What are the causes of lack of sex drive in women?
Absent libido or sex drive is very common in women, and there can be many different reasons for this. Libido in women can be very easily affected by stress and anxiety, as well as general illnesses and hormonally related issues.
Hormone Related Causes
The pelvic floor tissues are very sensitive to oestrogen and testosterone, and low libido can be very closely related to times of low hormone production such as after childbirth and in the pre and postmenopause. Not only is there no desire to have sex but any attempt at intercourse can be painful due to lack of inelasticity of the tissues and poor arousal. Orgasm may not occur or is difficult and unfulfilling.
The ovary produces oestrogen in a cyclical pattern from puberty through to the menopause. As the quality of eggs reduces with age and coming up to the menopause the amount of oestrogen also falls. This occurs even if there is a normal cycle with normal periods, the levels of oestrogen achieved just are not as high.
Oestrogen is important to improve the blood flow to the vulva, clitoris and vagina; therefore low levels of oestrogen result in failure of arousal and absent nerve response.
Women produce testosterone from the ovaries, adrenals and other parts of the body, although not in nearly as high levels as men. Once the ovaries start to fail, testosterone levels also fall and many women without realizing it do suffer from this and notice the difference. Replacing testosterone to within the normal female levels (2.0 to 4.0 nmol/L) compared to normal male levels (10.0-50.0 nmol/L) can result in vastly improved levels of energy and sex drive.
Testosterone replacement on its own does not always work if there is inadequate blood supply to the pelvic organs and this is mostly oestrogen related. Therefore, it is as important that the vulva and vagina are “well oestrogenised” before starting testosterone replacement therapy.
Other causes of low libido
For both men and women, lack of sexual interest can be either of physical or psychological origin.
Following the birth of a baby
‘Post-baby coolness’ is a term that is regularly used for the lack of sexual desire. Although it can also be caused by the hormonal changes that take place following childbirth , there can be other reasons. For example, if you have had a particularly traumatic birth or have a difficult baby to look after and you are feeling exhausted, this can contribute to the lack of desire. This can also lead to stress in a relationship, which is counter productive when trying to resume a normal sex life and more so, to the changes that a new baby can bring to a relationship.
Diabetes can result in reduced blood flow by constricting the arteries. This means that many of the pelvic organs are starved of oxygen and nutrients and do not function correctly and the nerve endings can die away.
Treating diabetes is very important, not only for short-term quality of life symptoms but for long-term risks.
The use of prescribed medications could also have an effect on your libido. It is important to discuss with the doctor at the time of your consultation at The Surrey Park Clinic any medications that you may be taking now or have taken recently. This may indicate as to why you have noticed a change in your sexual desire.
Painful sexual intercourse
If you experience pain whilst having intercourse, this can have a negative effect on sexual desire and you associate intercourse with discomfort. Finding and treating the cause of the discomfort can soon see the return of sexual desire. Topical oestrogen (creams, pessaries) to rejuvinate the area and or dilators or surgical vaginal enlargement, can make all the difference.
Psychological factors are very important in suppressing sex drive in women and depressed women often have no interest in sex and find it very difficult to become aroused. It is extremely understandable that if a woman is emotionally not happy, she may lose interest in sex for a period of time.
Stress can have a direct effect on the production of hormones in the brain. Whilst in some people a high stressed job can enhance their sex drive and libido, this appears to be more common in men than in women, where stress and anxiety about work has the opposite effect.
Serious relationship difficulties can cause stress and therefore have a negative effect on one’s libido. Lack of libido can also cause relationship difficulties, so it is important to look at all factors surrounding it, as it can turn into a vicious circle if left untreated.
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