Maybe you used to want sex and now you don’t. Maybe you never really did, and you’re trying to figure out if something is wrong with you. Maybe your partner’s desire feels like pressure, and the gap between you keeps widening.
Low desire is one of the most common reasons people seek sex therapy — and one of the most misunderstood. It’s rarely about hormones alone, and it’s almost never as simple as “just not being interested.”
There’s usually something underneath: exhaustion, resentment, body image, past experiences, a relationship that’s lost its emotional charge, or a pattern of sex that never really worked for you in the first place.
I offer this work in Pittsburgh and online across Pennsylvania, New Jersey, New Mexico, and Rhode Island.
If this resonates, I’d welcome the chance to talk it through.
Schedule a free consultation →What’s Actually Going On
Desire isn’t a switch. It’s more like a system — one that responds to context, safety, stress, and connection. When any of those are off, desire often goes quiet.
For many people, the issue isn’t that desire has disappeared. It’s that the conditions for desire aren’t there. That might mean too much stress, too little emotional connection with a partner, unresolved tension, or a sexual routine that doesn’t actually do much for you.
There’s also the matter of responsive desire — the kind that shows up after arousal starts, not before. Many people experience desire this way, but our culture teaches us that “real” desire is supposed to be spontaneous. When yours doesn’t work that way, it’s easy to assume something is broken. It’s not.
And then there’s the relational layer. When desire drops, partners often take it personally. They feel rejected, unattractive, unwanted. The person with lower desire feels guilty, pressured, defensive. Both people end up in pain — and the more they try to “fix” it, the worse the dynamic gets.
How This Work Helps
I don’t approach low desire as a problem to fix. I approach it as a signal worth understanding.
That means exploring what desire has meant for you historically — when it was present, when it wasn’t, and what was different. It means looking at the relational context: what’s happening between you and your partner that might be dampening desire rather than creating space for it.
Sometimes it involves rethinking what “sex” even means to you. A lot of people are trying to want a version of sex that was never built around their actual experience of pleasure. Expanding that definition — beyond the bedroom — often changes everything.
If you’re in a relationship, we’ll likely address the pursue-withdraw pattern that’s built up around the desire gap. That cycle often does more damage than the desire discrepancy itself.
This is tender, personal work — and it deserves a space that feels safe. A free 15-minute consultation is the first step.
Schedule a free consult →What Therapy Looks Like
Sessions are 53 minutes, in person in Pittsburgh or online via secure video. I work with individuals and couples — and often a combination is the most effective approach.
We’ll start by understanding your specific experience: when the shift in desire happened, what makes it better or worse, how it’s affecting you and your relationships. From there, the work unfolds at your pace.
As an AASECT Certified Sex Therapist, this is a core area of my training. You won’t need to educate me or explain why this matters — I already know it does.
Practical Details
I offer therapy for desire concerns in person at my office in Pittsburgh’s East End (East Liberty/Shadyside area) and online across Pennsylvania, New Jersey, New Mexico, and Rhode Island.
This is a private-pay practice. That means no insurance company deciding what we work on or how long we take. The depth and pace are determined by you.
Evening and Sunday appointments are available.
Frequently Asked Questions
Is low sexual desire always a problem that needs to be fixed?
Not necessarily. Desire varies across the lifespan, and there’s no “normal” amount of sex a person should want. What matters is whether you’re satisfied with your desire level and whether it’s causing distress in your relationship. Some people naturally have lower desire, and that’s completely healthy. But if you’re noticing a change—if desire used to be there and now it’s gone, or if the mismatch between your desire and your partner’s is creating conflict—that’s when therapy can help. We look at what’s changed and what you actually want, rather than what you think you should want.
What causes low sexual desire?
Low desire can come from many places, and usually it’s a combination of factors. Medical issues like thyroid problems, hormonal imbalances, depression, and certain medications can reduce desire. Stress, exhaustion, and being overwhelmed by life responsibilities are huge culprits—it’s hard to feel sexual when you’re running on empty. Relationship issues, unresolved conflict, resentment, and feeling emotionally disconnected can absolutely kill desire. And sometimes it’s rooted in past experiences, body image concerns, or learned messages about sexuality. That’s why I take time to understand your whole picture, not just look at one cause.
Can sex therapy actually help with low desire?
Yes. Therapy helps by addressing the underlying causes—whether that’s stress management, improving your relationship connection, processing past trauma, or working with your doctor on medical factors. I help you rebuild pleasure and intimacy in ways that feel authentic to you, not forced. We work on communication, reconnection with your partner, and sometimes addressing anxiety or shame around sexuality. The goal isn’t to manufacture desire out of nowhere; it’s to remove what’s blocking your natural desire and help you feel excited about sex again.
What do therapy sessions look like for low desire issues?
I start by understanding your relationship, your stress level, any medical factors, and what desire used to feel like for you. We explore what’s changed and what you’re experiencing emotionally. If you’re in a relationship, we often talk about how low desire is affecting your partner and your connection. From there, we develop a plan that might include stress reduction, relationship reconnection activities, communication exercises, or exploring what would actually feel pleasurable and exciting to you. I give you practical tools to use between sessions, and we adjust the approach based on what you learn about yourself.
Is medication better than therapy for low sexual desire?
Medication can help with certain causes of low desire—especially if hormones or depression are involved. But desire is complex, and medication alone often doesn’t address the relationship, stress, and psychological factors that are usually at play. In my experience, therapy tends to have longer-lasting effects because it helps you understand what’s really going on and builds sustainable changes in your relationship and how you experience pleasure. Sometimes combining both approaches works best—medication to address medical factors, therapy to address the rest. The key is understanding your specific situation and what will actually help you feel connected to sexuality again.
Ready to Get Started?
Schedule a free consultation to discuss how therapy can help.
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