For those of you who don’t read academic papers for funsies, to look at things through a biopsychosocial lens means to acknowledge that our health — including our sexual health — is impacted by a combination of biological, psychological, and social factors.
For example, your lack of sexual desire is probably not just about fluctuations in your hormonal levels. It could also have something to do with your levels of stress, how well you’re sleeping, the medications you’ve been taking… and so on.
In short, issues in the bedroom can be caused by a wide range of things, all playing off each other.
To help you take a more holistic view at what might be causing your sexual dissatisfaction, we’ve put together a list of common factors that can impact your sex life, with tips on what can be done about each one.
Biological/Physiological Factors. When something feels off, we tend to look for physiological problems first. They can be the easiest to pinpoint and, in some cases, the easiest to remedy. Here are a whole slew of biological/physiological factors that could be throwing your sex life off balance.
Illness. Sexual function can be adversely impacted by conditions such as diabetes, heart and vascular (blood vessel) disease, neurological disorders, hormonal imbalances, and chronic diseases, such as kidney or liver failure. Diabetic neuropathy, for example — a type of nerve damage associated with diabetes — can cause numbness and pain, leading to erectile dysfunction, anorgasmia, etc. And chronic kidney disease can also cause erectile dysfunction and decreased libido. If you have an illness, it may be worth talking to your doctor about how you might be able to mitigate those sexual side effects.
Medications and other treatments. In a terrible one-two punch, medications and other treatments — including antidepressants — can also affect sexual function. Because medications can affect each person differently, it’s worth working with your doctor to try out different medications and dosages until you land on one that works best for you.
Hormonal fluctuations. When we hear the phrase “hormonal fluctuations,” we often think of menopause. And while this can be the time when your hormones bounce around the most dramatically, we experience hormonal fluctuations almost constantly over the course of our lives. No matter what phase of life you’re at, it’s worth rereading my earlier post about how perimenopause and menopause can affect your sex life.
Childbirth. It probably won’t surprise you to hear that popping out a child can affect your sex life. Be easy on yourself during the postpartum period. You may be in pain. You’re likely not sleeping through the night. If you’re nursing, your child is literally feeding off your body. Then there’s the possibility of postpartum depression and anxiety. I don’t know about you, but the only thing I wanted to make sweet love to was my pillow. Be honest with your partner about how you’re feeling and talk to your doctor about possible solutions.
Sleep habits. If you’re not getting enough sleep (seven or more hours per night), you may find you’re rarely in the mood for sex and, when you do get intimate, you’re slower to arousal. Your sleep habits can affect so many aspects of your health, not just your sex life. So, if you find yourself tossing and turning at night or you don’t feel refreshed when you wake up in the morning, you may want to make some adjustments to your bedtime routine, your sleep environment, and the number of hours you leave for sweet, sweet slumber.
Eating habits. A poor diet can also have a huge impact on your health, including your sex life. One cannot live on Hot Cocoa Kisses alone, no matter how delicious they are.
Fitness. By taking care of your body and improving your overall physical health, you can improve your sexual health, too. After all, cardiovascular workouts increase circulation and blood flow, which can improve sexual response. Exercise can also help with stress and body image, both of which impact sexual desire. So, if you’re feeling lackluster in the bedroom, look at how you’re incorporating movement into your day-to-day life.
Substance abuse. Arousal, orgasm, and desire can all be affected by drug use. Because alcohol is a depressant, it can also decrease sexual desire and response. While we often think of certain substances as social lubricants, they may be impeding your ability to get busy in the bedroom.
Sexual dysfunctions. And then there are those sex-specific conditions such as erectile dysfunction, premature ejaculation, and the whole range of sexual pain disorders. These conditions are themselves biopsychosocial. Experiencing them can have additional impacts on your sex life. If you’re experiencing any of these issues, it’s definitely worth giving your doctor a call.
Psychological Factors. Once you’ve ruled out those physical issues, I recommend turning your attention to your mental health. We often minimize the impact certain stressors are having on our overall health and well-being. But folks: The struggle is real.
