Decreased Libido

Decreased Libido Quiz

Think you have Decreased Libido? Take our assessment to find out more.
Decreased libido, or a lessening in sexual desire, can impact women of any age. Women are two to three times more likely than men to be affected by a decline in sex drive as they age. Sometimes the reasons for a lack of interest in sex might be obvious: a new baby, a medical illness or a fight with your partner. Other times—and quite often in midlife and menopause—the reasons might be more elusive.

For women experiencing decreased libido in midlife, there are usually multiple causes. Fluctuating hormones can cause an array of symptoms that interfere with a woman’s physical and emotional readiness for sex (e.g., hot flashes, night sweats and vaginal dryness). Decreasing estrogen and testosterone can make sexual activity less pleasurable and cause a decrease in sexual thoughts, dreams or interest in sexual activity. Stress, worry and general busyness can cut down on opportunities for sex, and on a woman’s ability to connect emotionally to a partner—an important, and perhaps primary, component of female desire.

The good news for women who wish to increase their sexual desire is that decreased libido is a legitimate medical diagnosis, and there are many treatment options available.
Behavior:
  • Examine your relationship and situation. What are your turnoffs? Are they physical? Emotional? Find ways to address each one in turn. If your desires and needs have changed from what they once were, be honest with your partner. Women who learn to tell their partners about their sexual needs and concerns have a better chance at a more satisfying sex life.
  • If your turnoffs include discomfort or pain during sex, try using an over-the-counter vaginal lubricant to make sex more comfortable. Or, for longer-acting relief of vaginal dryness, try a vaginal moisturizer or coconut oil. (Do not use oil-based products like petroleum jelly, baby oil or mineral oil.)
  • Schedule a regular date night with your partner. Whether once a week or once a month, spending time with your partner one-on-one can help maintain and strengthen an emotional connection.
  • Consider having both partners participate in intimacy homework, where each initiates an intimate act, such as a kiss or caress, with the prior understanding that sex is “off the table.” Often couples lose that intimate connection because of the fear that sex will then be expected.
  • Stay sexually active, even if your desire for sex is less than it once was. Consider sexual activities such as massage, sensual baths, oral sex or manual stimulation.

Diet:
  • Limit your alcohol intake. Moderate drinking—which for women consists of one alcoholic drink per day—is considered safe for most women, but more than that may weaken sexual desire over time and lessen your ability to become aroused or responsive to sexual stimuli.
  • Many experts recommend eating foods that contain phytoestrogens (which may also help with hot flashes and night sweats) for women with low libido. These foods include nuts (almonds, cashews, hazelnuts, peanuts and walnuts), soy products, some fruits (apples, avocados, bananas, mangoes, papayas and rhubarb), dark leafy green vegetables and wildflower honey.

Exercise:
  • Get your body moving for at least 30 minutes at a time, three times a week. Women who work out have a better sex drive—possibly because of the link between physical exercise and dopamine.

Lifestyle Factors:
  • If you’re a smoker, please quit. This is one of the most positive steps you can take for your overall health. Smoking has been shown to interfere with blood circulation and decreased sex drive in both men and women.

Medical:
  • Make a list of medications or supplements you are taking and check to see whether any of them list decreased sexual desire or low libido as a side effect. Many antidepressants and blood pressure medications carry a risk of sexual side effects.
Libido is highly personal and varies from one woman to another—and, for most women, varies from day to day, week to week and year to year. It’s important to understand that no one pattern is more “normal” than another, and nearly everyone has a problem with sex at some time in their life.

Often, decreased libido can be worked out with patience and talking with your partner. However, if decreased libido is disrupting your life, causing trouble in your relationships or due to physical pain, it’s time to talk with a health care provider. In most cases, decreased libido can be treated with lifestyle changes, medications, counseling or some combination of those strategies.

Treatments for Decreased Libido

Medication:
  • Vaginal estrogen (available in topical creams, vaginal pills, caplets and a slow-release three-month ring) can reduce and reverse vaginal thinning, dryness or insensitivity.
  • Other FDA-approved treatments for vaginal atrophy include ospemifene (an oral medication) and dehydroepiandrosterone (DHEA), a vaginal suppository that extends the beneficial impacts of topical estrogen and testosterone into deeper layers of the vaginal wall.
  • In addition, flibanserin and bremelanotide are FDA-approved medications for the treatment of hypoactive sexual desire disorder (HSDD)—low sexual desire in women without underlying physical or psychological causes for decreased libido.
  • Hormone Therapy (HT): For women whose decreased libido stems mainly from the hormonal fluctuations of menopause, HT can be the best avenue for relief.
  • Psychotherapy/Sex Counseling: Talking to a qualified sex therapist can help identify problems inside (or outside) your relationship with your partner that may be contributing to sexual dysfunction.

