Low Libido

I had a woman come in to my office this week wanting a prescription.  (That never happens, right? LOL!)  In this case, she wanted a prescription for a topical cream to treat low libido.  Low sex drive is a common symptom in women that doesn’t really have effective treatments.

In this lady’s case the cream she wanted was suggested by a compounding pharmacist.  On looking up the ingredients I found no research to support their effectiveness and safety, so I didn’t prescribe it.  Just because this cream had no evidence to support it, that doesn’t mean there’s nothing we can do about low libido.

Quite frequently I see women in my office who tell me they have no interest in sex.  Often they don’t bring it up themselves, it comes up in the context of their annual physical and well-woman checkup.  I always ask whether a woman is sexually active.  Sometimes she perks right up and says “Yes!” with a smile.  Often she says “Sometimes” or “Not really.”

On further discussion many women say they’re too busy, the kids are always around, their husband or mate works a lot, or that they have pain with sex.

It’s a fact that female sexual function is VERY complicated.  Interactions between hormone status, cultural factors, relationship issues and stress levels make for a difficult problem to treat.  Many things cause low libido, including strained relationships, stress, sleep deprivation, changing hormone levels and childhood cultural conditioning.

Any attempts to simplify libido or sex drive into a pill or cream really has the potential to cause more problems than it solves because it ignores all the possible causes of low sex drive to create an artificial oversimplification of the female sex drive.

If you or your mate are having problems with low sex drive it’s important to explore 3 areas:

Is there pain with sex?

This one is fairly simple to address.  Speak to your doctor if you have pain with sex.  With menopause it is common for the loss of estrogen to cause vaginal tissues to become thin and fragile with loss of lubrication.  There are a number of safe and effective options for fixing this problem.  Younger women may have a problem called vaginismus which is a muscle spasm in the strong muscles of the pelvic floor.

How is your relationship with your mate?

Do you love your mate?  Do you like him or her?  Do you enjoy spending time together?  Do you actually make time to spend together and be romantic as a couple?

Is there resentment or anger between you?  Many long relationships accumulate baggage that can stifle sexual desire and romance.

Most couples have a very hard time teasing out and correcting relationship factors on their own.  Couples therapy is usually needed.  It is very hard work and requires a lot of trust and openness but I have seen amazing recovery for couples who seemed sure to break up.

It may also be that depression, stress and anxiety are standing in the way of a healthy sex life.  If your whole life is go-go-go and you fall into bed exhausted every night and never see your mate, who has the energy to have sex?  Your doctor can also address and treat mood problems that may be contributing.

What were you taught as a child about women and sex?

You would think that in this day and age women would be comfortable with their sexuality.  However, women heading into their 50s today were born in the 1960s to parents born in the 1930s and 1940s.  Childhood conditioning for little girls at that time was pretty restrictive.  In many ways, it still is.

Messages received as a small child are very powerful.  Little girls were taught to be quiet and ladylike, to keep a clean house and take care of their husband and family.

Horrible words were (and still are) used to describe girls and women who like to have sex.  Even within the boundaries of a loving marriage or long-term relationship, many women struggle with the messages of danger and distrust we were taught as children.  “Good girls” don’t ride in cars with boys, keep their clothes on, don’t let boys touch them “down there.”

And for Heaven’s sake you NEVER agree to have sex just because “he” wants to!

Unraveling and coming to grips with childhood teaching that may be standing in the way of sexual enjoyment as an adult also usually requires therapy.  Those messages may be buried so deep that patience and persistent effort is required to bring them to light.

If you or your mate have a low sex drive, please see your doctor.  There may be simple treatments to remove roadblocks that stand in the way of a happy sex life.

However, if pain is not a factor, and mood is good, chances are there are deeper factors at work.  Ask your doctor for a referral for counseling.

How important is it to you to have a happy sex life?  Is it worth working for?  I hope so!

QUESTION:  Do you remember being taught things about sex when you were a child that may be standing in the way of healthy enjoyment of sex as an adult?


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