Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Turkish women’s perception of low sexual desire, its causes and consequences: an online qualitative survey

Sinan Tetik https://orcid.org/0000-0002-0535-4313 A * and Özden Yalçınkaya Alkar https://orcid.org/0000-0001-8484-9199 B
+ Author Affiliations
- Author Affiliations

A Psychiatry Outpatient Clinic, Ankara Etlik City Hospital, Varlik Mh., Halil Sezai Erkut Cd., Yenimahalle, Ankara, 06170, Turkey. Email: sinanttk06@gmail.com

B Department of Clinical Psychology, Ankara Yildirim Beyazit University, Esenboga Campus Cubuk, Ankara, 06810, Turkey. Email: ozdenalkar@yahoo.com

* Correspondence to: sinanttk06@gmail.com

Handling Editor: Huachun Zou

Sexual Health 21, SH23185 https://doi.org/10.1071/SH23185
Submitted: 7 November 2023  Accepted: 8 April 2024  Published: 6 May 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background

The nature of sexual desire is complex, and little phenomenological consensus exists about its meaning. Low sexual desire (LSD) is a commonly reported sexual difficulty among women, but it is less frequently associated with sexual distress. The aim of this qualitative study is to explore women’s understanding of sexual desire, and their perceptions of factors that may contribute to LSD, its effects and their methods of seeking help.

Methods

The research employed a questionnaire with 12 open-ended questions, developed by the researchers based on sexual script theory. Data were collected from 165 heterosexual Turkish women who reported LSD, recruited through social media platforms between August and October 2021. The data were analysed using a contextual form of thematic analysis to identify and explore patterns.

Results

The ages of the participants ranged from 20 to 63 years. The majority of participants held a Bachelor’s degree (81.2%) and in a relationship (78.8%). Three main themes emerged from the study: (1) gendered messages concerning sex, (2) multi-level sexual desire, and (3) minimisation. The research revealed that women’s sexual desire is often ignored and repressed, and has negative consequences if not expressed in socially acceptable contexts. The causes of LSD in women go beyond personal factors, and include relational and social influences. Women experiencing LSD report distressing effects on their relationships and general wellbeing, yet they tend not to seek help.

Conclusions

Our findings contribute to a deeper understanding of the factors impacting women’s sexual desire and the barriers to seeking help.

Keywords: female sexual dysfunction, female sexual interest/arousal disorder, gender roles, hypoactive sexual desire disorder, qualitative research, sexual desire, sexual distress, sexual script theory.

References

Bancroft J. Sexual desire and the brain revisited. Sex Relat Ther 2010; 25(2): 166-171.
| Crossref | Google Scholar |

van Anders SM, Herbenick D, Brotto LA, Harris EA, Chadwick SB. The heteronormativity theory of low sexual desire in women partnered with men. Arch Sex Behav 2022; 51(1): 391-415.
| Crossref | Google Scholar | PubMed |

Kaplan HS. Hypoactive sexual desire. J Sex Marital Ther 1977; 3(1): 3-9.
| Crossref | Google Scholar | PubMed |

Levine SB. The nature of sexual desire: a clinician’s perspective. Arch Sex Behav 2003; 32(3): 279-285.
| Crossref | Google Scholar | PubMed |

Leiblum SR, Rosen RC. Sexual desire disorders. Guilford Press; 1988.

Brotto LA. The DSM diagnostic criteria for hypoactive sexual desire disorder in women. Arch Sex Behav 2010; 39(2): 221-239.
| Crossref | Google Scholar | PubMed |

Baumeister RF, Catanese KR, Vohs KD. Is there a gender difference in strength of sex drive? Theoretical views, conceptual distinctions, and a review of relevant evidence. Pers Soc Psychol Rev 2001; 5(3): 242-273.
| Crossref | Google Scholar |

Bouchars N. The orgasm gap: a systematic review and meta-analysis; 2021. Available at https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=1105&context=usri

Mustafa AI, El Esawy FM, Fawzy I. Female sexual dysfunction among married women from the Nile Delta of Egypt. Int J Sex Health 2019; 31(2): 131-141.
| Crossref | Google Scholar |

10  Maseroli E, Rastrelli G, Di Stasi V, Cipriani S, Scavello I, Todisco T, et al. Physical activity and female sexual dysfunction: a lot helps, but not too much. J Sex Med 2021; 18(7): 1217-1229.
| Crossref | Google Scholar | PubMed |

11  Witting K, Santtila P, Varjonen M, Jern P, Johansson A, von der Pahlen B, et al. Couples’ sexual dysfunctions: female sexual dysfunction, sexual distress, and compatibility with partner. J Sex Med 2008; 5(11): 2587-2599.
| Crossref | Google Scholar | PubMed |

