Low sex drive in women is not a black and white issue. After all,
there is no objective way to measure sexual desire or pleasure, and
every woman has to define for herself whether her libido is adequate for
her or not.
In polls, many women over age 40 tend to report their sex drive as being “below average.” In other words, the majority of women older than 40 believe they are in the minority (below the average) and more importantly may believe there is something wrong with them.
Just as the factors that contribute to each woman’s sexuality are complex and unique so too are the possible causes of low sex drive. Sometimes lowered sex drive is prompted by an underlying condition, but often it’s a normal part of aging. Women nearing menopause stop ovulating. And since ovulation often prompts a surge in sexual interest, women may feel that their libido flatten out as menopause nears. Other physical changes associated with menopause like hot flashes, insomnia, and vaginal dryness can also impact a woman’s desire to have sex.
Drugs to Boost Low Sex Drive?
One short-term placebo-controlled study, funded by the manufacturer of Viagra® showed that the drug might be helpful in women for treating the sexual side effects of some anti-depression medications. But other studies looking at Viagra as a libido booster have had disappointing results – for both women and men.
Testosterone for Women?
Yet when testosterone was given at lower (“normal physiologic”) doses in placebo-controlled studies, there was no improvement in libido except in those women who had had their ovaries surgically removed and were also on estrogen therapy. Then again, the enhanced libido benefit from “placebo” in these studies was almost as great as the benefit from testosterone which highlights the important contribution of psychological factors in improving libido.
Aside from the lack of success using lower doses of testosterone and the mostly unacceptable side effects of using high doses of testosterone, the major concern with using testosterone in women is that we do not know what the long-term risks of using testosterone might be. These safety concerns are especially significant for women who have a history of breast or uterine cancer, for whom elevated levels of estrogen present genuine risks. Testosterone, after all, is naturally converted to estrogen once it is in the body. In addition, no published medical study evaluating testosterone as therapy for women went on for longer than six months. Because of the limited data to support its efficacy and the absence of data to ensure its long-term safety, the FDA has not approved testosterone products for use in women.
Ultimately, women and their doctors should avoid approaching a complaint of “low libido” simply as a medical problem in search of a medical solution. Sometimes the most important thing doctors can do for women who express concerns about low libido is to help them understand the normal and healthy changes in our aging bodies that influence how we feel about sex.
Causes of Low Sex Drive in Women
In polls, many women over age 40 tend to report their sex drive as being “below average.” In other words, the majority of women older than 40 believe they are in the minority (below the average) and more importantly may believe there is something wrong with them.
Just as the factors that contribute to each woman’s sexuality are complex and unique so too are the possible causes of low sex drive. Sometimes lowered sex drive is prompted by an underlying condition, but often it’s a normal part of aging. Women nearing menopause stop ovulating. And since ovulation often prompts a surge in sexual interest, women may feel that their libido flatten out as menopause nears. Other physical changes associated with menopause like hot flashes, insomnia, and vaginal dryness can also impact a woman’s desire to have sex.
Drugs to Boost Low Sex Drive?
One short-term placebo-controlled study, funded by the manufacturer of Viagra® showed that the drug might be helpful in women for treating the sexual side effects of some anti-depression medications. But other studies looking at Viagra as a libido booster have had disappointing results – for both women and men.
Yet when testosterone was given at lower (“normal physiologic”) doses in placebo-controlled studies, there was no improvement in libido except in those women who had had their ovaries surgically removed and were also on estrogen therapy. Then again, the enhanced libido benefit from “placebo” in these studies was almost as great as the benefit from testosterone which highlights the important contribution of psychological factors in improving libido.
Aside from the lack of success using lower doses of testosterone and the mostly unacceptable side effects of using high doses of testosterone, the major concern with using testosterone in women is that we do not know what the long-term risks of using testosterone might be. These safety concerns are especially significant for women who have a history of breast or uterine cancer, for whom elevated levels of estrogen present genuine risks. Testosterone, after all, is naturally converted to estrogen once it is in the body. In addition, no published medical study evaluating testosterone as therapy for women went on for longer than six months. Because of the limited data to support its efficacy and the absence of data to ensure its long-term safety, the FDA has not approved testosterone products for use in women.
Ultimately, women and their doctors should avoid approaching a complaint of “low libido” simply as a medical problem in search of a medical solution. Sometimes the most important thing doctors can do for women who express concerns about low libido is to help them understand the normal and healthy changes in our aging bodies that influence how we feel about sex.
Causes of Low Sex Drive in Women
- Poor diet
- Lack of exercise
- Sleep loss and fatigue
- Excessive alcohol
- Stress
- Certain prescription medications
- Depression
- Menopause and effects of low estrogen
- Anti-hormone therapies to treat cancer
- Low thyroid function
- Body image issues
- Sexual performance anxiety
- Lack of interest/attraction in partner
- History of sexual assault
