What causes low sex drive in women?
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November 19, 2022 9:00 AM
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Low sexual desire in women – or, let’s face it, in either partner – can potentially damage your relationship and self-esteem. (Envato Elements pic)
If you feel bothered or distressed owing to a lack of sexual thoughts or interest, you may be experiencing hypoactive sexual desire. Hypoactive sexual desire disorder (HSDD), also known as sexual interest or arousal disorder, reduces a person’s sex drive, causing personal distress or difficulties in a relationship.
Many women may dismiss the signs of HSDD as the natural results of ageing or physical changes. Those with HSDD typically lack sexual desire for six months or longer. Symptoms include:
- little to no interest in sexual activity;
- never or seldom having sexual fantasies or thoughts;
- lack of interest in initiating sex;
- difficulties enjoying sex; and
- lack of pleasure when the genitals are stimulated.
There is no specific test to find out if you have HSDD; your doctor may ask questions concerning your sex drive, such as:
- In the past, was your level of sexual desire/interest good and satisfying to you?
- Has there been a decrease in your level of sexual desire/interest?
- Are you bothered by your decreased level of sexual desire/interest?
- Would you like your level of sexual desire/interest to increase?
The doctor will also try to determine the underlying cause(s) of the condition, which may be psychological, physical, or both. Physical causes include:
- medical conditions such as breast cancer, diabetes, thyroid problems, hormonal changes during or after pregnancy, arthritis, or coronary artery disease;
- hormonal changes, i.e. decreased oestrogen or testosterone levels;
- lifestyle causes, such as fatigue or exhaustion after work, too little sleep, drinking too much alcohol or smoking, or an unhealthy diet;
- taking certain medications such as anticonvulsants, antidepressants, hormonal contraceptives, opioid pain relievers, steroid medications, or cancer treatments.
Psychological causes of HSDD may include:
- depression, anxiety, low self-esteem, or poor body image;
- a history of sexual abuse;
- relationship challenges, including trust issues with a sexual partner.
Your doctor may further conduct a pelvic exam for signs of physical changes that might have affected your sexual desire. A blood test to check hormone levels and medical conditions including thyroid problems, diabetes, high cholesterol, and liver disorders could also be performed.
Your doctor may suggest counselling or sex therapy to address mental health or relationship issues. (Envato Elements pic)
Sometimes, there might not be a specific reason for HSDD, but this does not mean it cannot be treated. Recommendations may include:
1. Changing medications
Your doctor may either change the dosage of the causative medications or replace it with an equivalent or alternative that will not have sexual side effects. For instance, antidepressants such as mirtazapine and bupropion do not affect libido much, and in fact can improve it.
Be advised that you shouldn’t stop taking your medications without consulting your doctor.
2. Altering your lifestyle
Exercise regularly, set aside time for intimacy, reduce alcohol intake, quit smoking, eat a healthy diet, and practise stress-relieving techniques such as meditation and mindfulness.
3. Taking supplements
Many herbal aphrodisiacs contain natural ingredients that help with libido and issues such as erectile dysfunction. These include fenugreek, Tribulus, Eurycoma longifolia (longjack), and panax ginseng.
Do discuss with your pharmacist or doctor for further information before taking any herbal products.
4. Seeking counselling
Your doctor may suggest counselling or sex therapy to address mental health or relationship issues.
5. Treating underlying causes
Oestrogen therapy in the form of a cream, suppository or ring might be prescribed if low oestrogen levels are the root cause of HSDD. The FDA-approved drug bremelanotide or Vyleesi may be recommended to treat low sex drive in premenopausal women.
Note, however, that medication may not be suitable for everyone as it may cause side effects such as low blood pressure, dizziness, and fainting.
