When D and her husband are in bed, her mind is often elsewhere.
Her thoughts become weighed down by insecurity: how to summon confidence about her body, how to overcome self-consciousness.
Humming underneath is the stress – chronic, unrelenting stress. For D, 44, worry about work occupies much of her brain. Her career as a lawyer, though meaningful, exacts a heavy toll: the hours are always long, the deadlines gruelling, with much at stake for her clients.
“This very demanding job crashes into my psychological makeup, which is that of someone who is high achieving because they’re quite insecure. Stress has become controlling of my life,” D said from Vancouver. (The Globe is not using her name so she could speak freely without professional repercussions.)
In this frantic headspace, desire, arousal and orgasm have become elusive.
Though D feels otherwise close and in-tune with her husband, from a sexual perspective, things are “worse and worse” for her. She worries it would crush him to learn that her libido is “shot.” And so when they are intimate, D hides how she feels about the experience.
“If I’m having sex with my partner, I’m not thinking about having sex with him, really.”
The toxicity of stress on sex is a familiar reality for many couples. Splitting themselves between taxing careers, parenting, eldercare and domestic drudgery, partners can find themselves depleted, with little left for an intimate life.
Research has linked unmanaged stress to marital strain, finding that those who grow distracted by their stress, fixating on it, are less likely to pick up on sexual cues. For women, who tend to juggle more daily demands, stress plays a particularly outsized role in disrupting libido, arousal and pleasure.
Now, a growing body of science, therapy and tech is connecting the dots between burnout and desire.
Previously, much of the focus went to “quick fixes”: questionable treatments and pills, simplistic date night tips, wellness gimmicks – much of it targeting women. Researchers and therapists say we’ve got it backward. Today, they are channeling more of their efforts on the disruptors of desire: stress, burnout and the toxicity of busy life. More of the focus now goes to mitigating stress, from mindfulness sessions to apps with exercises that quiet worry and refocus the mind on sensations, to therapy guiding couples on reserving more time for intimacy.
Stress, whether work-related or personal, can have a damaging effect on people's sexual lives.TIMOTHY A. CLARY/AFP/Getty Images
It’s a shift that illuminates just how much of desire remains misunderstood.
Emily Nagoski, a prominent American sex educator, memorably likened the sexual response system to a car with gas and brakes. There’s the gas, the accelerant: a date night, spa day, exercise, erotica – anything the brain finds sensually relevant.
And then there are the brakes, the inhibitors: daily to-do lists, chores, stressors at work, or heavier burnout. These brakes put a strong hold on the brain’s central nervous system, lowering one’s openness and willingness to seek out sex.
Not enough attention is paid to the brakes, according to Dr. Nagoski, who worked as a researcher at the Kinsey Institute and has written books about burnout, desire and arousal, her latest Come Together: The Science (and Art!) of Creating Lasting Sexual Connections published in January.
The brakes are real: Nearly 40 per cent of women (and a third of men) aged 40 to 59 said their sexual desire was lower than they’d like, according to a 2018 survey of 2,400 Canadians led by University of Guelph researchers and published in the Journal of Sexual Medicine.
More than a third of women and nearly 15 per cent of men admitted a lack of interest in sex, according to the latest National Study of Sexual Attitudes and Lifestyles, a large-scale British survey of sexual behaviour querying nearly 12,000 people. A quarter of men and women in relationships spanning a year-plus complained about an imbalance in sexual interest between partners. Women were particularly blunt: 12 per cent said their sex lives had zero “enjoyment.”
Psychologist Lori Brotto studies the connection between stress and low interest in sex.Martin Dee
Stress is the most common unifying symptom for the patients psychologist Lori Brotto sees in her practice.
“Regardless of whether people are showing up for erection problems, or low desire, or pain with sex, chronic stress is part of the picture,” said Dr. Brotto, who holds the Canada Research Chair in Women’s Sexual Health.
Dr. Brotto’s patients often describe sex as an afterthought: there’s too much else going on. Whether their relationships are brief or decades long, solid or on shaky ground, their minds are preoccupied.
With women, Dr. Brotto hears about the juggle, paid and unpaid work, caring for children and elders, the domestic grind. With men, she sees strain about finances and career but also anxieties about fitting in with unrealistic masculine ideals.
Many of these partners are absorbed in putting out the fires of daily life, which feel more urgent than intimacy.
“There are no immediate consequences of not having sex – unlike if you don’t get that work project done or don’t have your kids’ permission form, there are immediate consequences,” Dr. Brotto said. “What happens for a lot of people is this compounds over time. Sex keeps getting de-prioritized and not being discussed.”
This avoidance can widen into a sexless marriage, breeding tension and unhappiness between spouses: “It creates a storm where stress gets in the way of sex but the more unsatisfying or infrequent the sex is, that itself becomes a stressor.”
