Abstract
Hypoactive sexual desire disorder (HSDD) in men, characterized by chronically low sexual desire, is associated with poor sexual well-being, such as lower sexual satisfaction and higher sexual distress. Additionally, despite their low desire, men with HSDD often report wanting sexual intimacy and validation within their sexual lives/relationships. Studies that apply self-determination theory to sexual relationships demonstrate that adopting more autonomous (e.g., engaging in sex for its inherent pleasure) and less controlled (e.g., engaging in sex for some external reward or consequence) motives for engaging in sex is associated with greater sexual well-being for both members of the couple. Given that autonomous motivation in relationships is associated with intimacy and sexual satisfaction, and lower sexual distress, having sex for autonomous reasons may allow men with HSDD and their partners to feel more sexually intimate despite their lower sexual desire, whereas having sex for controlled reasons may hinder sexual intimacy and satisfaction and augment sexual distress. In this dyadic cross-sectional study, we examined the associations between types of sexual motivation and sexual intimacy, sexual satisfaction, and sexual distress for men with HSDD and their partners (n = 64 couples). Men with HSDD who reported having sex for more autonomous reasons reported more sexual satisfaction and both partners reported more sexual intimacy. Men with HSDD who had sex for more controlled reasons had partners who felt less sexual intimacy and satisfaction, and both partners were more sexually distressed. Promoting autonomous sexual motivation and decreasing controlled motivation may help couples navigating HSDD to feel closer in their relationship, more sexually satisfied, and less sexually distressed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data and Materials Availability
The clinical interview and online eligibility screening survey are available on the Open Science Framework (OSF): https://osf.io/vfrgx/?view_only=8452190e2e9a41ffbb8bbc8d274f28ad.
Code Availability
Analyses were conducted using RStudio 4.1.0.
Notes
All men with HSDD enrolled in this study identified as a either man (n = 63) or transgender (identify as man n = 1). All participants approved of the terminology “men with HSDD” for the purposes of this study.
Respondent.io guidelines require that participants be compensated in increments of $5 USD.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
Basson, R. (2000). The female sexual response: A different model, Journal of Sex & Marital Therapy, 26(1), 51–65. https://doi.org/10.1080/009262300278641
Bhasin, S., & Basson, R. (2016). Sexual dysfunction in men and women. Williams Textbook of Endocrinology, 13, 785–830.
Birnbaum, G. E. (2018). The fragile spell of desire: A functional perspective on changes in sexual desire across relationship development. Personality and Social Psychology Review, 22(2), 101–127. https://doi.org/10.1177/108886831771535
Birnbaum, G. E., Reis, H. T., Mizrahi, M., Kanat-Maymon, Y., Sass, O., & Granovski-Milner, C. (2016). Intimately connected: The importance of partner responsiveness for experiencing sexual desire. Journal of Personality and Social Psychology, 111(4), 530–546. https://doi.org/10.1037/pspi0000069
Bockaj, A., Rosen, N.O., & Muise, A. (2019). Sexual motivation in couples coping with female sexual interest/arousal disorder: A comparison with control couples. Journal of Sex & Marital Therapy, 45(8), 796–808. https://doi.org/10.1080/0092623X.2019.1623356
Bois, K., Bergeron, S., Rosen, N., Mayrand, M., Brassard, A., & Sadijak, G. (2016). Intimacy, sexual satisfaction and sexual distress in vulvodynia couples: An observational study. Health Psychology, 35(6), 531–540. https://doi.org/10.1037/hea0000289
Bois, K., Bergeron, S., Rosen, N. O., McDuff, P., & Grégoire, C. (2013). Sexual and relationship intimacy among women with provoked vestibulodynia and their partners: Associations with sexual satisfaction, sexual function, and pain self-efficacy. Journal of Sexual Medicine, 10(8), 2024–2035. https://doi.org/10.1111/jsm.12210
Brotto, L. (2010). The DSM diagnostic criteria for hypoactive sexual desire disorder in men. Journal of Sexual Medicine, 7, 2015–2030. https://doi.org/10.1111/j.1743-6109.2010.01860.x
Brunell, A., & Webster, G. (2013). Self-determination and sexual experience in dating relationships. Personality and Social Psychology Bulletin, 39(7), 970–987. https://doi.org/10.1177/0146167213485442
