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Low Sex Drive In Women

What Is Low Sex Drive? What Causes Low Sex Drive?

Last modified: 
16/04/2013 - 13:59

Contributing Author: Guy Slowik FRCS

A low sex drive in women refers to a lack of interest in sexual relations. It is not unusual to experience a temporary decline in sexual desire at some point, and many women do. But if it persists, it may present problems.

The underlying reason for a decrease in sexual interest and activity, however, is not always obvious. Low sex drive can result from physical conditions (such as illness or pregnancy), psychological issues (such as stress or anxiety), or other factors. When a woman feels that her formerly normal sex drive has "stalled" or seems gone altogether, a medical or emotional problem may be at the root.

The signs of a low sex drive include:

  • Less frequent sexual thoughts and fantasies
  • Reduced sexual desire
  • Reluctance to initiate sex
  • Less frequent masturbation
  • Lack of desire for sex when you've gone without sex for days, weeks, or months (depending on what was previously normal for you)

In both men and women, sex drive is also referred to as libido.

It is important to note that a low sex drive should not be confused with an inability to reach orgasm. Many women with a low sex drive are capable of successful sexual arousal and may also achieve orgasm.

Anatomy of a womans arousal

As a woman becomes sexually aroused, fluid is produced within the vagina for lubrication. Blood flow to the genitals increases, causing a swelling of the labia - the lips surrounding the vulva.

The clitoris, a small mass of tissue located above the opening to the vagina, also swells and becomes highly sensitive. Heart rate, blood pressure, and breathing increase. The peak of sexual excitement, an orgasm, occurs with a series of pleasurable contractions of a woman's genital muscles.

What Causes A Low Sex Drive?

A low sex drive can stem from physical conditions or psychological problems. In order to find an effective solution, it's important to identify what has triggered it. Causes can include:

Menopause

Menopause (the time in a woman's life when she no longer has menstrual periods) can have an effect on sexual desire in several ways:

  • As a woman ages, it may take longer for her to become sexually aroused, and that arousal may be less intense than it was in her earlier years.
  • During menopause, a woman's ovaries stop producing the hormone estrogen. This can lead to vaginal dryness, which can make intercourse uncomfortable.
  • Lack of estrogen also can thin the walls of the vagina, leading to soreness during and after intercourse.

Dryness or discomfort can be relieved with hormone replacement therapy, which replaces the estrogen her body no longer is producing, or with the use of a vaginal lubricant, which is available over-the-counter at pharmacies and grocery stores.

For more information about hormone replacement therapy, go to Hormone Replacement Therapy.

Men also may experience decreased sex drive later in life. They may have difficulty achieving or maintaining an erection even if the desire is present. Couples need to be aware of each other's changing sexual needs, and should consider different approaches to sexual relations that may not necessarily include intercourse.

It's important to remember that sexuality need not end because of increasing age. For many couples, with a bit of adjustment, a normal healthy sex life can continue as they age.

Studies have shown that health problems play a role when sexual activity is seen to decline. About one-third of women said that if they or their partners were healthier, they would also be more sexually active.

Pregnancy

When a woman is pregnant, her entire body is affected. Changes in hormone levels can affect her physically and emotionally. As a result, her desire for sex may temporarily change.

During pregnancy, some women will experience a stronger sex drive. This may be because of the effects of hormones and because an increased blood flow to the vagina makes intercourse more pleasurable. Others find they have no desire for intercourse, either because it is uncomfortable or because they are worried about their unborn baby.

Sexual interest may vary throughout the stages of pregnancy.

  • Some women report lowered desire during the first three months, when morning sickness can be unpleasant and even debilitating.
  • Many say their desire increased in the second three months (second trimester), as morning sickness diminished.
  • Some say their desire decreased again the final trimester, when the abdomen's new bulk made sex awkward or uncomfortable.

