Suppressing Pleasure: the quiet disappearance of desire

“Not tonight, I’ve got a terrible headache...” 

We’re all familiar with the many obstacles that can get in the way of intimacy, some genuine, some not quite so genuine. But really, our desire is rarely "turned off" by one cause - it's eroded by an accumulation of factors - emotional, physical, medical, hormonal, and cultural - that each individually seem minor, reasonable, even invisible. Sometimes it’s not actually a state of being turned off, but more likely a mix of disconnect and distraction, which is where reactive desire comes in - but more on that another time…

Many of us will smile proudly at the effects an influx of hormones has on our libido, but what happens when other factors play a role, and indeed when certain hormones are taken out of the equation? And with such pressure to look a certain way at all points in our lives, how does that play into our appetite for pleasure?

Libido loss rarely arrives as a single dramatic event - it tends to be incremental, often unnoticed until it's gone, and rarely discussed because each cause (a prescription, a life stage, a cultural script) seems "normal" on its own. 

Consider our interest piqued, and toes dipped into the matter…

SOCIETAL SUPPRESSION

The medicalisation of female desire 

‘Hysterical’ women, step forward…

The suppression and medicalisation of pleasure have been intertwined for millenia, especially when it comes to the female variety. The idea that women’s clitoral pleasure was "disordered" underpinned the Victorian diagnosis of hysteria, "treated" via doctor-induced orgasm or clitoridectomy. Madness indeed.

People pleasers, assemble…

It seems that women have always been conditioned to prioritise a partner's pleasure over their own - and across all current generations we will know many with internalised scripts of being "desirable" or "not too needy" - this can cause complete disconnection from one's own sexual needs, where the goal becomes far more focused on pleasing the partner rather than personal satisfaction. As you can imagine, we are on quite the mission to resolve this. 

The Orgasm Gap is a subject we have discussed time and time again; referring to the disparity between men and women experiencing orgasms. It could go back as far as the origins of species, we really can’t say… Although ‘The Big Bang’ is quite an entertaining theory… Innuendoes aside though, currently, this disparity sits at roughly 30%. While 95% of men report reaching orgasm during heteronormative, partnered sex, only 65% of women do - dropping to just 18% when women have casual sex. Studies have found that Lesbian and bisexual women have significantly more orgasms than heterosexual women, and it could be down to a lack of understanding when it comes to female anatomy and the vulva. 

Consider adding Anorgasmia into the mix; the persistent, or recurrent inability to achieve an orgasm, despite adequate sexual stimulation and arousal. Anorgasmia can affect anyone regardless of gender, although it is most often associated with women, to the point that it is sometimes called Female Orgasmic Disorder. For a diagnosis, the condition must cause significant personal distress or negatively impact sexual relationships. The thought of seeking a diagnosis for such a frustrating and potentially devastating condition; it’s no wonder these issues can be swept under the carpet for so long, especially without compassion or communication.

MEDICAL SUPPRESSION

It’s on the tip of quite a few tongues, so let’s talk about the GLP-1 effect. 

GLP-1 receptor agonists, including semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), can negatively impact libido and sexual function in some users. This drop in sex drive is primarily driven by how these medications quiet the brain's reward centres, alongside physical side effects like fatigue, nausea, and, in some cases, rapid hormonal shifts. The effect is not universal, however - clinical data remains highly individualised, with some patients reporting the opposite effect.

There are several distinct mechanisms through which these medications may reduce sexual interest:

Brain reward pathways sit at the centre of the most compelling explanation. GLP-1 agonists reduce "food noise" and cravings by dampening dopamine and reward signalling in the brain. Because food and sex share overlapping neurological networks for drive and pleasure, this dampening effect can spill over into reduced interest in sex.

Fatigue and nausea - particularly during early treatment or dose escalation - drain energy and can make sexual activity feel unappealing or simply impractical.

Under-eating is a frequently overlooked factor. When calorie restriction becomes too severe, or nutritional intake too poor, the body can enter a deficit state - prioritising basic survival functions over pleasure and reproduction. Lauryn Higgins wrote an incredibly insightful piece that speaks to this - read here.

Hormonal shifts triggered by significant weight loss can temporarily cause fluctuations in oestrogen, testosterone, and other metabolic hormones - all of which play a role in sexual desire and genital arousal. 