12  Traeen B. When sex becomes a duty. Sex Relat Ther 2008; 23(1): 61-84.
| Crossref | Google Scholar |

13  Fugl-Meyer K, Fugl-Meyer AR. Sexual disabilities are not singularities. Int J Impotence Res 2002; 14(6): 487-493.
| Crossref | Google Scholar | PubMed |

14  Leiblum SR, Koochaki PE, Rodenberg CA, Barton IP, Rosen RC. Hypoactive sexual desire disorder in postmenopausal women: US results from the Women’s International Study of Health and Sexuality (WISHeS). Menopause 2006; 13(1): 46-56.
| Crossref | Google Scholar | PubMed |

15  Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol 2008; 112(5): 970-978.
| Crossref | Google Scholar | PubMed |

16  Tetik S, Yalçınkaya Alkar Ö. Incidence and predictors of low sexual desire and hypoactive sexual desire disorder in women: a systematic review and meta-analysis. J Sex Marital Ther 2023; 49(7): 842-865.
| Crossref | Google Scholar | PubMed |

17  Frost R, Donovan C. A qualitative exploration of the distress experienced by long-term heterosexual couples when women have low sexual desire. Sex Relat Ther 2021; 36(1): 22-45.
| Crossref | Google Scholar |

18  Berman L, Berman J, Felder S, Pollets D, Chhabra S, Miles M, et al. Seeking help for sexual function complaints: what gynecologists need to know about the female patient’s experience. Fertil Steril 2003; 79(3): 572-576.
| Crossref | Google Scholar | PubMed |

19  Braksmajer A. Struggles for medical legitimacy among women experiencing sexual pain: a qualitative study. Women Health 2018; 58(4): 419-433.
| Crossref | Google Scholar | PubMed |

20  Clayton AH, Kingsberg SA, Goldstein I. Evaluation and management of hypoactive sexual desire disorder. Sex Med 2018; 6(2): 59-74.
| Crossref | Google Scholar | PubMed |

21  Burri A, Spector T. Recent and lifelong sexual dysfunction in a female UK population sample: prevalence and risk factors. J Sex Med 2011; 8(9): 2420-2430.
| Crossref | Google Scholar | PubMed |

22  Parish SJ, Cottler-Casanova S, Clayton AH, McCabe MP, Coleman E, Reed GM. The evolution of the female sexual disorder/dysfunction definitions, nomenclature, and classifications: a review of DSM, ICSM, ISSWSH, and ICD. Sex Med Rev 2021; 9(1): 36-56.
| Crossref | Google Scholar | PubMed |

23  Simon W, Gagnon JH. Sexual scripts: permanence and change. Arch Sex Behav 1986; 15(2): 97-120.
| Crossref | Google Scholar | PubMed |

24  McCormick NB. Sexual scripts: social and therapeutic implications. Sex Relat Ther 2010; 25(1): 96-120.
| Crossref | Google Scholar |

25  Jackson S. Interchanges: gender, sexuality and heterosexuality: the complexity (and limits) of heteronormativity. Feminist Theory 2006; 7(1): 105-121.
| Crossref | Google Scholar |

26  McClelland SI. Intimate justice: a critical analysis of sexual satisfaction. Soc Personality Psychol Compass 2010; 4(9): 663-680.
| Crossref | Google Scholar |

27  Ford JV, Corona Vargas E, Finotelli I, Jr, Fortenberry JD, Kismödi E, Philpott A, et al. Why pleasure matters: its global relevance for sexual health, sexual rights and wellbeing. Int J Sex Health 2019; 31(3): 217-230.
| Crossref | Google Scholar |

28  Wiederman MW. The gendered nature of sexual scripts. Fam J 2005; 13(4): 496-502.
| Crossref | Google Scholar |

29  Lamb S. Feminist ideals for a healthy female adolescent sexuality: a critique. Sex Roles 2010; 62(5): 294-306.
| Crossref | Google Scholar |

30  Noorman MA, den Daas C, de Wit JB. How parents’ ideals are offset by uncertainty and fears: a systematic review of the experiences of European parents regarding the sexual education of their children. J Sex Res 2023; 60(7): 1034-1044.
| Crossref | Google Scholar | PubMed |

31  Sieving RE, McNeely CS, Blum RW. Maternal expectations, mother-child connectedness, and adolescent sexual debut. Arch Ped & Adoles Med 2000; 154(8): 809-16.
| Crossref | Google Scholar | PubMed |

32  Drew J. The myth of female sexual dysfunction and its medicalization. Sexualities, Evolution & Gender 2003; 5(2): 89-96.
| Crossref | Google Scholar |

33  Gill AK, Brah A. Interrogating cultural narratives about ‘honour’-based violence. Eur J Womens Stud 2014; 21(1): 72-86.
| Google Scholar |