Many women are afraid to have intercourse during pregnancy because they think it will harm the baby. But in most healthy pregnancies, there is no reason to avoid sex. Couples may need to experiment with different positions and techniques for maximum comfort. In rare cases, if there is an increased risk of miscarriage, a woman's doctor may recommend stopping or limiting intercourse until delivery of the baby.

Within weeks after the child is born, most doctors agree that a woman can return to a normal sex life if she feels comfortable. As her body returns to its pre-pregnancy shape, sexual feelings should return as well.

Tubal ligation (a sterilization procedure in which a woman's fallopian tubes are closed off so that eggs cannot pass through) or other sterilization procedures should not interfere with sex drive unless the woman or her partner was opposed to the procedure. In fact, many couples report an increase in desire once the worry over using birth control is removed.

Pain During Intercourse

If intercourse is uncomfortable or painful, a woman may tense up in anticipation of pain from sex, or she may avoid sex altogether. Painful intercourse may result from the following:

  • Dyspareunia, which is abnormal pain that a woman experiences when her partner's penis enters her vagina. It may result from:
    • A lack of estrogen, which is needed for vaginal lubrication
    • Pelvic infection
    • A tumor or cyst
    • Endometriosis, a condition in which tissue from the uterus adheres to other areas throughout a woman's internal pelvic region, causing pain and other symptoms

      For further information about endometriosis, go to Endometriosis.

  • Vaginismus, which is a spasm of the muscles of the lower vagina and results in painful or even impossible penetration. It can be a psychologically driven condition, related to an extremely distressing past experience such as a rape or sexual abuse.

    Vaginismus may also stem from a medical problem, such as an infection or vaginal irritation. If the vaginismus is not caused by an identifiable medical problem, treatment usually involves seeing a psychologist or psychiatrist.

    • Vaginal infections, such as a yeast or bacterial infection within the vagina that can irritate its sensitive tissues. Vaginal infections can be easily treated with oral medication or creams that are inserted inside the vagina.

Illness

Sickness frequently decreases desire, whether it's a mild illness such as a head cold or a more chronic or serious illness. When you don't feel well physically, it's often difficult to even think about having intercourse.

Several diseases have been found to directly reduce sex drive:

  • Addison's disease, in which the adrenal glands (glands located above the kidneys that produce many of the body's hormones) fail
  • Cushing's syndrome, a condition caused by high levels of a hormone called cortisol in the body over a long period of time
  • Diseases of the pituitary gland, a gland located near the brain that produces many important hormones

In many cases, it is not the disease itself, but rather the medications used to treat the disease, that reduces a woman's sex drive. This is particularly true of high blood pressure medications and some diuretics.

It's important to report any illness-related changes in sex drive to a physician or therapist.

Other conditions that may affect sexual function include:

  • Thyroid Disorders. Thyroid disorders such as an underactive thyroid gland (hypothyroidism) or an overactive thyroid gland (hyperthyroidism) are marked by changed levels of thyroid hormone in the body. These changes, particularly an abnormally low thyroid level, may decrease sex drive. However, once the condition has been effectively treated, sexual problems usually go away.

    For more information about hypothyroidism, go to Hypothyroidism.

    For more information about hyperthyroidism, go to Hyperthyroidism.

  • Diabetes. Nerve damage associated with diabetes may lead to decreased vaginal lubrication and difficulty in achieving orgasm. Vaginal lubricants may be effective in treating dryness.

    For more information about diabetes, go to Diabetes In Adults.

  • Kidney Problems. Kidney disease may cause hormonal imbalances and nerve damage, which in turn may affect sex drive. Women with kidney disease also should watch for vaginal infections, which may cause extreme discomfort during sex.
  • Arthritis. Arthritis causes pain and swelling in the joints, which can hamper mobility and make sex a physically painful experience. Some types of arthritis may dry out membranes responsible for vaginal lubrication. If you suffer from arthritis, you may be able to enhance your comfort during sex with these suggestions:
    • Try sexual positions that don't put pressure on painful joints
    • Use vaginal lubricants to ease dryness
    • Apply heat before sex to loosen joints

    For more information about arthritis, go to Osteoarthritis.

