Libido

What is libido?

Libido is the sexual instinct or erotic desire and pleasure. Your libido is otherwise known your 'sex drive'. Libido varies from woman to woman and can be influenced by a range of different factors.

Loss or reduction of libido can be experienced at any age and may result in:

• reduced desire to have sex
• sexual experiences that are no longer satisfying or pleasurable

Many women will experience low libido at some time in their lives. This may be over a long period of time or short-term such as after the birth of a baby, during a stressful life period or when a relationship is rocky.

Low libido can become an issue in relationships when one partner wants sex more often than the other. This is called 'desire discrepancy' and can cause conflict and unhappiness.

What affects your libido?

It's normal for desire to fluctuate and there may be many reasons for this.

Changes in hormone levels

• An increase in prolactin stimulates milk production after childbirth. This increase can result in reduced libido when breastfeeding.
• A reduction in the level of the female sex hormone oestrogen occurs with menopause. The reduction can:
  • cause symptoms that reduce your libido such as:
    • hot flushes
    • vaginal dryness
    • loss of vaginal elasticity
    • discomfort during intercourse
  • influence your perception of touch
  • decrease muscle tone and elasticity of the pelvic floor.

• A reduction in the level of the female hormone testosterone occurs as women age. For some women this causes symptoms such as:
  • loss of libido
  • lessened sexual responsiveness
  • a reduced sense of wellbeing
  • loss of energy.

Menopause

Natural, surgical, induced, premature and early menopause all have symptoms caused by changes in hormone levels.

• Hot flushes and night sweats are symptoms of menopause that can impact sleep making you tired and lethargic and uninterested in sex
• Weight gain and body shape changes can make some women self-conscious about their body so they feel less like sex.

Premenstrual syndrome (PMS)

PMS is a cluster of symptoms caused by changes in hormone levels. Symptoms of PMS can make women feel less feel like sex including:

• bloating
• tiredness
• breast tenderness
• headaches
• mood swings.

Medication

Medications such as antidepressants and some oral contraceptive pills affect hormone levels. The reduced hormone levels can decrease libido or your desire for sex.

Lifestyle

Rest, relaxation, recreation and suitable exercise can all have positive effects on your libido.

Psychological influences

These psychological influences can each affect libido by making you feel less confident, more negative and/or hesitant about having sex:

• Stress
• Depression and anxiety
• Poor body image
• Feelings of resentment, shame or guilt about sex
• Past experiences of sex including abuse and trauma.

Your relationship

Relationships can have the biggest influences on libido. If your relationship is unhappy and/or the sex you are having is disappointing, it is difficult to feel sexually inclined towards your partner and your willingness to engage in sex will be reduced. Relationship influences include:

• End of the 'honeymoon' period of the relationship
• Being time poor or feeling too tired/fatigued for sex
• Poor sexual compatibility or partner sexual problems
• Experiencing problems other than sexual such as financial issues.

Medical conditions

Medical conditions that can influence libido include:

• endometriosis
• pelvic inflammatory disease
• a prolapse
• haemorrhoids
• anaemia
• kidney failure
• infections (such as thrush or urinary tract)
• hypothyroidism (underactive thyroid gland)
• chronic pain.

Some of these conditions can lead to painful sex (dyspareunia) or involuntary spasms of the pelvic floor muscles ('vaginismus') that reduce the desire for sex.

Managing & treating low libido

Don't be concerned about when or how often others have sex. There is no 'normal' when it comes to the frequency of sex. What's important is whether you and your partner are happy with your level of sexual activity.

If your libido level worries you or is very different from your partner's and this causes you distress, there are a number of things you can do to improve the situation. Finding a solution to the problem involves determining what seems to affect your libido and then trying strategies to deal with this. The most important thing to remember is that just because one person in the relationship has a lower level of libido than the other, this doesn't mean there is something wrong with either person. It is when the difference in libido is causing problems that you may need to seek help to manage the issue. It does not mean that one person is good or bad, but just that you are different.