Clement, U. (2002). Sex in long-term relationships: A systemic approach to sexual desire problems. Archives of Sexual Behavior, 31, 241–246. https://doi.org/10.1023/A:1015296718952
Corona, G., Mannucci, E., Petrone, L., Giommi, R., Mansani, R., Fei, L., Forti, G., & Maggi, M. (2004). Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction. International Journal of Impotence Research, 16(3), 275–281. https://doi.org/10.1038/sj.ijir.3901158
Corsini-Munt, S., Bergeron, S., & Rosen, N. O. (2020). Self-focused reasons for having sex: associations between sexual goals and Women's pain and sexual and psychological wellbeing for couples coping with provoked vestibulodynia. Journal of Sexual Medicine, 17(5), 975–984. https://doi.org/10.1016/j.jsxm.2020.01.017
Corsini-Munt, S., Rancourt, K. M., Dubé, J. P., Rossi, M. A., & Rosen, N. O. (2017). Vulvodynia: A consideration of clinical and methodological research challenges and recommended solutions. Journal of Pain Research, 10, 2425–2436. https://doi.org/10.2147/JPR.S126259
Derogatis, L. R., Rosen, R., Leiblum, S., Burnett, A., & Heiman, J. (2002). The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexual related personal distress in women. Journal of Sex and Marital Therapy, 28, 317–330. https://doi.org/10.1080/00926230290001448
Doss, B. D., Simpson, L. E., & Christensen, A. (2004). Why do couples seek marital therapy? Professional Psychology: Research and Practice, 35(6), 608–614. https://doi.org/10.1037/0735-7028.35.6.608
Ellison, C. R. (2002). A research inquiry into some American women’s sexual concerns and problems. Women and Therapy, 24(1–2), 147–159. https://doi.org/10.1300/J015v24n01_17
Fisher, W. A., Rosen, R. C., Eardley, I., Sand, M., & Goldstein, I. (2005). Sexual experience of female partners of men with erectile dysfunction: The Female Experience of Men’s Attitudes to Life Events and Sexuality (FEMALES) study. Journal of Sexual Medicine, 2(5), 675–684. https://doi.org/10.1111/j.1743-6109.2005.00118.x
Frost, R. N., & Donovan, C. L. (2015). Low sexual desire in women: Amongst the confusion, could distress hold the key? Sexual and Relationship Therapy, 30(3), 338–350. https://doi.org/10.1080/14681994.2015.1020292
Gaine, G., & La Guardia, J. (2009). The unique contributions of motivations to maintain a relationship and motivations toward relational activities to relationship well-being. Motivation & Emotion, 33, 184–202. https://doi.org/10.1007/s11031-009-9120-x
Gore, J. S., Cross, S. E., & Kavangawa, C. (2009). Acting in our interests: Relational self-construal and goal motivation across cultures. Motivation and Emotion, 33(1), 75–87. https://doi.org/10.1007/s11031-008-9113-1
Gravel, E. (2017). On the benefits of being sexually autonomous and costs of being sexually pressured: The contributions of different motives for sex to experiences of sexual wellbeing (Doctoral dissertation, Université d'Ottawa/University of Ottawa).
Gravel, E., Pelletier, L., & Reissing, E. (2016). “Doing it” for the right reasons: Validation of a measurement of intrinsic motivation, extrinsic motivation, and motivation for sexual relationships. Personality and Individual Differences, 92, 164–173. https://doi.org/10.1016/j.paid.2015.12.015
Gravel, E. E., Reissing, E. D., & Pelletier, L. G. (2019). Global, relational, and sexual motivation: A test of hierarchical versus heterarchical effects on well-being. Journal of Happiness Studies, 20(7), 2269–2289. https://doi.org/10.1007/s10902-018-0047-3
Gravel, E., Reissing, E., & Pelletier, L. (2020). The ebb and flow of sexual wellbeing: The contributions of basic psychological needs and autonomous and controlled sexual motivation to daily variations in sexual wellbeing. Journal of Social and Personal Relationships, 37(7), 2286–2306. https://doi.org/10.1177/026540752092155
Hadden, B. W., Rodrigues, L. M., Knee, C. R., & Porter, B. (2015). Relationship autonomy and support provision in romantic relationships. Motivation and Emotion, 39, 359–373. https://doi.org/10.1007/s11031-014-9455-9
Herbenick, D., Mullinax, M., & Mark, K. (2014). Sexual desire discrepancy as a feature, not a bug, of long‐term relationships: Women's self‐reported strategies for modulating sexual desire. Journal of Sexual Medicine, 11(9), 2196–2206. https://doi.org/10.1111/jsm.12625
Hurlbert, D. F., & Apt, C. (1994). Female sexual desire, response, and behavior. Behavior Modification, 18, 488–504. https://doi.org/10.1177/01454455940184006
Impett, E., Strachman, A., Finkel, E., & Gable, S. (2008). Maintaining sexual desire in intimate relationships: The importance of approach goals. Journal of Personality and Social Psychology, 94, 808–823.
