Female Low Libido
Female low libido or decreased sexual desire and interest can have multiple causes. These symptoms may be attributed to biological factors, including hormonal causes, medical health factors, and medications; In addition, symptoms can be attributed to psychological factors, including relationship stress, mental illness, and a history of sexual abuse.
Who it Effects:
This condition is often underreported and not uncommon.
In one study in 1999, 22% of women in the general US population reported low sexual interest. A survey of women from 29 countries acknowledged low sexual interest rates from 26% to 43%.
Biological Causes:
Surgical:
Hysterectomy can result in a sudden drop in estrogen and testosterone, which has been related to a lack of sexual desire. Studies have demonstrated that a sharp decline in these hormonal levels is a risk factor for Hypoactive Sexual Desire Disorder HSDD) particularly among younger patients. HSDD is a condition that causes a lack of sexual desire or sexual interest for six months or longer that is distressful.
Medication Usage:
It has long been demonstrated that certain medications used to treat anxiety and depression, specifically Selective Serotonin Reuptake Inhibitors (SSRI), negatively affect sexual desire. Several Forms of hormonal contraceptives have also been shown to reduce sexual arousal.
General Health Status:
Fatigue, chronic pain, and mood irregularities caused by chronic illness and pain can all contribute to a decrease in sexual desire in women. Studies on post-menopausal women have demonstrated that participants with poorer health reported low sexual desire. Researchers have demonstrated lower levels of sexual arousal in patients with diabetes, pelvic vascular disorder, and multiple sclerosis.
Hormonal Changes:
Estrogen affects blood flow to vaginal and genital tissues. Reducing estrogen, which can occur during and after menopause, childbirth or surgical menopause created secondary to a hysterectomy can result in reduced vaginal blood flow and lubrication.
Psychological Causes:
Diminished sexual desire and interest have been linked to psychosocial issues in men and women. Daily living activities which create a stressful environment can contribute to diminished sexual desires. Couples with sexual challenges also reported more conflict resolution and communication issues which further contribute to difficulties in discussing and addressing sexual difficulties in the relationship.
Psychological conditions such as social phobia, obsessive-compulsive disorder, panic disorder, depression, and generalized anxiety disorder are commonly associated with a lack of sexual interest.
Treatment:
A thorough history and physical exam will be made to develop the most optimal treatment plan at NV Medical Orlando. During the evaluation process, you may be asked to complete a questionnaire that will allow us to assess your symptoms further and devise an appropriate treatment regimen to address your concerns and symptoms.
The type of treatment recommended will depend on your identified needs, including hormone replacement therapy, treatments for the genital area, oral medication, a medication injected under the skin, sexual therapy, or additional treatment regimens.
References
Laumann EO, Paik A, Rosen RC, Page P. Sexual dysfunction in the United States, JAMA. 1999;282(13): 1229.
Laumann EO, Nicolosi A., Glasser DB, Paik A, Gingell C, Moreira E, et al., Sexual problems among women and men aged 40-80 y : prevalence and correlates identified in the global study of sexual attitudes and behaviors. Int J Impot Res. 2005;17 (1):39-57.
Dennerstein L, Koochaki P. Barton I, Graziottin A. Hypoactive sexual desire disorder in menopausal women: a survey of Western European women, J Sex Med. 2006;2:212-22.
Leiblum SR, Koochki PE, Rodenberg CA, Barton IP. Rosen RC. Hypoactive sexual desire disorder in postmenopausal women: US results from the Women’s International Study of Health and Sexuality. Menopause. 2006;13(1):46-56.
Stahl SM, Targeting circutis of sexual desire as a treatment strategy for hypoactive sexual desire disorder. J Clin Psychiatry. 2010;71(7):821-2.
Pfaus JG, Pathways of sexual desire. J Sex Med. 2009;6(6): 1506-33.
Hulter, B. (1999). Sexual function in women with neurological disorders (Doctoral dissertation, Acta Universitatis Upasaliensis).
Lew-Starowicz M, Rola R. Prevalence of sexual dysfunction among women with multiple sclerosis. Sex Disabil. 2013;31(2): 141-53.
Schover LR, Jensen SB. Sexual problems and chronic disease: a comprehensive approach. New York, NY: Guilford Press; 1988.
Spector IP, Leiblum SR. Carey MP, Rosen RC. Diabetes and female sexual dysfunction: a critical review. Ann Behav Med. 1993;15(4):257-64.
Smith NK, Jozkowski KN, Sanders SA. Hormonal contraception and female pain, orgasm, and sexual pleasure. J Sex Med. 2014;11(2)462-70