Lack of sexual desire affects all types of couples. One study by Dr. Brotto found stress-related problems to be especially severe among lesbian and bisexual women.Anthony Bolante/Reuters
Long interested in the connection between stress and difficulties with sexual interest and arousal, Dr. Brotto helped lead a pioneering treatment study between 2015 and 2018, involving 148 women ages 19 to 70 who reported “low or absent” sexual desire. Some 42 per cent were married, 29 per cent common law, with the rest dating or single. For those with partners, the average duration of their unions was 11.4 years. Asked about “relationship closeness,” 45 per cent said they were satisfied, 55 per cent dissatisfied.
Still, the links between stress and sex were real in their lives. And among lesbian and bisexual women, who made up 19 per cent of the cohort, higher levels of stress had an especially negative effect on desire.
The researchers tracked the women as they took part in mindfulness-based cognitive therapy and sex education, following up with each participant for an additional year afterward. The research, published in April in the Journal of Behavioral Medicine, found the mindfulness sessions in particular helped tone down stress, with some positive downstream effects on women’s intimate lives.
“A good part of the improvement in desire is because we helped people learn how to manage their stress,” said Dr. Brotto, author of Better Sex Through Mindfulness: How Women Can Cultivate Desire.
Struggling, D enrolled herself in the treatment study. The women she found there identified parallels at home: a deep sense of feeling overwhelmed.
“We were all different. But a consistent theme was the demands of life on us as women,” D said. “Their baggage, or whatever was burdening or blocking them, included that variable.”
While the sessions weren’t a remedy for D, they illuminated something critical. During one of the in-person meetings, another woman gave her the words to describe the wall that goes up for her during sex: she isn’t able to let go.
“To let yourself go, be a part of it, dissolve into the sex, lose your mind – all the encumbrance is gone,” D said. “The revelation was that I’m not present. Ever.”
There are clear lines drawn in the body from chronic stress to a dimming of desire and the ability to summon arousal.
“Chronic stress – where something is weighing on your mind or is hard to escape – can lead to elevated cortisol, the stress hormone,” explained Lisa Dawn Hamilton, an associate professor in psychology at New Brunswick’s Mount Allison University who studies the links between sex and stress.
These spikes in cortisol can suppress testosterone and estrogen, sex hormones involved in arousal. Cortisol jumps can also make it impossible to focus on sexual cues, or immerse oneself in pleasurable sensations.
Dr. Hamilton’s research is now looking at how all this works in couple’s private lives, outside of a lab setting. For a current study, her team is collecting saliva samples from people who report, via text message, on their stressors each day; whether they desired sex or not; whether sex happened and how it was for them.
“We’re measuring hormones for testosterone, cortisol, estradiol, and sympathetic nervous system markers, trying to figure out what are the links to stress and sex – in beneficial or harmful ways,” said Dr. Hamilton, who is associate editor of the Archives of Sexual Behavior.
The researcher is interested in which elements of stress are harmful for sex and which are actually useful. Any activity that gets the heart rate up is, physiologically speaking, a stressor. Exercise qualifies as a “positive stressor” – one that can serve as a sexual cue.
“It’s been shown that exercise, if you go for a run or ride a bike, you’re more likely to get more aroused in that sort of scenario,” Dr. Hamilton explained.
Sex, she noted, is a positive stressor too, as is masturbation. She offered a counterpoint: what if more people could harness intimacy as the de-stressor, as a healer for burnout?
“Orgasms help release muscle tension,” Dr. Hamilton said. “They’re like an ultimate form of mindfulness: you’re not thinking about other things as you’re having an orgasm. Humans need touch and connection. Even if it’s not sex, even cuddling or having some sort of affectionate time with another human can be soothing and help lower stress levels.”
Simple human contact has a valuable role to play in reducing stress.John Morstad/Globe and Mail
But she offered a caveat: the sex has to be worth wanting.
“No amount of meditation or exercise or whatever is going to make you look forward to sex if the sex is not enjoyable to begin with,” Dr. Hamilton said. “That’s a big piece that doesn’t get talked about enough.”
She pointed to the provocative 2020 book Magnificent Sex: Lessons from Extraordinary Lovers, from University of Ottawa professor Peggy Kleinplatz and Dana Ménard, an assistant professor at the University of Windsor.
Dr. Kleinplatz and Dr. Ménard are direct about the “sexual relationship death spiral” that many harried, long-term couples fall into. For people who have been together for many years, the authors argue, worthwhile sex has to involve being intentional, setting aside time from the daily churn to prepare the mind, body and space. They point to early-stage date nights, when partners put time and effort into the details of courtship.
In other words, desire is not a random, spontaneous happening, the way we’ve been socialized to believe. Instead, it’s more responsive: to sexual stimuli, to previous intimate encounters, even to the general environment.
Though this is intuitive, sex therapists say their patients often falsely assume sex should “just happen,” and that if it doesn’t, the relationship is irrevocably broken. These patients don’t love hearing that jump starting libido might involve planning and scene setting, particularly when life becomes busy.
People can be very skilled at managing their time when it comes to work, socializing or dating, and some sex therapists suggest they apply the same rigour to more intimate matters.PHILIPPE LOPEZ/AFP/Getty Images
Certified sex therapist Laurie Mintz is a proponent of scheduling sex on a calendar. This invariably elicits groans from her clients, who find the concept awkward and stilted.
