Measuring Success
To assess how well the intervention worked, the doctors reviewed three main areas: whether the therapists followed the treatment guide, how much of the in-session and homework exercises were completed, and how satisfied the couples were with the treatment.
Couples were asked about their sexual desire and distress through validated questionnaires like the Dyadic Sexual Desire of a Partner survey and the Sexual Distress Scale-Revised.
Did it Work?
Overall, couples-based therapy was a big win! The therapists stuck closely to the treatment manual, following it nearly 97% of the time. The couples were seriously engaged, completing about 91% of the in-session exercises and 82% of the homework.
Women who did the virtual therapy sessions rated their satisfaction at a solid 8 out of 10, and their partners were similar with a 7.72. Additionally, six months after therapy, the women experienced a major boost in their sexual desire: a change they had not seen in years! Their desire scores jumped significantly, reflecting a large psychological improvement.
The benefits didn’t stop there – sexual distress, a major concern before therapy, plunged. Women reported feeling far less distress about their low desire and even their partners felt less distressed too.
When it came to what the couples loved most about the therapy, the clear winner was the “sensate focus” exercises. These exercises, which help reintroduce touch in a non-demanding way, were a favorite with nearly half the participants, with 46.9% naming it as the most helpful part of their experience. One woman said it allowed her to “reconnect physically” with her partner and felt natural and pressure-free.
The least favorite part? Breathing exercises. About 27.8% of the participants found these exercises to be the least helpful, with some saying they didn’t resonate or felt awkward.
As one participant put out, the therapy helped them see that both partners “are affected by the SIAD symptoms,” and they both needed to contribute to reigniting the spark.
Bring Back Your Desire
You don’t have to struggle with SIAD to feel your flame fizzle – there are simple ways you and your partner can boost desire in your relationship.
Focus on Connection, Not Just Sex
The researchers found that “sensate focus” exercises were a game-changer for many couples. These exercises aren’t about rushing into sex; they are all about rediscovering touch without any pressure.
- Start with simple touching – holding hands, giving a back rub, or sitting close together on the couch.
- Mix it up with different types of touching like massaging your partner’s shoulders or running your fingers through their hair. Keep it playful and pressure-free.
- Set aside time each day or week for moments of touching. Think of it as a no-stress date where the focus is enjoying each other’s company.
Talk to Each Other
Good communication is the key to any strong relationship – especially using it to bring back your desire. The study emphasizes improving “emotion regulation and communication skills” as an important part of the process.
- Start with an open conversation about what you’re both feeling. Be honest about your needs and listen to your partner without interrupting or judging.
- Use “I” statements to share your feelings without making your partner feel defensive. For example, “I feel disconnected when we don’t spend time together” instead of “You never make time for me.”
- Plan regular check-ins to chat about your relationship – what’s working and what could be better.
Make Time for Connection
Don’t stop spending intentional time with each other. Your connection and intimacy do not need to start and stop within the bedroom.
- Try new activities together that get you both out of your comfort zone. It could be something as simple as cooking a new recipe together or going on a long walk. These activities can reignite excitement and your bond.
- Don’t underestimate the power of little gestures – sending a sweet (or spicy) text during the day, planning a surprise date night, or leaving a love note where your partner will find it. These small acts can build anticipation and desire.
Communicate and make time for each other. Your desire isn’t simply sex: it’s about feeling valued and close to your partner.
