Causes for loss of female libido and ways to make it better | Dr N Layyous

Causes for loss of female libido and ways to make it better

If sex is the core of all marital relationships, then it is sex drive or libido that affects or dictates all sexual relationships. A fall or decline of libido is commonly seen in women after a particular age. This leads to further loss of sexual desire. This problem is seldom found in men, however they have their own problems which center on erectile dysfunction. There are no accepted theories for the causes for the decline of female libido, but there are a few general circumstances that can lead to such a decline or loss.

During any period of fluctuating hormones, including post partum, perimenopause phases, and menopause, most of women start to experience low sex drive, insomnia, digestive issues, mood changes, hot flashes, fatigue, and weight gain. These symptoms will make women feel bad. That is why their interest in sex will decline. Therefore, in most women, feeling better, physically, is the most important step in improving libido.

Causes of lack of libido in women:

This can be either of physical or psychological in origin.

Physical causes for loss of female libido:

• Anemia and the most common type is iron deficiency anemia, due to iron loss during menstrual periods.

• Alcoholism: excess alcohol intake can cause a decrease in sex drive. It is important to moderate your alcohol intake to no more than 3 to 4 units a day, if you are a man and no more than 2 to 3 units if you are a woman.

• Drug abuse.

• Medications that decrease libido in men include antihypertensive drugs, medication for hyperprolactinaemia, anti-androgenic drugs such as cimitidine, finasteride, and cyproterone, and a low sex drive can be caused by SSRI type of antidepressants. This can happen in both men and women.

• Post-baby coolness, this describes the loss of libido that happens after birth, and its caused by hormonal changes that occurs at that period. It can be caused by the general trauma of child birth.

• Hormonal changes such as hyperprolactinaemia, abnormalities in production of luteinizing hormone (LH), lack of androgenic hormone and underactive thyroid.

• Physical changes in the vagina that affect libido:

As women near menopause, levels of estrogen begin to fall, which will cause thinning, tightening, dryness, and atrophy (a decrease in the muscle mass) in the vagina and the vulva that will lead to irritation, itching, and severe pain during sex, that will cause decreased libido.

Psychological Causes for loss of female libido:

• Depression: This is a serious illness of feeling unhappy, or miserable, that may last for a long time and may become severe enough to interfere with your daily life, including your sex life. In this case, you may feel better if you take an antidepressant, prescribed by your GP. On the other hand, a type of antidepressant called selective serotonin reuptake inhibitors may cause low sex drive. If this has been prescribed for you, it will be better to switch to a different type of antidepressant.

• Stress and exhaustion: If you feel stressed, you have to make some lifestyle changes as stress can have a major impact on your happiness by causing adrenal imbalance. This will cause a decrease in production of estrogen and testosterone that are important for desire and sexual response.

• Relationship problems (problems with your sexual partner):

Relationship problems are the most common causes of loss of libido, so if you are not happy in your relationship, or if you have any doubts or worries, this might be the main reason for your loss of sexual desire. Alternately, the problem might be a performance issue that makes sex difficult. For example, impotence, premature ejaculation in men and painful sex or vaginismus (the involuntarily tightening of the muscles around the vagina before penetration) in women.

• Past sexual abuse or rape.

• Difficult living conditions.

Solutions for low libido - Treatment for loss of female libido:

• Treatment of the underlying causes of vaginal dryness and thinning:

- Vitamin E vaginal suppositories twice weekly can be beneficial if the symptoms are new or mild, They act by hydrating the tissues and by increasing sensation.

- Adding dietary soy that contains phytoestrogens that promote vaginal lubrication.

- Restore adequate estrogen level: Your Doctor can help with this using regular blood analysis.

- When ovarian estrogen production declines, the body starts to produce adequate estrogen from subcutaneous fat and adrenal glands, as long as raw materials are provided. Therefore, nutritional supplements and endocrine supports are the key to helping relieve vaginal dryness.

- Some women have less estrogen than others, and they can benefit from using topical estrogen that can be placed directly into the vagina. It acts by soothing vaginal tissues and allowing the secretions necessary for comfortable sex. They are available as suppositories, creams or rings.

• Testosterone:

Testosterone is important in our sex drive because it stimulates interest, arousal, sexual response, orgasm and lubrication. After menopause, estrogen levels fall quickly in women, while testosterone levels decrease more slowly. Some women do not have normal testosterone levels, and testosterone level decreases under stress due to progesterone, the molecule precursor to testosterone. It is converted to stress hormone that will lead to a decrease in libido.

In the Post Menopausal period, when ovarian testosterone production decreases, the adrenal glands will produce testosterone if adrenal reserves remain strong. On the other hand, adrenal reserve can be tapped down if the woman has experienced severe stress over a number of years. Therefore, good nutrition and a less stressful lifestyle can maintain better adrenal function that will keep good testosterone production throughout perimenopause and menopause.

For all what mentioned above, testosterone can be suggested as a treatment of hypoactive sexual desire disorder. And it has been tried on women for more than 40 years, rarely with benefits and its associated by side effects include hair loss, deep voice and clitoris enlargement. In spite of that, there is some clinical evidence to support the use of testosterone as a treatment for low sexual desire.

Intrinsa is a testosterone skin patch that became available in 2007 in the United Kingdom and it is licensed for women who have had a surgically-induced menopause, and who are already receiving estrogen therapy.

Many compounding pharmacies (that make medicine from scratch) offer testosterone cream and gel that can be applied to the vagina and clitoris to increase sensation and orgasm.

• Suction vibrators:

This can increase female desire by applying suction to the clitoris, however, the ordinary non-suction vibrators have been used with good results, in the last decade.

• Desire cream:

This cream produces a tingly sensation in the clitoris, and it's made of wintergreen. It was introduced in the early part of this century.

• Erection drugs (like Viagra):

This can be beneficial by increasing blood flow to the vagina and clitoris, and by increasing lubrication. But those drugs have not been proven to help women who have low libido. They are not licensed for use in women.

• Zestra:

This is a genital massage oil that contains borage seed, evening primrose oils, Angelica root, and Vitamins C and E. and it provides a significant increase in arousal, genital stimulation and ability to orgasm. This worked in women with or without sexual desire problems, and it worked equally well in women using SSRI antidepressants.

• Argimax:

It has been found that this nutritional supplement increases sexual desire and satisfaction. This was published in 2001 in the journal of sex and marital therapy.

Note: You should first have a discussion with your doctor before using any supplement to know about the side effects or interactions that may occur.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist