Sexuality in Older Women and Their Partners

Sexual Desire

Desire is a term that people assume means the same thing to each of us but is actually a complex concept. Desire refers to one's interest in being sexual and is determined by the interaction of three related but separate components: (1) Drive; (2) Beliefs/Values; and (3) Motivation (Levine, 1992).

Drive is the biologic component of desire. It is the result of neuroendocrine mechanisms and is experienced as spontaneous, endogenous sexual interest. Drive is typically manifested by sexual thoughts, feelings, fantasies or dreams, increased erotic attraction to others in proximity, seeking out sexual activity (alone or with a partner), and genital tingling or increased genital sensitivity. Although we still do not fully understand the exact neuroendocrine mechanisms that are responsible for drive, we do know that drive declines in both men and women as a function of aging. For some women declining levels of free testosterone, related to declining ovarian function, will result in a noticeable decrease in sexual drive. The sudden decrease in free testosterone as a result of surgical menopause may also result in a noticeable decrease in sexual drive for some women. The second component of desire reflects an individual's expectations, beliefs and values about sexual activity. The more positive the person's beliefs and values are about sexuality, the greater the person's desire to behave sexually. The third component of desire is the psychological and interpersonal motivation. Motivation is driven by emotional or interpersonal factors and is characterized by a willingness of a person to behave sexually with a given partner. This component tends to have the greatest impact overall on desire and is the most complex and elusive.

This distinction between drive and desire is absolutely essential for anyone assessing or treating sexual problems because treatment is vastly different based on which component or components of desire have declined. For example, a woman might have a very strong sexual drive but if she is not motivated to be sexual, say if she is angry with her partner, dealing with a stressful work problem or suffering from depression, she will not act on the drive. In fact, it is virtually wiped out. On the other hand, if a woman has lost some of her drive but remains motivated to be close and intimate with her partner, then despite having little physical cues or interest, she still enjoys the sexual experience. This differentiation of drive from desire is particularly important to the understanding of female sexuality.

Last Modified: September 5, 2006