34  Turkish Society of Sexual Education and Research. Cinsel saglik ve ureme sagligi arastirmasi [Sexual and reproductive health research]; 2006. Available at https://www.cetad.org.tr/CetadData/Books/10/2692011154421-Arastirma_sonuclari_Dosyasi_1.pdf

35  Sakallı Uğurlu N, Türkoğlu B, Kuzlak A, Gupta A. Stereotypes of single and married women and men in Turkish culture. Current Psychol 2021; 40: 213-225.
| Crossref | Google Scholar |

36  Sev’er A, Yurdakul G. Culture of honour, culture of change: a feminist analysis of honor killings in rural Turkey. Violence Against Wom 2001; 7(9): 964-998.
| Google Scholar |

37  Tuğrul C, Kabakci E. Vaginismus and its correlates. Sex Marit Ther 1997; 12(1): 23-34.
| Crossref | Google Scholar |

38  Mark KP, Lasslo JA. Maintaining sexual desire in long-term relationships: a systematic review and conceptual model. J Sex Res 2018; 55(4–5): 563-581.
| Crossref | Google Scholar | PubMed |

39  Hinchliff S, Gott M, Wylie K. Holding onto womanhood: a qualitative study of heterosexual women with sexual desire loss. Health 2009; 13(4): 449-465.
| Crossref | Google Scholar | PubMed |

40  Sungur MZ, Bez Y. Cultural factors in the treatment of sexual dysfunction in Muslim clients. Curr Sex Heal Rep 2016; 8(2): 57-63.
| Crossref | Google Scholar |

41  Akbari PA, Ozgoli G, Simbar M, Besharat MA. Women’s perceptions and feelings about loss of their sexual desire: a qualitative study in Iran. Int J Community Based Nurs Midwifery 2018; 6(2): 167-174.
| Google Scholar |

42  Dürr E. Women’s experience of lack of sexual desire in relationships, and implications for intervention. Social Work 2009; 45(3): 256-274.
| Google Scholar |

43  Goldhammer DL, McCabe MP. A qualitative exploration of the meaning and experience of sexual desire among partnered women. Can J Human Sex 2011; 20(1–2): 19-29.
| Google Scholar |

44  Moor A, Haimov Y, Shreiber S. When desire fades: women talk about their subjective experience of declining sexual desire in loving long-term relationships. J Sex Res 2021; 58(2): 160-169.
| Crossref | Google Scholar | PubMed |

45  O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med 2014; 89(9): 1245-1251.
| Crossref | Google Scholar | PubMed |

46  MacNeela P, Murphy A. Freedom, invisibility, and community: a qualitative study of self-identification with asexuality. Arch Sex Behav 2015; 44(3): 799-812.
| Crossref | Google Scholar | PubMed |

47  Braun V, Clarke V, Boulton E, Davey L, McEvoy C. The online survey as a qualitative research tool. Int J Soc Res Methodol 2021; 24(6): 641-654.
| Crossref | Google Scholar |

48  Parish SJ, Meston CM, Althof SE, Clayton AH, Goldstein I, Goldstein SW, et al. Toward a more evidence-based nosology and nomenclature for female sexual dysfunctions-part III. J Sex Med 2019; 16(3): 452-462.
| Crossref | Google Scholar | PubMed |

49  Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3(2): 77-101.
| Crossref | Google Scholar |

50  Ling J, Kasket E. Let’s talk about sex: a critical narrative analysis of heterosexual couples’ accounts of low sexual desire. Sex Relat Ther 2016; 31(3): 325-343.
| Crossref | Google Scholar |

51  Wood JM, Mansfield PK, Koch PB. Negotiating sexual agency: postmenopausal women’s meaning and experience of sexual desire. Qual Heal Res 2007; 17(2): 189-200.
| Crossref | Google Scholar | PubMed |

52  Sims KE, Meana M. Why did passion wane? A qualitative study of married women’s attributions for declines in sexual desire. J Sex Marital Ther 2010; 36(4): 360-380.
| Crossref | Google Scholar | PubMed |

53  Jordan-Young RM. Brain storm: the flaws in the science of sex differences. Harvard University Press; 2011.

54  Basson R. The female sexual response: a different model. J Sex Marital Ther 2000; 26(1): 51-65.
| Google Scholar |

55  Tiefer L. Historical, scientific, clinical, and Feminist criticisms of ‘the human sexual response cycle” model. Sex is not a natural act and other essays. Routledge; 2018. pp. 41–61.

56  Bancroft J, Loftus J, Long JS. Distress about sex: a national survey of women in heterosexual relationships. Arch Sex Behav 2003; 32(3): 193-208.
| Crossref | Google Scholar | PubMed |

57  Cruz C, Greenwald E, Sandil R. Let’s talk about sex: integrating sex positivity in counseling psychology practice. Couns Psychol 2017; 45(4): 547-569.
| Crossref | Google Scholar |