Kasser, T., & Ryan, R. M. (2001). Be careful what you wish for: Optimal functioning and the relative attainment of intrinsic and extrinsic goals. In P. Schmuck & K. M. Sheldon (Eds.), Life goals and well-being: Toward a positive psychology of human striving (pp. 116–131). Hogrefe & Huber Publishers.
Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. Guilford Press.
Kim, J. J., Muise, A., Barranti, M., Mark, K. P., Rosen, N. O., Harasymchuk, C., & Impett, E. (2021). Are couples more satisfied when they match in sexual desire? New insights from response surface analyses. Social Psychological and Personality Science, 12(4), 487–496. https://doi.org/10.1177/1948550620926770
Knee, C. R., Lonsbary, C., Canevello, A., & Patrick, H. (2005). Self-determination and conflict in romantic relationships. Journal of Personality and Social Psychology, 89(6), 997–1009. https://doi.org/10.1037/0022-3514.89.6.997
Knee, C. R., Patrick, H., Vietor, N. A., Nanayakkara, A., & Neighbors, C. (2002). Self-determination as growth motivation in romantic relationships. Personality and Social Psychology Bulletin, 28(5), 609–619. https://doi.org/10.1177/0146167202288005
Lawrence, K. A., & Byers, E. S. (1995). Sexual satisfaction in long-term heterosexual relationships: The Interpersonal Exchange Model of Sexual Satisfaction. Personal Relationships, 2, 267–285. https://doi.org/10.1111/j.1475-6811.1995.tb00092.x
Mark, K. P. (2012). The relative impact of individual sexual desire and couple desire discrepancy on satisfaction in heterosexual couples. Sexual and Relationship Therapy, 27, 133–146. https://doi.org/10.1080/14681994.2012.678825
Mark, K. P. (2015). Sexual desire discrepancy. Current Sexual Health Reports, 7, 198–202. https://doi.org/10.1007/s11930-015-0057-7
Mark, K. P., & Lasslo, J. A. (2018). Maintaining sexual desire in long-term relationships: A systematic review and conceptual model. Journal of Sex Research, 55(4–5), 563–581. https://doi.org/10.1080/00224499.2018.1437592
Mark, K. P., & Murray, S. H. (2012). Gender differences in desire discrepancy as a predictor of sexual and relationship satisfaction in a college sample of heterosexual romantic relationships. Journal of Sex and Marital Therapy, 38, 198–215. https://doi.org/10.1080/0092623X.2011.606877
McCabe, M. P., & Cobain, M. J. (1998). The impact of individual and relationship factors on sexual dysfunction among males and females. Sexual and Marital Therapy, 13(2), 131–143. https://doi.org/10.1080/02674659808406554
McCabe, M. P., & Connaughton, C. (2014). Psychosocial factors associated with male sexual difficulties. Journal of Sex Research, 51(1), 31–42. https://doi.org/10.1080/00224499.2013.789820
Meston, C., & Buss, D. (2007). Why humans have sex. Archives of Sexual Behavior, 36, 477–507.
Muise, A., Bergeron, S., Impett, E., Delisle, I., & Rosen, N. (2018). Communal motivation in couples coping with vulvodynia: Sexual distress mediates associations with pain, depression, and anxiety. Journal of Psychosomatic Research, 106, 34–40. https://doi.org/10.1016/j.jpsychores.2018.01.006
Muise, A., Boudreau, G., & Rosen, N. (2017). Seeking connection versus avoiding disappointment: An experimental manipulation of approach and avoidance sexual goals and the implications for desire and satisfaction. Journal of Sex Research, 54(3), 296–307.