  • Epilepsy. Epilepsy causes a "short circuit" in the messages sent throughout the brain, and this may include those sent from the nerves that control sexual arousal. Individuals with epilepsy may experience a loss of sex drive and lack of responsiveness. Medication can be very effective in controlling epilepsy.

    For more information about epilepsy, go to Epilepsy.

  • Cancer. Living with cancer can be psychologically and physically distressing. Chemotherapy medication may leave a woman feeling ill and tired, eradicating any sexual appetite. Cancer also may affect a woman's self-esteem and her overall feeling of femininity, especially if she has lost her hair from chemotherapy, her ovaries through a hysterectomy, or her breast through a mastectomy.

    Counseling may be an effective way of helping a woman cope with the side effects of her illness. Often group therapy or support groups will provide a woman with reassurance as she meets others who had gone through this painful process and survived.

Obesity Or Anorexia

Women come in all shapes and sizes, and in most cases, weight is irrelevant to sex drive. However, those who are medically obese may:

  • Be physically unfit and lethargic, which could result in a lack of physical activity and possibly a lack of sexual interest as well
  • Be deficient in certain sex hormones that can influence desire
  • Feel less sexually attractive and may therefore avoid intimate contact

On the opposite end of the weight scale, women who suffer from anorexia nervosa or who are severely underweight may also experience a lack of sexual interest, in addition to other serious health problems. An overly thin woman may feel sexually undesirable, and this can affect her sex drive.

For more information about anorexia, go to Anorexia.

Drugs And Alcohol

Many prescription medications may interfere with arousal and the ability to achieve orgasm. These include:

  • Antidepressants to treat anxiety or depression
  • Antipsychotic drugs to treat severe mental disorders
  • Antihypertensive agents to treat high blood pressure

Many people think that alcohol reduces inhibition and therefore is an effective treatment for low sex drive. This is not true. A small amount of alcohol may lower sexual inhibitions when anxiety or tension is the primary cause for low sex drive, but research has proven that alcohol consumption does not improve either sex drive or performance.

Many women report that drinking before sex has a "numbing" effect on them and actually results in diminished desire

Psychological Factors

Stress, fear, and anxiety are all factors that can dampen sexual desire. The demands of juggling work, family and many other daily responsibilities can be overwhelming for many people. Bills may pile up and cause financial worries, and this distress can lead to low sex drive.

Anxiousness and fear over an ability to perform in bed or to satisfy a partner may sometimes lead to "spectatoring," in which individuals are so concerned about monitoring the experience that they are unable to enjoy it.

Emotional-medical issues, such as depression, have also been linked to dampened desire. In addition, many medications that are prescribed to combat depression or anxiety may have a negative impact on sex drive.

Relationship Issues

The quality of a relationship often strongly influences the couple's sexual satisfaction. In many cases, a lack of communication is at the heart of the problem. The problem may lie both inside and outside the bedroom. For example, the woman may feel that her partner is not responsive or listening to her concerns, likes, and dislikes in her daily life. The communication problem may transfer to the bedroom or it may start there.

Many women are too shy or embarrassed to discuss their sexual desires and needs frankly with their partner. Yet it is crucial to communicate openly. Bottling up emotions, or failing to tell your partner what pleases you, may lead to sexual frustration and unhappiness, and could even bring your sex life to a grinding halt.

Remember, few men have an innate knowledge of what pleases a woman. But in a healthy relationship, most are willing and eager to learn how to please their partners. Many men may need to be taught where to touch and how to stimulate their partner to the point of arousal.

Sexual Abuse

Sexual abuse is a deeply traumatic experience and may lead to fear and avoidance of sexual experiences later in life. Some women who have been victims of past abuse are afraid to trust a man; others respond to these negative experiences by losing sexual desire altogether. Counseling can be extremely valuable in helping women come to terms with the trauma and restore sexual desire.

 
 
 
 
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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.