Anorgasmia - the difficulty in reaching orgasm - has also been reported by some users, and may be linked to reduced genital blood flow or alterations in serotonin and norepinephrine signalling. A 2025 case report published in Sexual Medicine documents this emerging side effect and strengthens the case for further investigation into what could be a significant long-term side effect.  

Recently Netflix aired a fascinating documentary ‘The Ozempic Effect: Beyond the Waistline’ - considering how GLP-1 drugs are now reshaping body image, billion-dollar industries, and desire itself. Truthfully, we expected to be horrified and depressed, but it was so interesting, and left plenty of food for thought.

The most interesting, and seemingly least discussed angle, is neurological. GLP-1 drugs act on brain regions governing dopamine-driven reward and motivation - the same circuitry behind hunger, drive, and sexual interest. In the documentary clinicians described patients losing interest not just in food but in wine, restaurants, shopping, sex: a global flattening of appetite rather than a targeted one. One proposed mechanism echoes the SSRI section directly - GLP-1 drugs may increase activity at the brain's 5-HT2C serotonin receptor, the same pathway implicated in antidepressant-induced desire suppression. Two completely different drug classes, prescribed for completely different reasons, potentially converging on the same neurochemical quietening.

The data is genuinely mixed, and honesty matters here. It is important to note that GLP-1 medications do not uniformly suppress libido. No large clinical trial has shown semaglutide consistently reduces libido - and it doesn't appear on official prescribing information. Sexual desire is rarely measured in GLP-1 trials at all. The research and surveys carried out so far consistently show two camps: those who experience a noticeable drop, and those who report the reverse. 

The Kinsey Institute recently featured in a fascinating article by Self, following a survey they carried out that found GLP-1 drugs to be  changing sex and dating lives for 50-60% of users, in both positive and negative directions - 18% reported increased desire, 16% reported decreased desire. The split result reinforces the fact; nothing about pleasure suppression is uniform, and yet almost nothing about it is talked about either. 

Men were roughly twice as likely as women to report both increased and decreased libido, and three times more likely to report improved dating confidence. A 2024 study did find men on semaglutide had significantly elevated relative risk of erectile dysfunction and testosterone deficiency - though absolute risk remains small.

Given that we are in such early days, it feels like a space to watch, with great caution.

HAPPY PILLS

Antidepressant use has increased across virtually every country with available data, and SSRIs remain by far the most prescribed subclass. In England alone, 92.6 million antidepressant items were prescribed to nearly 8.9 million patients in 2024–25 - a number that has tripled since 1998. 

A 2025 systematic review and meta-analysis of 13 randomised controlled trials found SSRIs associated with more than a threefold increased risk of orgasmic dysfunction. Estimates of how many users experience some form of sexual side effect range, depending on the study, from 30% to over 80% - and that variance is itself telling. It suggests inconsistent measurement, chronic under-reporting, and a clinical environment in which many patients simply don't feel able to raise the subject. 

When studies do ask directly, the picture sharpens: women on SSRIs report difficulties with desire in roughly 72% of cases, arousal difficulties in 83%, and problems reaching orgasm in 42%. The fact that depression itself causes sexual dysfunction - baseline rates of inhibited arousal run from 11% to 48% in the general population, independent of any medication - makes attribution genuinely complicated. But it doesn't explain away figures of that magnitude. 

What makes this more than a side-effect story is what can happen after the prescription ends. Post-SSRI Sexual Dysfunction, or PSSD, describes the persistence of sexual side effects after discontinuation - reduced sensation, blunted desire, difficulty with orgasm - in some cases lasting months or years. 

The European Medicines Agency formally acknowledged PSSD in 2019. A 2022 study found that 62.4% of men and 56.9% of women reported sexual dysfunction after stopping antidepressants, with nearly four in ten describing their symptoms as intolerable. This should be a notable small print, as most people starting a course of SSRIs are rarely told about this.

The mechanism at work is one worth understanding: excess serotonin appears to suppress the dopamine pathways involved in motivation, reward and arousal - a neurochemical trade-off in which serotonergic activity dampens the very circuitry that underlies sexual response. It is a suppression not just of distress, but of appetite in the broadest sense.

MENOPAUSE

Let’s start with the scale of this hormonal desire-wrecking ball… This directly affects around 50% of the global population who reach the menopause, and indirectly affects us all. 

Up to half of women report lower sexual desire during this transition, driven by a triple hormonal decline: falling oestrogen causes hot flushes and vaginal dryness; progesterone drops contribute to fatigue; and plummeting testosterone directly suppresses libido. That last point tends to get lost in mainstream conversations, which focus almost exclusively on oestrogen. 