Muise, A., Impett, E., & Desmarais, S. (2013a). Getting it on versus getting it over with: Sexual motivation, desire, and satisfaction in intimate bonds. Personality and Social Psychology Bulletin, 39(10), 1320–1332. https://doi.org/10.1177/0146167213490963
Muise, A., Impett, E., Kogan, A., & Desmarais, S. (2013b). Keeping the spark alive: Being motivated to meet a partner’s sexual needs sustains sexual desire in long-term romantic relationships. Social Psychology and Personality Science, 4(3), 267–273.
Muise, A., Schimmack, U., & Impett, E. A. (2016). Sexual frequency predicts greater well-being, but more is not always better. Social Psychological and Personality Science, 7(4), 295–302. https://doi.org/10.1177/1948550615616462
Murray, S. H. (2018). Heterosexual men’s sexual desire: Supported by, or deviating from, traditional masculinity norms and sexual scripts? Sex Roles, 78, 130–141. https://doi.org/10.1007/s11199-017-0766-7
Murray, S. H. (2019). Not always in the mood: The new science of men, sex, and relationships. Rowman & Littlefield Publishers.
Murray, S. H., Milhausen, R. R., Graham, C. A., & Kuczynski, L. (2017). A qualitative exploration of factors that affect sexual desire among men aged 30 to 65 in long-term relationships. Journal of Sex Research, 54(3), 319–330. https://doi.org/10.1080/00224499.2016.1168352
Parish, M., & Hahn, S. (2016). Hypoactive sexual desire disorder: A review of epidemiology, biopsychology, diagnosis, and treatment. Sexual Medicine Reviews, 4(2), 103–120. https://doi.org/10.1016/j.sxmr.2015.11.009
Paterson, L. Q. P., Handy, A. B., & Brotto, L. A. (2017). A pilot study of eight-session mindfulness-based cognitive therapy adapted for women’s sexual interest/arousal disorder. Journal of Sex Research, 54, 850–861. https://doi.org/10.1080/00224499.2016.1208800
Reis, H. T., & Shaver, P. (1988). Intimacy as an interpersonal process. In S. Duck (Ed.), Handbook of personal relationships (pp. 367–389). Wiley.
Rosen, N. O., Bailey, K., & Muise, A. (2018). Degree and direction of sexual desire discrepancy are linked to sexual and relationship satisfaction in couples transitioning to parenthood. Journal of Sex Research, 55(2), 214–225. https://doi.org/10.1080/00224499.2017.1321732
Rosen, N. O., & Bergeron, S. (2019). Genito-pelvic pain through a dyadic lens: Moving toward an interpersonal emotion regulation model of women’s sexual dysfunction. Journal of Sex Research, 56(4–5), 440–461. https://doi.org/10.1080/00224499.2018.1513987
Rosen, N. O., Dubé, J. P., Corsini-Munt, S., & Muise, A. (2019). Partners experience consequences, too: A comparison of the sexual, relational, and psychological adjustment of women with sexual interest/arousal disorder and their partners to control couples. Journal of Sexual Medicine, 16(1), 83–95. https://doi.org/10.1016/j.jsxm.2018.10.018
Rosen, N. O., Muise, A., Bergeron, S., Impett, E., & Boudreau, G. (2015). Approach and avoidance goals in couples with provoked vestibulodynia: Associations with sexual, relational, and psychological wellbeing. Journal of Sexual Medicine, 12, 1781–1790. https://doi.org/10.1111/jsm.12948
Ryan, R., & Deci, E. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78. https://doi.org/10.1037/0003-066X.55.1.68
Ryan, R., & Deci, E. (2014). Autonomy and need satisfaction in close relationships: Relationships motivation theory. In N. Weinstein (Ed.), Human motivation and interpersonal relationships: Theory, research, and applications (pp. 53–73). Springer. https://doi.org/10.1007/978-94-017-8542-6_3
Ryan, R., & Deci, E. (2017). Self-determination theory: Basic psychological needs in motivation, development, and wellness. Guilford Publishing.
