It is really difficult to define how people become interested in possible sexual activity and the Arousal that follows this. Different factors such as the ease, frequency and intensity of these feelings come into play. Where one step leads into another can be hard to decide. Libido is the term generally used to describe Sex drive, the urge to sexual fantasy or activity. It varies between individuals and there is no identifiable “normal” level of intensity; there is a range of experience from the lowest to the highest and whatever feels right and good for you may be considered normal.

When interest is stimulated and the sex drive is engaged then arousal is usually manifested in the body. This is probably most noticeable in the male with Erection, but is evident in both males and females in various ways in preparation for sexual activity - in women the Vagina lubricates, the Clitoris swells, the breasts enlarge. In both, heart rate and breathing speed up and there is a feeling of being "turned on". Without this arousal, sexual activity is possible but tends to be mechanical and without passion - like someone simply going through the motions. It is more likely that lack of arousal leads to other apparent sexual Dysfunction eg painful sex.

Arousal usually develops through exposure to stimulation of the senses which the person perceives to be Erotic (sexy). The source of this stimulation varies greatly from person to person and to some extent is determined by previous experience. The degree of appropriateness of this material is largely a socially determined factor. For this reason, when stimulation occurs, there may be an accompanying or subsequent feeling of guilt which may have both psychological and physical consequences for sexual capability.

Inability to become aroused at all can develop for a number of reasons which can be both physical and psychological. This only becomes a problem if the individual decides it is a problem, when they wish to be capable of being aroused, or start to feel powerless if the frequency of arousal gets in the way of the rest of their lives. They may choose not to participate in an active sex life for their own reasons and this is as valid a choice to make as any other. If the situation is one of avoidance induced by e.g. fear or guilt however, then counselling might be considered and a real choice then based upon true options being opened up to the individual. This is true also for physical origins.

Some factors which may result in impaired arousal include;

Previous ability to become aroused may be impaired for a number of reasons such as;  

• Imbalanced Hormone levels, particularly with regard to Testosterone which is believed to figure significantly in arousal in both men and women.
• A reduction in response capability induced by the natural ageing process.
• Illness, surgery or injury which results in significant pain, fatigue, disfigurement, etc.
  
• Medication used in the treatment of illness.
  
• Misuse of “recreational” drugs such as alcohol or “hard” drugs.
  
• Previous sexual assault which may have occurred in childhood or as an adult.
  
• Dissatisfaction with previous experience of sexual contacts.
  

Guidance with regard to these can be obtained from a number of sources which include your own doctor, GUM and Sexual Health Clinics or counselling services.

The ease with which arousal develops, its intensity and frequency of occurrence can become particularly problematic when partners are involved. Where these factors are generally matched between partners, there is less likelihood of conflict. However, if a partner wishes sex more often than their partner does, the other partner may feel pressurised to have sex even though they don't feel they want to.

Where there is a difference between partners then this can be a source of dissatisfaction and difficulty.

The difference may have always been there and the partners may have worked out a compromise in activity or go their separate ways.

Where the difference is new, causes such as those listed above can be involved, but there may be reasons specific to the relationship with a partner. These can include;

• Boredom with an established routine which may be resolved by introducing some novel practices, change of location, use of sex toys or erotic material.
  
  
• Loss of interest in the sexual partner which may be recoverable or not, and if not may result in a change of partners.
  

The differing sexual demands of a partner can lead to reluctance to make any physical contact at all in case this initiates sexual overtures. A compromise between the extent of activity mutually engaged in may resolve this.

• The nature of sexual activity desired by a partner may be unacceptable to another, such as Oral sex. Again, negotiation may resolve this.
  
  
• The sexual orientation or paraphilias (sexual behaviour preferences of a more unusual nature) of a partner may be at odds with that of the other and hidden from them.
  
  
• A partner may be less careful with regard to personal hygiene and this may be off-putting.