Alternative Therapies:

Supplements:
  • Folic acid: Found naturally as folate in dark leafy greens, asparagus, broccoli, beans, peas, lentils, avocados and citrus fruits, folic acid has been shown to support healthy libido in both women and men.
  • Magnesium: Low magnesium correlates with lower testosterone levels, which can negatively impact female libido, especially during menopause. Natural sources of magnesium include leafy greens, dark chocolate, seeds, nuts, beans, bananas, yogurt and avocados.
  • Red ginseng: In one study, menopausal women taking red ginseng reported significant improvements in sexual arousal compared with those taking a placebo.
  • Yoga: Some yoga poses specifically strengthen the pelvic and abdominal muscles, which may improve sexual sensation or ease pelvic pain during sex. In addition, practicing yoga regularly has been shown to boost women’s libido, arousal, ability to achieve orgasm and overall sexual satisfaction.
What is libido?
“Libido” refers to sexual desire, your interest in sex and in being sexual. It has three interrelated components:
1. Drive. This is the biological component. It manifests as sexual thoughts and fantasies, erotic attraction to others, seeking out sexual activity, or genital tingling or sensitivity. Sex drive varies a lot from woman to woman and from day to day.
2. Attitudes about sexual activity. Your natural drive may be tempered by your personal beliefs, values and expectations around sex, which are influenced by culture, religious beliefs, family, peers and even media. Generally, the more positive your attitudes about sex, the stronger your libido.
3. Motivation. This component involves your willingness to behave sexually at a given time and with a given partner. Because it is driven by emotional and interpersonal factors, motivation is the most complex component of desire.

How common is decreased libido during menopause?
While women of any age may experience decreased desire for sex for any number of reasons, more women in midlife (ages 45 to 64) report having low sexual desire (12%) than women 65 or older (7%) or women younger than 45 (9%).

What causes decreased libido during menopause?
When women experience a decrease in libido during menopause, it’s usually due to a number of physical, psychological and/or interpersonal factors rather than just a lack of sex drive. Physical causes may include pain during sex; medication side effects; hormonal changes; chronic stress or sleep deprivation; and medical conditions like obesity, diabetes, heart disease or cancer. Psychological causes may include stress from work or family responsibilities, depression or anxiety, body image and self-esteem problems, concern about sexual performance, or fear of pain during sex.  Interpersonal causes may include intimacy issues, feeling a lack of connection with your partner, unresolved conflicts or resentments, a mismatch in your sexual needs (how often to have sex, for example), lack of mutual physical attraction, trust issues or communication problems.

Is there something wrong with me if I just don’t feel like having sex anymore?
No, a lack of sexual desire in and of itself isn’t necessarily any cause for concern. In fact, sex drive tends to decrease gradually with age in both men and women, with decreased libido becoming much more common for women starting in their late 40s and 50s.

When should I be concerned about having low libido?
Every woman’s journey through menopause is different. Some women experience a big decrease in sexual desire during perimenopause or menopause. Others notice no change, and a few even report increased interest in sex at midlife. Whatever you’re experiencing, you aren’t alone.

If you’ve recently experienced a drastic change in your level of sexual desire, first determine whether any medications or undiagnosed medical conditions might be to blame. Next, work to address some of the more common libido-busters for women in midlife: hormonal fluctuations, vaginal dryness, stress, exhaustion, communication issues with your partner and other relationship stressors, and unmet emotional needs.

If you’re still experiencing low libido, and this lack of desire is causing you distress or leading to problems with your partner, it’s time to talk to a health care provider or counselor.

My sex drive hasn’t so much decreased as completely disappeared. Is this normal, and will it be permanent?
Many women who experience a marked decrease in sexual desire during perimenopause or menopause find their interest in sex rebounding within a year or two of their last menstrual period. One reason might be that secondary symptoms of menopause, like hot flashes and night sweats finally resolve. Another reason might be that stressful life events (which, for some women, may include menopause) affect the hormones and neurotransmitters related to female sexual function.

That said, if you’re experiencing a troubling lack of sexual desire during menopause, you don’t need to wait a year or two to resume having a satisfying sex life. Multiple treatments exist to successfully treat low libido during menopause that won’t negatively impact your health after menopause.