Low libido in women

One of the top sexual complaints I hear from women is that of a low libido. Low libido, medically termed as hypoactive sexual desire disorder, is when your lack of interest in sex is recurrent or persistent and causes personal distress.

 

 

 

Symptoms of low sex drive in women include:

  • Having no interest in any type of sexual activity;
  • Never or only seldom having sexual fantasies or thoughts;
  • Being concerned by your lack of sexual activity or fantasies.

“Female sexual function is a very complex issue because of the multitude of factors involved.”

But before we can say there are problems with your sex life, we first need to understand what “normal” looks like. Sexual function and the sexual response cycle are different for men compared to women. Men have higher levels of testosterone than women and will have a spontaneous sexual desire. On the other hand, women have what we call a responsive sexual desire. This means that most women’s desire to have sex is in response to sexual stimulation.

Dr-Basson-Female-sexual-cycle
Fig.: Dr Rosemary Basson described the female sexual response cycle

Some women will have a spontaneous sexual drive, but for the majority of women, especially those in a long-term relationship, sexual desire is in response to sexual arousal and before you get aroused, you will need sexual stimulation in an appropriate context.

For stimulation to lead to arousal, there are certain psychological and biological processes that need to be in place and this is where things can go wrong.

What can go wrong?

1. Psychological causes

Your state of mind can affect your sexual desire. There are several psychological causes of low sex drive, including:

  • Mental health problems, such as anxiety or depression
  • Stress, such as financial stress or work stress
  • Poor body image
  • Low self-esteem
  • History of physical or sexual abuse
  • Previous negative sexual experiences

For many women, emotional closeness is an essential prelude to sexual intimacy, meaning that problems in your relationship can also be a major factor in low sex drive. Decreased interest in sex is often a result of ongoing issues.

2. Biological or physiological causes

A wide range of illnesses, physiological changes and medications can cause a low sex drive, including:

  • Sexual pain
    If you have pain during sex or can’t orgasm, it can reduce your desire for sex. Vaginismus is one of the most common reasons for sexual pain that I see. It is caused by the involuntary contraction of the muscles around the vagina, resulting in difficult or impossible penetration, entry pain, uncomfortable insertion of the penis.
  • Medical diseases
    Many nonsexual diseases can affect sex drive, including diabetes, thyroid problems, high blood pressure, heart disease and neurological diseases.
  • Hormonal problems
    Changes in your hormone levels may alter your desire for sex. Hormone changes during pregnancy, after childbirth and during breastfeeding can put a damper on your sex drive. After pregnancy, there is a rapid drop in oestrogen which can result in low libido, vaginal dryness and difficulty in getting aroused.

    Fatigue, changes in body image and the pressures of pregnancy or caring for a new baby can also contribute to changes in your sexual desire. Testosterone is a male hormone, but women need it for normal sexual function. Prolactin (the hormone that helps with milk production during breastfeeding) suppresses testosterone, which could ultimately lead to a low libido.
  • Medications
    Certain prescription drugs, especially antidepressants called SSRIs (selective serotonin reuptake inhibitors) are known to lower the sex drive. However, there are antidepressants that don’t affect sexual function so speak to your prescribing physician if you are experiencing problems. Certain contraceptives can also result in low testosterone levels, which can have a massive inhibiting effect on your sex life.

Female sexual function is a very complex issue because of the multitude of factors involved. Women often feel that things will get better without intervention, but that is not true. If you feel that you are missing out and that things are not the way they should be, talk to your doctor and get help. Let’s embracing female sexuality and ensure that your sex life is the best it can be!

Also read:

Why sex may be the last thing on his mind
What is the right birth control for you?