Confronting Sexual Anorexia: Understanding Your Fear Of Sex

Sexual anorexia, also known as sexual aversion disorder, is often characterized by a persistent fear or avoidance of sexual contact, potentially leading to difficulties in intimate relationships, shame, and anxiety. 

By increasing awareness and understanding of sexual anorexia, individuals might be able to take the first step towards overcoming their fears and improving their sexual and intimate lives. Despite its impact on an individual's well-being, sexual anorexia is often under-recognized and misunderstood. Therefore, it can be crucial to have comprehensive information on the causes, symptoms, and treatments for this condition, as well as methods to support those struggling with it.

This article explores the work of Patrick Carnes in understanding sexual addiction and its counterpart, sexual anorexia. By delving into strategies for overcoming sexual self-hatred, sexual anorexia, and avoidance of sex, it provides insights for individuals who experience sex addiction, sexual anorexia, or a combination of addiction to and aversion towards sex.

What is sexual anorexia?

Unlike its polar opposite, sex addiction, which involves excessive or compulsive engagement in sexual activity, sexual anorexia is a pattern of behavior characterized by intense fear or avoidance of sexual contact. This fear could be related to various factors, such as trauma, anxiety, or a lack of sexual experience, which may lead to challenges in forming fulfilling relationships.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) does not currently categorize sexual anorexia as an official diagnosis. Instead, some healthcare professionals and therapists may use it to describe specific behavioral tendencies. In some cases, sexual anorexia may be associated with sexual disorders like hypoactive sexual desire disorder or sexual dysfunction. 

Individuals with sexual anorexia might experience various symptoms, including a lack of sexual desire, difficulty with arousal and orgasm, and physical discomfort during sexual activity. In severe cases, in addition to avoiding sex, sexual anorexia could lead to avoiding all forms of physical intimacy, including kissing and hugging. 

According to Patrick Carnes, author of “Sexual Anorexia: Overcoming Sexual Self-Hatred,” some individuals who engage in compulsive behaviors, such as using strip clubs, prostitutes, and porn sites, yet are unable to form a sexual relationship beyond a transactional or secret interaction, may also have sexual anorexia. Overcoming sexual self-hatred and sexual anorexia may help these individuals increase their quality of life and relationships. 

These patterns are often observed in sex addicts, who might struggle with two disorders: sexual anorexia and another form of sexual dysfunction.

Sexual anorexia is not the same as asexuality, which is a valid identity and sexuality. When someone is asexual, they do not experience sexual attraction. People who are asexual may choose to partake in sexual activity or not. Asexuality is not a mental illness or flaw. 

The impact of sexual anorexia on relationships

Sexual anorexia could significantly impact an individual's intimate and sexual relationships. The fear and avoidance of sex may cause shame or sadness, which may strain the relationship. In severe cases, the compulsive avoidance of sexual encounters may lead to complications or other addictions involving alcohol or substance abuse. 

The lack of physical intimacy could cause a disconnection between partners, making it challenging to maintain a healthy and fulfilling relationship. Understanding the impact that sexual anorexia could have on one's relationships and seeking support and treatment may be beneficial.

Potential causes of inhibited sexual desire

Various factors, including psychological, physiological, and environmental factors, could cause sexual anorexia. Some of the most common potential causes of sexual anorexia include the following: 

• Trauma: Traumatic experiences, such as sexual abuse and assault, could cause an individual to develop a fear or avoidance of sexual activity.

• Anxiety and depression: Anxiety and depression may sometimes lead to sexual anorexia, as these conditions could make it difficult for an individual to relax and enjoy sexual activity.

• Lack of sexual experience: Individuals with limited sexual experience may become insecure or nervous about engaging in sexual activity, leading to a fear of sexual contact.

• Cultural and religious beliefs: A strict religious upbringing and cultural beliefs could also contribute to sexual anorexia, as they might discourage or prohibit sexual activity, leading to shame. 

Other potential causes of sexual anorexia may include:

• Hormone imbalances

• Physical problems like pain during sex, injuries, or infections

• Medical conditions like hypothyroidism

• Fatigue

• Stress

• Medication side effects

• Relationship problems

The causes of sexual anorexia can vary. In many cases, multiple factors may play a role in whether an individual chooses to avoid sex. A healthcare provider may recommend blood tests and a complete examination to determine what may be causing a person to avoid sexual activities. 

Treatment options for sexual anorexia

Sexual anorexia could be treated through therapy, medication, and lifestyle changes. Some of the most effective treatment options for sexual anorexia include the following. 

Psychotherapy

Psychotherapy, such as cognitive-behavioral therapy (CBT) and exposure therapy, could help individuals with sexual anorexia overcome their fears of sexual contact.

Medication

Some medications might treat sexual anorexia by reducing anxiety and depression symptoms. However, consult a doctor before starting, changing, or stopping medication. 

Lifestyle changes

Lifestyle changes, such as exercise, relaxation techniques, and healthy eating habits, could help individuals manage stress and anxiety and improve overall sexual health.

Couples therapy

Couples therapy could be beneficial for individuals in a relationship who are struggling with sexual anorexia. This type of therapy may improve communication and intimacy between partners.

Support groups

Support groups may allow sexual anorexics to discuss experiences and coping strategies. They can also help individuals find ways to maintain healthy relationships and work through challenges regarding sexual behaviors and activities.

However, the treatment of sexual anorexia might vary depending on the individual and the underlying causes of their condition, especially if they have a history of sexual disorders. A trained mental health professional can work with individuals to determine the best course of treatment for their specific needs.

How to support someone with sexual anorexia

If you know someone who might be struggling with sexual anorexia, try to offer support and understanding. In addition, you can consider the following tips: 

• Be patient and non-judgmental: Listen to the person and attempt to understand their feelings without judgment. 

• Encourage them to seek help: Encourage the person to seek help from a mental health professional and consider different treatment options.

• Provide a safe and supportive environment: Create a safe and supportive environment for people to discuss their experiences and feelings. Avoid negative or critical comments, instead offering encouragement and support.

• Be understanding and respectful: Consider sexual anorexia as a mental health challenge. Be understanding and respectful of the person's experiences and struggles.

• Educate yourself: Learning about sexual anorexia could help you better understand and support your loved one. 

Alternative support options to improve sexual intimacy

Psychotherapy could be a beneficial treatment option for individuals struggling with sexual anorexia. However, some people seeking therapy may face barriers to traditional in-person methods. In these cases, online platforms like BetterHelp for individuals and ReGain for couples may be more convenient.

With an online therapy platform, clients can choose between phone, video, and live chat sessions. In addition, they can message therapists outside of sessions, receiving a response as soon as the professional is available, which may be more convenient for some people than waiting for another appointment to ask a question. 

One study found that sexual dysfunction is more common among individuals with chronic illnesses and is associated with distress and reduced quality of life. The study presents a model of coping with sexual dysfunction that focuses on the construct of flexibility, including the definition of sexual functioning and its centrality to overall self-concept. The study highlights the need for a comprehensive approach to treating sexual dysfunction in individuals with chronic illnesses, including therapy. 

Online therapy is as effective as in-person therapy in treating potential causes of sexual anorexia, including attachment anxiety and avoidance. One study determined that both challenges were reduced after clients attended internet-based therapy.