A woman’s sexual desire naturally fluctuates over the years. There can be both highs and lows that correlate with the beginning or end of a relationship, pregnancy, menopause, illnesses, or a major life change. The term hypoactive sexual desire disorder refers to a persistent or recurrent lack of interest in sex that causes you distress. Sometimes a woman finds that she has less sexual desire than her partner and that may not be abnormal but could still cause problems with their relationship. On the other hand, even though your sexual desire is weaker, a relationship may be stronger than ever. Every woman is different, and every relationship is different.
Symptoms that may suggest a woman has a low sex drive include those who: have no interest in any type of sexual stimulation, no sexual fantasies or thoughts, and those that are bothered by this lack of desire. There are many things that can affect a woman’s sexual desires. Anything that impacts a woman’s physical well being, emotional well being, experiences, beliefs, lifestyle, and relationship can have an effect on sexual desire. Physical causes of decreased sexual desire can be pelvic pain, arthritis, cancer, high blood pressure, heart disease, diabetes, or neurological diseases. Other components that may affect sexual desire can be antidepressants and anti-seizure medications, alcohol, drugs, smoking, pelvic surgery, exhaustion, and changes in hormone levels.
Low sexual desire in women can also be influenced by many psychological causes. Mental health problems such as anxiety and depression can have a negative effect on sexual desire. Other causes such as stress, whether financial or work related, poor body image, low self-esteem, history of physical or sexual abuse, and previous bad relationships can also initiate decreased sex drive. Many women require an emotional closeness with their partner in order to have sexual intimacy. Decreased sexual interest is often a result of an ongoing issue such as: lack of connection with your partner, unresolved conflicts or fights, poor communication of sexual needs or preferences, and infidelity or breach of trust.
In order to have decreased sexual desire evaluated, a woman should have an evaluation from her OB/GYN office. This may include a pelvic exam, blood work checking hormone levels, thyroid disorders, diabetes, liver disorders, and high cholesterol. Your doctor will want to review your medications to see if any of them tend to cause sexual side effects. Anti-depressants such as Prozac or Paxil may be switched to Wellbutrin, which tends to improve sex drive. Adding hormone therapy may also help with sexual desire.
Estrogen can have a positive effect on brain function and mood factors that enhance sexual libido. There are many different forms of estrogen such as pills, patches, gels, and sprays that are a systemic therapy but come with some risks such as blood clots, heart attack, stroke, and breast cancer. Other smaller doses of estrogen such as vaginal creams and rings that are placed in the vagina may increase blood flow to the vagina and help improve sexual desire without the increased risks. Some women may be prescribed a combination of estrogen and progesterone. Another hormone that may be replaced is testosterone. Women have testosterone at low levels, but it may play an important role in sexual desire. Some side effects may include acne, excess body hair, personality changes, and mood changes.
There is only one medication that has been approved by the Food and Drug Administration to treat decreased sexual desire in premenopausal women and that is Addyi. This is a daily pill that may take eight weeks to work, and certain side effects such as low blood pressure, dizziness, and fainting may occur especially if mixed with alcohol. Your OB/GYN must be certified to prescribe this medication.
Other non-medical changes that may increase sexual desire are regular aerobic exercise and strength training. This can increase one’s stamina, improve body image, and elevate mood. Finding ways to cope with financial, work, and daily stress may also help. Communication plays a big key in a healthy sexual relationship. Couples who learn to communicate in an open, honest way usually maintain a stronger emotional connection resulting in a better sex life as well. Couples should also set aside time for intimacy. This may sound silly, but actually scheduling sex into your calendar puts a higher priority on your intimate relationship.
Finally, ditching bad habits such as smoking, illegal drugs, and excess alcohol can rev up your sexual desire as well as improve your overall health. Even though low sexual desire can be very frustrating and difficult to deal with, try not to focus all of your attention on sex. Instead, spend some time nurturing yourself and your relationship. Go for long walks together, kiss your partner goodbye every day, make a date night. Actually feeling good about yourself and your partner is the best foreplay of all.
Melissa Waddell, WHNP, is a nurse practitioner at Atlantic Ob/Gyn. Please call 757-463-1234 or visit www.atlanticobgyn.com.