The psychologist gently reminds them sex isn’t “just happening,” which is why they’re in her office. She challenges them: if they’re able to pro-actively set aside time in a busy schedule for therapy with her, why does it seem impossible in their intimate lives with one another?
“Find the time and schedule it,” she tells her patients. “And not as in this obligatory, ‘Oh God, I gotta do it’ way. Have time for touch, a ritual. This is a potent intervention. And for the low desire woman it’s such a relief because she knows when it’s going to happen and she’s going to carve out time for it,” said Dr. Mintz, who wrote A Tired Woman’s Guide to Passionate Sex.
Still, she acknowledges that many self-care fixes touted for burnout can feel lofty when time is the issue.
“The great irony in this work is that you have women who are stressed, overloaded, overwhelmed. Many of the behavioural changes that we know work for stress take time: meditation, yoga and so on. It’s a dance to talk to people about, ‘To get your stress better, you’re going to need to carve out time.’ And then the question becomes, where is this going to come from?”
Dr. Mintz finds all kinds of couples deeply affected by this problem.
“Stress is stress. It’s going to impact you whether you’re happy in your marriage or unhappy – it’s going to hit you either way,” she said. “If you’re in a happy relationship, maybe that’s one more social support against stress. But it’s not going to change what stress does to one’s sex drive.”
Couples in longer term relationships tend to raise this issue more often than new partners, she said, because with time come more challenges: mortgages, balancing children with careers, illness, eldercare duties. “But it’s not about the age of the relationship,” Dr. Mintz said. “It’s about these life milestones that typically occur later into relationships.”
Echoing Dr. Brotto’s research, she has found some of her LGBTQ clients acutely affected by the stress-desire link.
“On top of the everyday stressors, they are also dealing with the stress of discrimination,” she said. “We know that aggressions based on identity are stressors, which affect health, well-being and desire.”
Lingerie and sex toys are examples of the 'gas' that couples can use to charge up their libidos, but the 'brakes' can be equally important, sex educators say.Jennifer Roberts/The Globe and Mail
The gas and the brakes: Much of the conundrum around burnout and desire comes back to this, according to Anna Hushlak and Billie Quinlan, co-founders of Ferly, a digital sexual well-being app for women.
“We tend to focus so much on the gas – find new sex toys, try new positions, wear sexy lingerie. That might create more sexual stimuli but it does nothing to take the foot off the brakes. And until we can get that foot off the brakes, there’s no way forward,” said Ms. Hushlak, who is from Calgary, now based in Britain.
The app, which charges membership fees, offers programs and individual sessions women can access at their own pace to scale down their rumination on stress, cultivate a stronger mind-body connection and clearer understanding of turn-ons and turn-offs. There are exercises on body mapping, mindful masturbation and “interoceptive awareness,” or being aware of sensations in the body.
As with Dr. Mintz’s sex scheduling concept and the thoughtful lovers peppering Dr. Kleinplatz and Dr. Ménard’s research, Ferly’s exercises make clear that desire requires care and prioritizing. It’s a notion that still draws resistance from couples who think desire should simply materialize, or hope for a quick fix.
“There’s no sugar-coating it: there is no magic pill,” Ms. Hushlak said.
“As much as we talk about the dreaded Goop promoting supplements to boost this instantaneously, or Addyi, the female Viagra – they don’t work, purely because that’s not the way our central nervous system works. You might be able to increase blood flow, or change arousal, or increase lubrication or sensation. But that’s not desire. That’s not this subjective wanting, this anticipating, this openness.”
Fundamentally, Ms. Hushlak emphasizes changing the language around desire.
“A lot of people think something’s wrong with them, that they’re not normal or they’re broken, especially when we use language like ‘dysfunction.’ They don’t realize that a lot of what they’re experiencing is completely expected,” she said.
“It’s pretty normal to not want sex that we either don’t like, or that we don’t have capacity for because we’re busy, stressed, burnt out.”
COVID-19 kept Canadians at a distance from one another, and while that was a source of anxiety and uncertainty for many, for others it could remove stress factors from their lives.Darryl Dyck/The Canadian Press
For D, the Vancouver lawyer, life changed radically during the COVID-19 pandemic. Trials were suspended and adjourned for many months, her draining work hours put on an abrupt hiatus.
“Life became very simple. There wasn’t a lot of demand on me. It came at a time when I was desperate for that pause,” D recalled.
“The black around my eyes lightened and I was sleeping more. A lot of things changed and demonstrated that the healthiest version of me does not live in the toil of law. It lives in something else.”
With life slowing and contracting in those lockdown months, D’s sex life with her husband flickered back on. This time yielded another revelation: maybe the problem wasn’t one to correct in her own body.
“For us as women, it’s important to recognize that there is a cause to this thing often called a dysfunction that isn’t our fault,” D said.
“It could take away some of the blame or guilt if we recognize that society and circumstances created this situation that affects all aspects of our lives, including sexual health.”
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