Sanchez, D. T., Moss-Racusin, C. A., Phelan, J. E., & Crocker, J. (2011). Relationship contingency and sexual motivation in women: Implications for sexual satisfaction. Archives of Sexual Behavior, 40, 99–110. https://doi.org/10.1007/s10508-009-9593-4
Santos-Iglesias, P., Mohamed, B., Danko, A., & Walker, L. M. (2018). Psychometric validation of the female sexual distress scale in male samples. Archives of Sexual Behavior, 47, 1733–1743. https://doi.org/10.1007/s10508-018-1146-2
Sarin, S., Amsel, R., & Binik, Y. M. (2016). A streetcar named “derousal”? A psychophysiological examination of the desire-arousal distinction in sexual functional and dysfunctional women. Journal of Sex Research, 53, 711–729. https://doi.org/10.1080/00224499.2015.1052360
Segraves, K. B., & Segraves, R. T. (1991). Hypoactive sexual desire disorder: Prevalence and comorbidity in 906 subjects. Journal of Sex & Marital Therapy, 17(1), 55–58. https://doi.org/10.1080/00926239108405469
Shifren, J. L., Monz, B. U., Russo, P. A., Segreti, A., & Johannes, C. B. (2008). Sexual problems and distress in United States women. Obstetrics & Gynecology, 112(5), 970978. https://doi.org/10.1097/AOG.0b013e3181898cdb
Shoikhedbrod, A., Rosen, N. O., Corsini-Munt, S., Harasymchuk, C., Impett, E. A., & Muise, A. (2023). Being responsive and self-determined when it comes to sex: How and why sexual motivation is associated with satisfaction and desire in romantic relationships. Journal of Sex Research, 60, 1113–1125. https://doi.org/10.1080/00224499.2022.2130132
Smith, K. B., & Pukall, C. F. (2014). Sexual function, relationship adjustment, and the relational impact of pain in male partners of women with provoked vulvar pain. Journal of Sexual Medicine, 11(5), 1283–1293. https://doi.org/10.1111/jsm.12484
Sprecher, S. (2002). Sexual satisfaction in premarital relationships: Associations with satisfaction, love, commitment, and stability. Journal of Sex Research, 39(3), 190–196. https://doi.org/10.1080/00224490209552141
van Lankveld, J., Jacobs, N., Thewissen, V., Dewitte, M., & Verboon, P. (2018). The associations of intimacy and sexuality in daily life: Temporal dynamics and gender effects within romantic relationships. Journal of Social and Personal Relationships, 35(4), 557–576. https://doi.org/10.1177/0265407517743076
Wang, G. A., Corsini-Munt, S., Dubé, J. P., McClung, E., & Rosen, N.O. (2023). Regulate and communicate: Associations between emotion regulation and sexual communication among men with hypoactive sexual desire disorder and their partners. Journal of Sex Research, 60(3), 325–335. https://doi.org/10.1080/00224499.2022.2092588
Wild, T. C., Enzle, M. E., Nix, G., & Deci, E. L. (1997). Perceiving others as intrinsically or extrinsically motivated: Effects on expectancy formation and task engagement. Personality and Social Psychology Bulletin, 23(8), 837–848. https://doi.org/10.1177/0146167297238005
Wood, J., Desmarais, S., Burleigh, T., & Milhausen, R. (2018). Reasons for sex and relational outcomes in consensually non-monogamous and monogamous relationships: A self-determination theory approach. Journal of Social and Personal Relationships, 35(4), 632–654. https://doi.org/10.1177/0265407517743082
Funding
Funding was provided by Canadian Institutes of Health Research (Grant No. 141986).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
No potential conflict of interest was reported by the authors.
Ethical Approval
This study was approved by the Research Ethics Board at Dalhousie University.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
McClung, E., Rosen, N.O., Dubé, J.P. et al. Motivation When Desire Is Low: Associations Between Sexual Motivation and Sexual Intimacy, Sexual Satisfaction, and Sexual Distress for Men with Hypoactive Sexual Desire Disorder and Their Partners. Arch Sex Behav 53, 1075–1089 (2024). https://doi.org/10.1007/s10508-023-02752-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-023-02752-x