A look at low libido
Low libido or loss of sexual desire occurs frequently in women. It can be a significant source of stress and low self-esteem for the individual and their relationship. As if feeling less desire for sex wasn’t bad enough, if it causes enough distress and difficulty, the medical community labels it ‘hypoactive sexual desire disorder (HSDD)’. There are plenty of disorders out there, so may as well add a sexual disorder to the list to make us feel abnormal. In reality, the prevalence of low sexual desire is fairly high, reaching 43% of women according to Kingsberg and Rezaee (2013), with 1 in 10 women suffering from HSDD. This concern is multifactorial, and can come and go throughout the lifespan of every woman. Various changes, such as relationships, pregnancy and menopause all play a role. But personal topics such as sexual desire are still taboo and embarrassing for most people to discuss in a doctor’s office. Let’s shed a bit of light on the topic.
So what is low sexual desire? According to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), hypoactive sexual desire disorder is defined as “persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity”. It can significantly alter your relationship and quality of life. Putting aside the known causes of sexual dysfunction such as substance-induced (illicit drugs, alcohol, and certain prescription medications) or a medical condition, what about the rest of the population that has lost their sexy mood?
An important factor is hormones. They play an intricate role in reproductive health, including libido and sexual desire. Androgens, like testosterone and DHEAS, are significant when considering sexual desire in women. Low levels are often seen in women with low libido and “testosterone-treated women experienced significantly greater increases in satisfying sexual activity and sexual desire, and greater decreases in distress” according to Nappi et al. (2006). In fact, at any moment where hormones are low, women are at greater risk of seeing libido changes in their life. For example, menopause is a significant time for hormonal change. During your reproductive years, the balance of estrogen, progesterone and androgens produced by your ovaries keep your body primed and ready for sex through healthy mood and vaginal tissues. However, “the hypoestrogenic state of menopause cause physical changes and alterations in mood or a diminished sense of well-being, which have been found to have a significant, negative impact on sexuality” (Phillips, 2000). Hormones are low and 45% of post-menopausal women are affected by vaginal atrophy which includes vaginal dryness, pain during sex, itching and irritation (Lindahl, 2014).The drop in estrogen cause friable tissues which makes it uncomfortable for initiation and carrying through intercourse. Addressing these imbalances and supporting the tissues are important in promoting healthy sexual desire and ensuring a pleasurable experience. Including phytoestrogenic foods like soy and flax, and hormone balancing botanicals like chaste tree, black cohosh, tribulus and wild yam can be useful in this regard.
But physical and physiological changes don’t explain everything – emotional and psychological factors are essential when considering sexual desire. Changing roles in a woman’s life, new challenges, stress and emotional balance can often be more important in regulating sexual desire, especially for women. Changes in libido are normal and to be expected when stress and emotional balance are prevalent. It then becomes more important to focus treatment on this aspect rather than treating sexual desire per se. Ensuring a healthy balanced diet and supporting your adrenal glands with B vitamins, and herbs like rhodiola and ashwaganda can be of great benefit for stress. Mood support with fish oils, vitamin D and key nutrients for the brain health can restore emotional balance.
Additionally, interpersonal conflicts in a relationship play a psychological role in sexual desire. But unfortunately there isn’t a quick and easy way to address psychological factors. Psychotherapy and cognitive behavioral therapy help alter unrealistic or dysfunctional thoughts surrounding sex and resolve unconscious conflicts affecting your life (Montgomery, 2008). Dealing with difficult subject with a sexual partner, being honest about your lack of desire, addressing stress and working on thoughts and emotions relating to sex is the real key to unblocking you from a sexual slump. Seeking counseling can benefit both partners in finding the intimate connection they once had.
Remember, there is no shame in enjoying sex and wanting a healthy sexual relationship. Find the important imbalances, treat them accordingly, and bring sexy back!
References:
Kingsberg,SA., Rezaee, RL. Hypoactive sexual desire in women. Menopause. 2013; 20(12):1284-300.
American Psychiatric Association. Diagnostic and statistical manual for mental disorders, fourth edition. Text revision. Washington: The Association; 2000.
Nappi, RE., Wawra, K., Schmitt, S. Hypoactive sexual desire disorder in postmenopausal women. Gynecol Endocrinol.2006; Jun:22(6):318-23.
