Inhibited sexual desire and sexual avoidance

Inhibited sexual desire (ISD) is one of the most common sexual dysfunctions, especially in women. Family physicians have an opportunity to recognize ISD before the associated problems become entrenched, and to guide couples toward satisfactory resolution. A summary is presented of current thinking on ISD and its causes. Case reports and observations about frequency of and treatment for ISD are included. Much less has been written about sexual avoidance in the presence of desire. A definition is offered of simple sexual avoidance in the absence of genital dysfunction. Frequency, treatment response, and specific cases are described. A newly identified entity-mutual unwillingness to importune for sex-is discussed briefly. Counselling which focuses on communication, self responsibility, and sex education is very helpful to patients with sexual problems.