Despite the importance of distress in the diagnosis and treatment of desire disorders, the phenomenon of distress has received scant empirical investigation. Measures are limited, and the individual and couples factors that predict, moderate or ameliorate distress are poorly understood. While practitioners regularly treat sexual desire at the couple level, the literature has not yet caught up and is still highly focused on women alone.

Objective The current research aims to build our understanding of distress as it occurs within a dyad, with a focus on describing the distress and consequences resulting from low or discrepant sexual desire.

Materials and Method Semi-structured interviews were conducted with 26 participants (13 couples) between the ages 18 and 47 years (average age 31.8 years), who were in long-term heterosexual relationships (average duration 8 years 10 months), and who self-reported low or discrepant sexual desire and distress in either member of the couple. Data collection and analysis were informed by grounded theory methodology and SDI, FSDS-R, DASS and KMSS measures were completed.

Results Thematic analysis resulted in 29 conceptually distinct themes of distress and consequences that were clustered into four overarching categories: negative emotions, behavioural change, impacts on the relationship, and problematic thoughts.

Conclusions The previous focus on frequency of sexual activity for an individual or couple is insufficient for describing and understanding the consequences of low or discrepant desire for both members of the couple, and their relationship. The results of this study suggest that that low sexual desire or desire discrepancy in distressed couples, leads to significant change in couples’ behaviour, emotion, cognition and attributions. Researchers and treating clinicians should conceptualise it as a complex, multifaceted and deeply distressing concern for which we need to improve our understanding and treatment options.

Disclosure Work supported by industry: no. The presenter or any of the authors act as a consultant, employee (part time or full time) or shareholder of an industry.