Classic research by Sherwin found that surgically menopausal women given oestrogen-testosterone combinations reported significantly higher desire, arousal and sexual fantasy than those on oestrogen alone - a finding the ADORE study later reinforced, with transdermal testosterone patches producing meaningful improvements in libido and satisfying sexual events. 

There's a complication worth noting: oral oestrogen can actually raise SHBG, which binds free testosterone and reduces its availability - sometimes working against the very desire it is meant to support. Switching to transdermal oestrogen can help. A 2024 UK observational study of 500+ women already on HRT found that adding low-dose testosterone improved libido in 52%, mood in 47%, and cognitive clarity in 39% - a reminder that pleasure and broader wellbeing are not, and should not be, separate.

There is hope - for many women, menopause is also a liberation - a shedding of old pressures and an unexpected reopening. The hormonal turbulence is real, but so is what can follow.

Make sure to take care of yourself along the way, and keep exploring yourself - you deserve it.

ANHEDONIC FACTORS

The pharmaceutical causes of blunted pleasure get most of the attention of late, but the forces running alongside them are incredibly significant. Hormonal contraception raises SHBG, which binds free testosterone and quietly reduces desire; sometimes persistently. 

The postpartum period compounds this further: prolactin suppress es oestrogen and testosterone simultaneously, while sleep deprivation and the psychological weight of new parenthood pile onto an already depleted baseline. These are transitions medicine tends to frame as temporary and therefore not worth treating.

Then there is the broader cultural condition that requires no prescription at all. Chronic stress and overwork flatten the brain's reward circuitry in ways that increasingly resemble pharmacological suppression. The phrase "dopamine fatigue" is imprecise, but it gestures at something real - a low-grade anhedonia produced by burnout and always-on culture that treats rest as inefficiency and pleasure as afterthought. When cortisol chronically suppresses dopamine, the capacity for desire diminishes quietly, cumulatively, and in ways that are easy to mistake for just how things are.

MOTHERS LITTLE HELPERS

They may not take away the suppressing factors, but there is so much hope, and a world of pleasures to enjoy. And the ways to support people, and ourselves, are plentiful. 

Communicate - normalise the conversation. Be it with partners, friends, family and indeed professionals - support is readily available, and worth seeking. Speak, listen - let’s normalise the conversation - guaranteed there is plenty to laugh about in the midst, and what’s more intimate than being, and feeling understood? That level of safety is quite the playing ground for pleasure.

Bring it back to the naming problem: almost none of these causes are discussed together, by clinicians or culturally, which means people experiencing them often feel isolated or assume something is wrong with them specifically rather than recognising a pattern. 

Women often feel embarrassed to address the changes they are experiencing and the adverse effects they feel it is having on their sexual identity, which couldn’t be more destructive to contentment, and a healthy self. Discuss pleasure as a legitimate subject of inquiry, rather than an embarrassing footnote - it is part of your being, a healthy part of a healthy body and an emotionally receptive being. Recognising the importance of your pleasure should be as important as your sleep behaviours, energy levels, metabolism, and so on. Consider this a different kind of healthy appetite, that needs just as much attention…

On a practical level, lubricant should be on everyone’s bedside table, as far as we are concerned - especially when it looks, and feels, as good as our Divine Glow and Radiant Bloom. There is such a curious taboo around lubricants, but they make a world of difference, and hold all sorts of benefits. With added Hyaluronic Acid, this is quite the rejuvenation. Indeed, our Pure Delight Orgasm Balm may indeed be the titillating little helper you need as well. When in Rome…

Consider other ways to be intimate - how do you feel heard and seen? How does that relate to others? How do you feel attracted to others? What stirs you in the moment? It could be a sharing of hobbies, intellect, culinary delicacies, trying new things independently, healthy competitiveness, stillness - a sprinkle of role play and erotic escapism, perhaps - there are so many ways to rediscover your pleasure - Explore the possibilities.

If you are curious about broadening your horizons, our Salons are a safe, and joyful way to explore new possibilities, be it solo, partnered or with like-minded people in the Home of Pleasure. 

Appreciating that at different ages and stages in our life, our body will respond differently is empowering, so being in tune with ourselves at every stage makes a huge difference to female arousal. Discovering what works for you can lead to a true sense of enjoyment and pleasure, which really can be life-changing. Enjoy the journey.