Lack of sexual desire can be upsetting for women before and after menopause.
Studies have found that between 10-15% of women of all ages report low sexual desire and feel distress about it.
Despite the prevalence of this problem, many women are still uncomfortable talking about this to their health care provider.
Providers, in turn, are sometimes uncomfortable asking women about their sexual health, due perhaps to a lack of training, time constraints or some other barrier.
But the end result is the same: Too many women suffer in silence, assuming they are broken or defective. They then concede to the notion that this problem must be the new normal.
The good news? Low sexual desire is a legitimate medical diagnosis, for which treatment options exist.
Find the factors
The medical term for decreased libido is hypoactive sexual desire disorder. It’s defined as the absence of sexual thoughts, dreams or interest in sexual activity.
Most notably, this absence leads to personal distress.
A decreased sexual desire screener is a simple screening tool health care providers can use to diagnose the disorder and help determine if it’s related to other causes.
A thorough examination of the patient’s sexual history will help identify various factors—biological, psychological, social and such—that may be inhibiting desire.
Biological factors may include things like pain, side effects of medication, fatigue or even hormone changes arising from menopause.
Psychological factors may entail depression or anxiety, poor body image or a history of sexual abuse.
Social or interpersonal factors relate to the relationship itself.
Is there unresolved conflict? Do you communicate well with your partner? Has there been any infidelity? Is intimacy lacking?
Breaking down these elements is an important part of individualizing a treatment plan.
Spontaneous vs. responsive
Treatment for hypoactive sexual desire disorder begins with education.
Understanding that men and women experience desire differently is key.
There are two types of sexual desire: spontaneous and responsive.
Spontaneous desire happens when mental interest arises first. It is like a light switch is turned on for no apparent reason.
You are thinking of sex and you want it.
It’s no surprise that we think of this as the norm. Getting swept up in the throes of passion is hammered into our brains via movies, magazines, romance novels and pornography.
Responsive desire, on the other hand, happens as a result of physical stimulation or other environmental cues. In other words, arousal first, then desire.
This is why many women still report feeling satisfied with sex, even if they aren’t fully in the mood when deciding to engage.
To put these types of desire into perspective: Statistics show that 75% of men and 15% of women have spontaneous sexual desire. About 5% of men and 40% of women have responsive desire. The remainder of people have a little of both.
That fascinating bit of data comes from the informative, easy-to-understand book “Come As You Are: The Surprising New Science That Will Transform Your Sex Life,” by Emily Nagoski, Ph.D.
Any patient struggling with low libido could benefit from reading that book.
Knowing that almost half of the female population experiences responsive desire can be game-changing and free up energy to start recognizing what sexual cues you might respond to.
This can help address the biological, psychological or social factors that influence desire.
This may include lifestyle changes to reduce fatigue and stress, adjusting medications that could be affecting libido, treating disruptive hot flashes, night sweats and vaginal dryness and referring patients to individual or marital counseling.
Pelvic floor physical therapy is also sometimes needed if pelvic muscles are too tight, or not tight enough.
Finally, there are also FDA-approved medications to treat hypoactive sexual desire disorder.
Bottom line: Sexual health is an important component to emotional and physical well-being.
A sexual problem such as low desire can be distressing, but there is help.
Don’t let embarrassment keep you from asking important questions or bringing up concerns with your health care provider.