Your libido, also known as your sex drive, can change a lot throughout your life. After all, so many factors can affect it, such as relationship strain, the work-life juggle, financial pressures or looking after family.
So it's not surprising that, for many women, sex can easily slip off the radar. And if you're a woman in midlife who is experiencing low libido, research shows you are far from alone. In a study led by Professor Susan Davis at Monash University's Women's Health Research Program, almost 70% of women aged 40-65 years old reported experiencing low libido.
An author of the Bupa-funded study, Jean Hailes specialist Dr Rosie Worsley, was surprised by the findings. "We know from previous research that it's a common problem, but it was a big number to see," she says. "It's clearly a concern for a lot of women." Low libido, sexually related personal distress and hypoactive sexual desire dysfunction (HSDD) are relatively new areas of research, but have emerged as major issues affecting women around midlife.
In fact, from her research and clinical experience, Dr Worsley believes it is time for doctors to start screening for low sexual desire (libido) and HSDD at women's midlife health check, by taking the initiative and raising the subject with their patients. "Women want to talk about it, but don't want to bring it up with their GPs," Dr Worsley says. "What we know from clinical experience is that women often find it hard to get advice about the subject. By the time they come to Jean Hailes, they've tried a whole lot of different places for information, or just found it really hard to get."
3 things to know
- Low libido can be a sign of other problems, such as mood or relationship issues, but it may also be due to something quite straightforward and symptomatic
- Vaginal dryness can be safely and effectively treated with an oestrogen cream or pessary
- Help is available – find a clinician who specialises in sexual counselling
So what causes libido to decline around midlife?
Women entering menopause experience physical symptoms from the associated drop in their oestrogen levels; a common symptom is vaginal dryness, which can lead to uncomfortable or painful sex. Dr Worsley says 21% of women in the study reported pain during or after intercourse, which can also affect libido.
Australians are the second-highest users of antidepressants in the developed world. In Australia, one in five women aged 40 to 65 years take antidepressant medication. "It's a clear sign of just how much stress Australian women are under," says Dr Worsley. "Unfortunately, a lot of these medications can affect sexual function and it's one of the main reasons people choose to come off them, or not start them at all."
However, women who stop taking antidepressants without the supervision of their doctor can create a new set of problems for themselves; coming off such medication suddenly or too quickly can cause a woman's mood to plunge dramatically. Dr Worsley recommends talking to your GP to find out your options, as there are some medications that have less impact on libido. "Women need to feel comfortable in knowing that there is information and help out there," Dr Worsley says.
Alcohol may also affect a woman's libido. The study found that binge drinking is an issue for many midlife women, particularly in women with depression. "We were pretty surprised at how common it is," says Dr Worsley. "We found 11% of women aged 40-65 were having four or more drinks at least once per week –and women who were depressed are more likely to binge drink."
When it comes to a woman's educational background, low libido does not discriminate. However, socio-economic stability definitely plays a part. Financial worries can affect women's mental and emotional wellbeing, causing their desire for sex to wane.
Some women may not be worried about having low libido; they may be very happy to have infrequent sex, or none at all. For others, the impact of low libido on their wellbeing is comparable to that of chronic back pain or urinary incontinence, says Dr Worsley. If low libido is an issue for you, identify the possible causes and seek the appropriate help. Start by talking to your GP about how to improve your overall wellbeing.
Your doctor may prescribe an oestrogen cream or pessary for vaginal dryness, individual/relationship counselling or sexual therapy and in some cases a testosterone cream maybe helpful. Once the door is open for conversation, your GP can make suitable referrals.
Dr Worsley says women can rest assured low libido is very common and they're not alone. "Sometimes women come in just to find out if they're normal or not – and quite often they are," she says. "Just talking about it can improve their quality of life." She says women also need to know low libido is not something they simply have to 'put up with'.
"Women often dismiss symptoms that don't seem life threatening because they think they won't be taken seriously, or they may not know that there are treatments available," says Dr Worsley. "A lot of people also assume it's a normal part of ageing, but it doesn't have to be."
Read more about sexual health and libido.
This article was originally published in vol. 2, 2017 of the Jean Hailes Magazine.