Phillips, N. Female Sexual Dysfunction: Evaluation and Treatment. Am Fam Physician. 2000; 62(1): 127-136.
Lindahl, SH. Reviewing the options for local estrogen treatment of vaginal atrophy. Int J Womens Health. 2014; 13(6):307-312.
Montgomery, KA. Sexual Desire Disorders. Psychiatitry (Edgmont). 2008; 5(6):50-55.
So what is low sexual desire? According to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), hypoactive sexual desire disorder is defined as “persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity”. It can significantly alter your relationship and quality of life. Putting aside the known causes of sexual dysfunction such as substance-induced (illicit drugs, alcohol, and certain prescription medications) or a medical condition, what about the rest of the population that has lost their sexy mood?
An important factor is hormones. They play an intricate role in reproductive health, including libido and sexual desire. Androgens, like testosterone and DHEAS, are significant when considering sexual desire in women. Low levels are often seen in women with low libido and “testosterone-treated women experienced significantly greater increases in satisfying sexual activity and sexual desire, and greater decreases in distress” according to Nappi et al. (2006). In fact, at any moment where hormones are low, women are at greater risk of seeing libido changes in their life. For example, menopause is a significant time for hormonal change. During your reproductive years, the balance of estrogen, progesterone and androgens produced by your ovaries keep your body primed and ready for sex through healthy mood and vaginal tissues. However, “the hypoestrogenic state of menopause cause physical changes and alterations in mood or a diminished sense of well-being, which have been found to have a significant, negative impact on sexuality” (Phillips, 2000). Hormones are low and 45% of post-menopausal women are affected by vaginal atrophy which includes vaginal dryness, pain during sex, itching and irritation (Lindahl, 2014).The drop in estrogen cause friable tissues which makes it uncomfortable for initiation and carrying through intercourse. Addressing these imbalances and supporting the tissues are important in promoting healthy sexual desire and ensuring a pleasurable experience. Including phytoestrogenic foods like soy and flax, and hormone balancing botanicals like chaste tree, black cohosh, tribulus and wild yam can be useful in this regard.
But physical and physiological changes don’t explain everything – emotional and psychological factors are essential when considering sexual desire. Changing roles in a woman’s life, new challenges, stress and emotional balance can often be more important in regulating sexual desire, especially for women. Changes in libido are normal and to be expected when stress and emotional balance are prevalent. It then becomes more important to focus treatment on this aspect rather than treating sexual desire per se. Ensuring a healthy balanced diet and supporting your adrenal glands with B vitamins, and herbs like rhodiola and ashwaganda can be of great benefit for stress. Mood support with fish oils, vitamin D and key nutrients for the brain health can restore emotional balance.
Additionally, interpersonal conflicts in a relationship play a psychological role in sexual desire. But unfortunately there isn’t a quick and easy way to address psychological factors. Psychotherapy and cognitive behavioral therapy help alter unrealistic or dysfunctional thoughts surrounding sex and resolve unconscious conflicts affecting your life (Montgomery, 2008). Dealing with difficult subject with a sexual partner, being honest about your lack of desire, addressing stress and working on thoughts and emotions relating to sex is the real key to unblocking you from a sexual slump. Seeking counseling can benefit both partners in finding the intimate connection they once had.
Remember, there is no shame in enjoying sex and wanting a healthy sexual relationship. Find the important imbalances, treat them accordingly, and bring sexy back!
References:
Kingsberg,SA., Rezaee, RL. Hypoactive sexual desire in women. Menopause. 2013; 20(12):1284-300.
American Psychiatric Association. Diagnostic and statistical manual for mental disorders, fourth edition. Text revision. Washington: The Association; 2000.
Nappi, RE., Wawra, K., Schmitt, S. Hypoactive sexual desire disorder in postmenopausal women. Gynecol Endocrinol.2006; Jun:22(6):318-23.
Phillips, N. Female Sexual Dysfunction: Evaluation and Treatment. Am Fam Physician. 2000; 62(1): 127-136.
Lindahl, SH. Reviewing the options for local estrogen treatment of vaginal atrophy. Int J Womens Health. 2014; 13(6):307-312.
Montgomery, KA. Sexual Desire Disorders. Psychiatitry (Edgmont). 2008; 5(6):50-55.
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