While you should never feel you have to have sex with someone you are not attracted to or don't like, nor do you have to have sex that doesn't please you, the following strategies may help you:

Health

• Maintain a healthy lifestyle by being physically active, eating a healthy diet, reducing your alcohol intake
• Find ways to reduce stress and take time out to relax regularly

Opportunity

• Create goodwill and some intimacy between you and your partner, by talking, listening and touching and holding each other, so you are more likely to feel sexual towards each other
• Don't wait for sex to happen spontaneously – allocate time for sex
• Create a physical environment for sensuality and intimacy

Communication

• Let your partner know what makes you feel loved and encourage them to do these things and do the same for them in return
• Work with your partner as a team to deal with libido issues – if there is desire discrepancy try to find a compromise agreeable to both of you
• Communicate what works best for you during sex – your partner may not know what you like

Options

If you have low desire but still enjoy sex, try:

• 'decision-driven' sex rather than waiting to have 'desire-driven' sex – you make some decisions by saying to yourself: "Sex is good for our relationship, so even though I can't be bothered, I will suggest making love tonight"
• sex for affection or intimacy or because sex is good for your relationship or because you enjoy sex
• manual or oral stimulation rather than intercourse

Realise that sex is not only penetrative intercourse but includes touching, kissing, holding, trusting and/or oral stimulation. Talk about this with your partner. Take it in turns to make love to the other with no expectations.

Exploration

• Rather than automatically saying no to sex when the opportunity arises, ask yourself "why not?" – if no good reason presents itself, give sex a try
• Optimise the quality of sex you are having with your partner – the better the sex, the more likely you are to want it
• Explore your own sexuality – get to know your sexual anatomy, learn how things work and what gives you pleasure
• Where do you like to be touched, what sort of pressure, can you bring yourself to orgasm? If you don't know, how can your partner know?
• Nothing gives most men more pleasure than seeing their partner enjoy sex
• When together, focus on your own pleasure – stay present and enjoy

Chronic or long-term, low libido can create differences in sexual desire in couples. Sometimes, your partner can fear hurting you (physically and emotionally) and this starts a negative cycle in your sexual relationship.

Seek advice

It is better for your relationship and future sexual experiences to discuss your feelings of low libido. You may want to seek advice from your doctor, with your partner if appropriate. Some of the following may help:

• Treatment for any underlying illness or medical condition
• Lifestyle changes and stress management
• Herbal remedies (see an accredited naturopath)
• Hormone therapy (if appropriate)
• Medication changes
• Antidepressants (certain antidepressants may be more suitable, others can reduce libido)
• Stress management
• Couples counselling
• Counselling with a therapist who specialised in sexual concerns.

Testosterone therapy

Testosterone levels fall as a woman ages, with levels approximately 25% less in her 40s compared to what she had in her 20s. The levels reach their lowest around early 60s then stabilise or slightly rise for the rest of a woman’s life.

Low desire and low desire causing distress is very common especially for women around midlife^[1]. Some women seeking help from their doctors about their sexual function have low testosterone levels but the relationship between testosterone and libido is complex. Factors like age, mood, general wellbeing and sexual relationships need to be considered^[2].

Research shows that testosterone therapy may be a suitable treatment for postmenopausal women who are experiencing a loss of sexual desire that is causing them personal distress. This condition is known as hypoactive sexual desire disorder (HSDD).

Learn more about testosterone therapy for HSDD here.

Leading researcher and endocrinologist Professor Susan Davis presents the latest facts about testosterone therapy for treatment of low lidibo in this video (or listen to the podcast).

Herbal remedies for low libido

Many cultures use herbs that traditionally have had a reputation for increasing libido. It's not clear whether these herbs actually stimulate a sexual urge or act as a placebo. The mind is a powerful sexual organ! For more information on libido and natural therapies visit our webpages.

There are many factors that can influence a woman's libido and the general advice is to address the lifestyle, nutrition and relationship factors that may be playing a role in low libido and not just rely upon medications.