Low sex drive/Libido in women
A woman's sexual desires naturally fluctuate over the years. Highs and lows commonly coincide with the beginning or end of a relationship or with major life changes, such as pregnancy, menopause or illness. Some antidepressants and anti-seizure medications also can cause low sex drive in women.
If you have a persistent or recurrent lack of interest in sex that causes you personal distress, you may have hypoactive sexual desire disorder.
But you don't have to meet this medical definition to seek help. If you are bothered by a low sex drive or decreased sex drive, there are lifestyle changes and sex techniques that may put you in the mood more often. Some medications may offer promise as well.
Some signs and symptoms that may indicate a low sex drive include
- Has no interest in any type of sexual activity, including masturbation
- Doesn't have sexual fantasies or thoughts, or only seldom has them
- Is bothered by her lack of sexual activity or fantasies
A woman's desire for sex is based on a complex interaction of many components affecting intimacy, including physical well-being, emotional well-being, experiences, beliefs, lifestyle and current relationship. If you're experiencing a problem in any of these areas, it can affect your sexual desire.
Physical causes
A wide range of illnesses, physical changes and medications can cause a low sex drive, including:
Painful intercourse: If you experience pain during sex or an inability to orgasm, it can hamper your desire for sex.
Medical diseases: Numerous nonsexual diseases can also affect desire for sex, including arthritis, cancer, diabetes, high blood pressure, coronary artery disease and neurological diseases.
Medication: Many prescription medications — including some antidepressants and anti-seizure medications — are notorious libido killers.
Lifestyle habits: A glass of wine may make you feel amorous, but too much alcohol can spoil your sex drive; the same is true of street drugs. Smoking decreases blood flow, which may dampen arousal.
Surgery: Any surgery related to your breasts or your genital tract can affect your body image, sexual function and desire for sex.
Fatigue: Exhaustion from caring for young children or aging parents can contribute to low sex drive. Fatigue from illness or surgery also can play a role in a low sex drive.
Hormonal changes
Changes in your hormone levels may alter your desire for sex. This can occur during:
Menopause. Estrogen levels drop during the transition to menopause. This can cause decreased interest in sex and vaginal dryness, resulting in painful or uncomfortable sex.
At the same time, women may also experience a decrease in testosterone — a hormone that boosts sex drive in men and women alike —which may lead to decreased libido. Although many women continue to have satisfying sex during menopause and beyond, some women experience a lagging libido during this hormonal change.
Pregnancy and breast-feeding. Hormone changes during pregnancy, just after having a baby and during breast-feeding can put a damper on sex drive. Of course, hormones aren't the only factor affecting intimacy during these times. Fatigue, changes in body image, and the pressures of pregnancy or caring for a new baby can all contribute to changes in your sexual desire.
Psychological causes
Your problems don't have to be physical or biological to be real. There are many 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
Primary care doctors and gynecologists often ask about sex and intimacy as part of a routine medical visit. Take this opportunity to be candid about your sexual concerns.
If your doctor doesn't broach the subject, bring it up. You may feel embarrassed to talk about sex with your doctor, but this topic is perfectly appropriate. In fact, your sexual satisfaction is a vital part of your overall health and well-being.
By definition, you may be diagnosed with hypoactive sexual desire disorder if you frequently lack sexual thoughts or desire, and the absence of these feelings causes you personal distress. Whether you fit this medical diagnosis or not, your doctor can look for reasons that your sex drive isn't as high as you'd like and find ways to help.
In addition to asking you questions about your medical history, your doctor may also:
- Perform a pelvic exam. During a pelvic exam, your doctor can check for signs of physical changes contributing to low sexual desire, such as thinning of your genital tissues, vaginal dryness or pain-triggering spots.
- Recommend testing. Your doctor may order blood tests to check hormone levels and look for evidence of thyroid problems, diabetes, high cholesterol and liver disorders.
- Refer you to a specialist. A specialized counselor or sex therapist may be able to better evaluate emotional and relationship factors that can cause low sex drive.
Most women benefit from a treatment approach aimed at the many causes behind this condition. Recommendations may include sex education, counseling and medication.
Medications
Your doctor will want to evaluate the medications you're already taking, to see if any of them tend to cause sexual side effects. For example, antidepressants such as paroxetine (Paxil) and fluoxetine (Prozac, Sarafem) may lower sex drive. Switching to a different type of antidepressant — usually improves sex drive.
Hormone therapy
Estrogen delivered throughout your whole body (systemic) by pill, patch, spray or gel can have a positive effect on brain function and mood factors that affect sexual response. But systemic estrogen therapy may have risks for certain women.
Smaller doses of estrogen — in the form of a vaginal cream or a slow-releasing suppository or ring that you place in your vagina — can increase blood flow to the vagina and help improve desire without the risks associated with systemic estrogen. In some cases, your doctor may prescribe a combination of estrogen and progesterone.
Male hormones, such as testosterone, play an important role in female sexual function, even though testosterone occurs in much lower amounts in women.
Orgasm Enhancer Cream
Scream Cream
Scream cream is a combination of vasodilators (to increase blood flow), testosterone (to increase sex drive) and other medications to increase vaginal lubrication and sensation. Since Scream cream is applied directly to the clitoris, it has an enhanced rate of absorption and maximized local effects.
As with any compounded medications, the formula can be custom tailored to each individual's needs upon request, but generally it's a combination of Aminophylline, Isosorbid dinitrate, ergoloid mesylate, Pentoxyfylline and L-Argenine dissolved in a water based, hypoallergenic, transdermal vehicle.
References
Frequently asked questions. Women's health FAQ072. Your sexual health. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Your-Sexual-Health. Accessed Nov. 7, 2014.
Shifren JL. Sexual dysfunction in women: Epidemiology, risk factors, and evaluation. http://www.uptodate.com/home. Accessed Nov. 7, 2014.
Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Nov. 7, 2014.
Hoffman BL, et al. Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.mhmedical.com/book.aspx?bookId=399. Accessed Nov. 7, 2014.
McAninch JW, et al., eds. Smith & Tanagho's General Urology. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://accesssurgery.mhmedical.com/book.aspx?bookID=508. Accessed Nov. 7, 2014.
Shifren JL. Sexual dysfunction in women: Management. http://www.uptodate.com/home. Accessed Nov. 7, 2014.
Buster JE. Managing female sexual dysfunction. Fertility and Sterility, 2013; 100:905.
http://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/basics/symptoms/con-20033229
Dr. J. Kaminetsky, New York University College of Medicine; University of Chicago College of Medicine; J Berman M.D., I. Goldstein, M.D., Boston University School of Medicine, Dept of Urology/Continence.