Mental health illnesses. Depression and anxiety, chronic or otherwise, can dampen libido and arousal, as can other mental health illnesses. If you struggle with your mental health, cut yourself some slack. Then, if you haven’t already, consider having a talk with a mental health professional about how you can manage your illness. If you’re on medication and suspect it’s having an adverse impact on your sexual health, your doctor may also be able to help.
Daily stressors. Whenever I go through the list of day-to-day stressors that can impact libido — stuff like work, relationship shenanigans, parenting, household responsibilities, and more — I marvel at the fact that any of us ever have sex at all. Are one or more of these things leaving you feeling overwhelmed and exhausted? That could be why you’re not in the mood. Once you deal with those stressors, you may find that your sex drive improves.
Concerns about sexual performance. Yup. Concerns about sexual performance can beget problems with sexual performance. It’s worth interrogating the source of your concerns and, perhaps, even having a conversation about it with your sexual partner(s). Just talking about it could ease your mind or help you and your partner(s) find ways to combat your self-consciousness.
Concerns about body image. Similarly, research shows that low body image can lead to sexual anxiety. I can’t exactly tackle such a large, culturally systemic problem within a single, pithy paragraph. But I can recommend you read Sonya Renee Taylor’s The Body Is Not an Apology.
Sexual trauma. I’ve written in the past about how to rediscover your sexuality after trauma. I invite you to revisit that post if you have past trauma, but I’ll just reiterate here that trauma can lead to moments of being triggered, dissociation, shame, and other symptoms. If you or someone you know is in need of trauma-related support, you can get help through organizations like RAINN or your state’s Coalition Against Sexual Assault. They’ll be able to point you toward hotlines, support groups, long-term counseling, and more.
Social Factors. Some of the psychological sources of stress mentioned above can also be tied up in sociocultural expectations, and it is that social element we tend to forget about when we’re looking for the source of our sexual “problems.”
Those body image issues we mentioned before? They exist because of systemic cultural messaging around weight and other beauty standards.
Experiencing dissatisfaction with your relationship? Relational satisfaction and stability are also impacted by what we’ve been taught a healthy relationship is supposed to look like.
What are some of the sexually specific sociocultural expectations we are unconsciously carrying around with us?
Expectations around sexual style and frequency. We make assumptions about how much sex others are having. We assume that women have lower sexual desire than men, while men are eager to drop their pants at the drop of a hat. All these assumptions have been contradicted by research, which shows that sexual desire fluctuates based upon context.
We also carry with us a very limited definition of sex, assuming that penis-in-vagina (PIV) penetrative intercourse that ends in orgasm is the most valid expression of sexuality. Everything else? It’s just foreplay and, therefore, less than.
Conflicted feelings around identity, such as gender and sexual identity. Because PIV sex is seen as the gold standard of sex, those who deviate from the cisgender, heterosexual mold are often othered.
Conflicted feelings around kink, sex toy usage, etc. And then there are the forms of sexual expression we enjoy, many of which we are shamed for if they are seen as outside the norm. Of course, we here at Pure Romance believe that all consensual forms of sexual expression are valid.
The role of negative attitudes towards sexuality as a whole. I’ve written before about why we treat sex like a dirty word. I won’t belabor the point.
I’ll just say that with all the sociocultural factors that exist around sexuality, it can be worth questioning your feelings around them. Might you be carrying certain beliefs about your sexuality that are holding you back in the bedroom? Try journaling about these issues or, if you’re open to it, talking to your partner(s) or even a mental health professional who specializes in sexuality.
Tl;dr: if you’re dissatisfied with your sex life, it can help to do a wider assessment of your overall health and well-being. We’re so quick to blame ourselves for problems in the bedroom when so much is outside of our control. We assume that we are the problem, that we are broken.
But our sexuality is sensitive and, just as an entire day can be thrown off-kilter by a tiny sequence of annoyances that happen first thing in the morning, your bedtime activities can also be thrown off-kilter by any number of things.
Hopefully, this list will help you take a more holistic view of your sex life.