decrease in libido

Many women at some point in their life experience a decrease in libido.

Some women when faced with decreased libido chalk it up to the aging process. A reduction in sex drive is not a natural age related event. More often a reduction in sex drive is related to one specific problem or a combination of many problems.

Sexual dysfunction is more common in women than men, and is more common around menopause. Changes in sex drive around menopause are often related to sporadic ovarian function and fluctuating hormone levels. Decreasing estrogen levels can lead to decreased blood flow to the vagina and clitoris and atrophy of these areas, causing sexual intercourse to be painful.

All women produce some testosterone. Decreases in testosterone levels may also affect sexual function. Testosterone appears to be necessary for sexual motivation, arousal and orgasm. Declines in testosterone can occur well before menopause and can be caused by removal of the ovaries, radiation therapy and some medications.

Sexual function is also dependent on many other factors such as:

• general health
• personal well being
• performance anxiety
• body image
• relationship issues
• medical issues
• medications

Diagnosis of sexual dysfunction can usually be made with a history and detailed gynecologic exam. Laboratory testing is guided by findings on physical exam. There are no laboratory studies that are recommended for all women experiencing decreased libido.

treatments for sexual dysfunction include:

Lifestyle changes
Changes in lifestyle such as smoking cessation, drinking more water, strength training and aerobic exercise can all have positive effect on sexuality.

Improving communication with your partner

Vaginal weights
Vaginal weights can be used to strengthen pelvic floor muscles.

Break the mold
Change the routine of sexual encounters. Changing the time of day, location or position may be helpful. Changing the level of intimacy prior to a sexual encounter may have a positive effect.
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pharmacological therapy

Estrogen
Estrogens restore vaginal elasticity and lubrication. It has also been shown to increase feeling and sensation in the vagina and clitoris.

Testosterone
The use of testosterone in women is controversial. Some studies have shown increases in sexual fantasies, libido and sexual arousal as well as improvement in mood and well being.

Side effects of testosterone may include lowering of levels of good cholesterol, increased acne and abnormal hair growth.

Compounding pharmacists often are able to titrate formulations to minimize the negative side effects.

Evaluation for sexual dysfunction should begin with a discussion with your gynecologist, regarding problems you may be having.
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