One of the number one sexual complaints I hear women complain of is that of a low libido. Low libido, medically termed hypoactive sexual desire disorder is when your lack of interest in sex is recurrent or persistent and causes personal distress.

In other words, symptoms of low sex drive in women include:

  • Having no interest in any type of sexual activity
  • Never or only seldom having sexual fantasies or thoughts
  • Being concerned by your lack of sexual activity or fantasies

But before we can say there are problems with your sex life we first need to understand what normal looks like. Sexual function and the sexual response cycle is different for men compared to women. Men, because of higher levels of testosterone will have a spontaneous sexual desire. Women on the other hand have what we call a responsive sexual desire. This means that most womens’ desire to have sex is in response to sexual stimulation. Dr Rosemary Basson described the female sexual response cycle as follow. 

Some women will have a spontaneous sexual drive, but for the majority of women, especially those in a long term relationship, sexual desire is in response to sexual arousal. And before you get aroused you will need sexual stimulation in an appropriate context. But for stimulation to lead to arousal there are certain psychological and biological processes that need to be in place. And this is where things can go wrong… 

What can go wrong?

  1. Psychological causes 

Your state of mind can affect your sexual desire. There are several psychological causes of low sex drive, including:

  • Mental health problems, such as anxiety or depression
  • Stress, such as financial stress or work stress
  • Poor body image
  • Low self-esteem
  • History of physical or sexual abuse
  • Previous negative sexual experiences

For many women, emotional closeness is an essential prelude to sexual intimacy. So problems in your relationship can also be a major factor in low sex drive. Decreased interest in sex is often a result of ongoing issues.

  1. Biological or Physical causes

A wide range of illnesses, physical changes and medications can cause a low sex drive, including:

  • Sexual Pain

If you have pain during sex or can’t orgasm, it can reduce your desire for sex. Vaginismus is one of the most common reasons for sexual pain that I see. It is caused by the involuntary contraction of the muscles around the vagina resulting in difficult or impossible penetration, entry pain, uncomfortable insertion of penis. Here is some more information on painful sex

  • Medical diseases

Many nonsexual diseases can affect sex drive, including diabetes, thyroid problems, high blood pressure, heart disease and neurological diseases.

  • Hormonal problems

Changes in your hormone levels may alter your desire for sex. Hormone changes during pregnancy, just after having a baby and during breastfeeding can put a damper on sex drive. After pregnancy there is a rapid drop on estrogen which can result in low libido, vaginal dryness and difficulty getting aroused. Fatigue, changes in body image, and the pressures of pregnancy or caring for a new baby also can contribute to changes in your sexual desire. Testosterone is a male hormone, but women need it for normal sexual function. Prolactin (the hormone that helps with milk production during breastfeeding) suppresses testosterone which could ultimately lead to a low libido.

  • Medications. 

Certain prescription drugs, especially antidepressants called selective  serotonin reuptake inhibitors, are known to lower the sex drive. There are antidepressants that doesn’t affect sexual function. So if you are experiencing problems talk to your doctor about it. Certain contraceptives can result in low testosterone levels which can have a massive inhibiting effect on your sex life.

Female sexual function is a very complex issue because of all the factors involved. Women often feel that things will get better by itself, but that is not true. If you feel that you are missing out and that things are not the way it should be talk to your doctor and get help. August is women’s month, let’s celebrate it by embracing female sexuality and ensuring that your sex life is the best it can be.