Shop Bonafide

Desire vs. Arousal: What’s the Difference?

Dr. Alyssa Dweck

Written by Dr. Alyssa Dweck, MS, MD, FACOG, Chief Medical Officer

Dr. Alyssa Dweck

Written by Dr. Alyssa Dweck, MS, MD, FACOG, Chief Medical Officer

Seems like a simple enough question on the surface, right? Not so fast….   

Desire is that incredibly intense feeling of “wanting to want.” This might also be referred to as, libido, sexual drive or feeling “in the mood.” Muscles tense, heart rate increases, skin may get flushed and the mind gets busy with sexual thoughts.

Arousal entails the unmistakable physical signs of the sexual response. The clitoris becomes super sensitive, the vagina lubricates copiously, and the genitals swell and become noticeably engorged with blood.

In fact, theories about the sexual response in women have been contemplated and debated for years; specifically, which, if any, comes first, desire or arousal?

One theory, proposed by Masters and Johnson in the 1960s, states that it’s linear. In other words, they proposed four distinct steps during the female sexual response that appeared to occur in a clear and sequential pathway. The four phases included, excitement (desire, libido, drive), plateau (arousal), orgasm and resolution. This model suggests that each step occurs in this exact order, linearly, during the female sex response during solo and/or partnered sex.

In contrast, in 2001, Basson proposed a nonlinear, more circular female sexual response model in which these steps were more loosely intertwined, overlapping and could occur in different sequences. This model incorporates the importance of emotional intimacy, sexual stimuli, and relationship satisfaction. Basson suggested, in contrast to the linear model, that women have many reasons for engaging in sexual activity, other than desire alone.

Sex, desire and arousal… can be complicated for women, and unlike for men, is probably more like a complex mission control panel than a simple light switch. 

Why? The most important sex organ for women may very well be the brain, where a delicate balance of hormones and neurotransmitters are at play.  For example, there are hormone receptors for estrogen, progesterone and testosterone in the brain, which most definitely influence one’s sexual drive and experience. Add to that, a collection of neurotransmitter chemicals that work within the nervous system and send specific signals to organs, vessels, muscles and other nerves with every activity. When it comes to sex, dopamine, oxytocin and norepinephrine are excitatory or “pro-sexual” neurotransmitters. Serotonin, in contrast, is inhibitory and thus more of a bedroom “buzz kill.” This delicate balance of hormones and neurotransmitters influences the female sexual response on a physiological level.

Many external factors have tremendous impact on the female sexual response.  For example, one’s partner status and relationship health are hugely influential. If one has anger, resentment or just plain isn’t attracted to a partner, response may be muted and dulled. Chronic medical conditions, various medications and physical discomforts may also play a role. How one feels about herself as a sexual being, aka “sexual self-esteem,” is also quite important. I often see women in my practice who are admittedly unhappy with their weight or muscle tone, and feel less sexy and thus less sexual. Finally, stress and the busy mind play a big role in a woman’s sexual experience; this is proving to be even more dramatic during the COVID-19 pandemic.

So now to the question at hand…  What’s the difference between desire and arousal? In some instances, desire comes first (you see a scene from Fifty Shades of Grey) and results in arousal (you get hot and bothered physically). For others, both happen simultaneously without a distinct boundary. Perhaps in the end, it’s all really just a matter of semantics. Either way, it feels great!


Post comment

Bonafide’s articles have helped me to better understand more about menopause and concomitant sexual behavior. I highly recommend that anyone wishing to learn more about women’s health to read as many of the suggested articles presented by Bonafide. Dr. Alyssa Dweck, M.S., M.D., FACOG, as well as her fellow writers, have good recommendations for addressing many issues that affect women. In addition, they have suggested providers in the healthcare field who can additionally offer advice for addressing gynecological health. That is why I advise readers to follow Bonafide’s advice as it affords women to learn more about themselves before seeking medical treatments.

Dr. David J. Frey on

I have a problem with both of these and severe dryness. I think the dryness is the worse. No libido

Darlene Anderson on

I am on my third bottle of Ristella and I can honestly tell you it changed my life! My husband is getting used to the “new me”!!
I am 66 years old and have had a low sexual desire so I asked my OBGYN Dr. the last time I was there in November if he could give me something for my libido. He gave me a sample of the Ristella and a coupon and also a brochure about another prescription medication, if the Ristella didn’t work. I started taking the Ristella that night and haven’t stopped! I strongly recommend it to women who have lost their sexual desire. I not onlly enjoy sex so much more, but I initiate it more than I ever have. I’ve also lost some weight while using it, which a plus. I have more energy too. I am only taking 1 pill in the morning however, because I think it was keeping me awake at night. I haven’t read where this is a side affect, but since I’ve lowered myself to only 1 pill a day, I’m sleeping better.

MJ on

I’m 51 & had problems with my libido. Spoke with my doctor about it. Of the options she provided, Ristela was the all natural one. Unfortunately she had never had a patient take it so could not advise of it’s efficacy. I decided to try it. Taking it daily for a month, my libido is back! I am pleasantly surprised and so is my partner! I definitely recommend trying Ristela before any prescription drugs or injections.


Thanks Dr D. This was informative & makes sense to me, this 62 year old female. My sexual desire is very low. I’ve just begun taking Ristela & am hopeful. I’m glad you mentioned weight gain in the time of COVID. I’ve been happy with my weight for years but have gained 5 lbs all in my belly, of quarantine comfort eating. I’ve begun to feel self conscious around my husband. One thing that helps a bit is dancing. When we dance together & I allow myself to cut loose I begin to lean in to feeling sexy & desire him.

Jeannie on

Leave a comment

Please note, comments need to be approved before they are published.

* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Related Posts

Trending Articles