What you need to know about loss of libido in women

Loss of libido or sex drive can happen in both men and women. Some women may describe persistent, recurrent problems with sexual response, desire, orgasm or pain that cause them relationship problems.

This can occur at any stage of life. It can occur only in certain sexual situations or all.

Sexual response involves physiology, emotions, experiences, beliefs, lifestyle and relationships. Disruption of any component can affect sexual desire, arousal or satisfaction, and treatment often involves more than one approach.

If you have ongoing sexual difficulties, make an appointment with your doctor, even if you feel slightly embarrassed because a satisfying sex life is important to a woman’s wellbeing at every age.

You might have a treatable, underlying condition, or you might benefit from lifestyle changes, therapy or a combination of treatments.

Symptoms

• Low sexual desire. This most common of dysfunctions involves a lack of interest and willingness to be sexual.

• Sexual arousal disorder. You have difficulty with arousal, are unable to become aroused or maintain arousal during sex.

• Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm.

• Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.

Causes

Sexual problems often develop when you have an imbalance of your hormones, such as after having a baby or during menopause.

Factors, often interrelated, that contribute to sexual dissatisfaction or dysfunction include:

• Medical conditions, including cancer, kidney failure, multiple sclerosis, heart disease and bladder problems.

• Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs.

• Lower oestrogen levels after menopause may lead to changes in your genital tissues which can lead to painful intercourse (dyspareunia).

Sexual desire also decreases when hormonal levels decrease. Your body’s hormone levels also shift after giving birth and during breastfeeding, which can lead to vaginal dryness and affect your desire to have sex.

• Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress and a history of sexual abuse.

• Long-standing conflicts with your partner about sex or other aspects of your relationship.

• Cultural and religious issues and problems with body image.

Diagnosis

To diagnose female sexual dysfunction, your doctor will:

Discuss your sexual and medical history. The more forthcoming you can be, the better your chances of finding an effective approach to treating them.

Perform a pelvic exam looking for thinning of your genital tissues, decreased skin elasticity, scarring or pain.

Your doctor may also refer you to a psychologist specialising in sexual and relationship problems.

Treatment

Because female sexual dysfunction has many possible symptoms and causes, treatment varies.

It’s important for you to communicate your concerns and understand your body and its normal sexual response. Also, your goals for your sex life are important in determining treatment and evaluating progress.

Women with sexual concerns most often benefit from a combined treatment approach that addresses medical as well as relationship and emotional issues.

Picture: iStock

Nonmedical treatment

• Talk and listen. Open communication with your partner makes a world of difference in your sexual satisfaction.

• Practice healthy lifestyle habits. Go easy on alcohol. Drinking too much can blunt your sexual responsiveness.

• Be physically active. Regular physical activity can increase your stamina and elevate your mood, enhancing romantic feelings. Learn ways to decrease stress so you can focus on and enjoy your sexual experience.

• Seek counselling. Therapy often includes education about how to optimise your body’s sexual response, ways to enhance intimacy with your partner, and recommendations for reading materials or couples exercises.

• Use a lubricant. A vaginal lubricant may be helpful during intercourse if you have vaginal dryness or pain during sex.

• Try a toy. Use a vibrator to provide clitoral stimulation or clitoral vacuum suction devices.

Medical treatment 

To treat sexual dysfunction tied to a medical condition, your doctor might recommend that you:

• Adjust or change medication that has sexual side effects.
• Treat a thyroid problem or other hormonal condition.
• Optimise treatment for depression or anxiety.
• Try strategies for relieving pain.

Treatment linked to a hormonal cause might include:

• Oestrogen therapy in the form of a vaginal ring, cream or tablet which improves vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.

• Androgen therapy, which is controversial. The risks of hormone therapy may vary and might require close monitoring by your doctor.

• Others: One drug, sildenafil (Viagra), may prove beneficial for some due to taking selective serotonin reuptake inhibitors, a class of drugs used to treat depression.

Lifestyle

Find ways to be comfortable with your sexuality, improve your self-esteem and accept your body.

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