This week at work, I observed a stressed-out soccer mom, a newlywed, an executive empty nester, and a marathoner who were all experiencing low sex drive. Everyone was convinced that their ovaries were the reason behind their lack of mojo and wanted to check their “hormones levels.” This is a problem I frequently encounter, as 40% of women report having low sex drive at some point in their lives.
Sufficient hormones are beneficial for sexual function. Testosterone stimulates sexual cravings, while estrogen promotes blood flow to the vagina and permits proper lubrication. However, female sexual desire is frequently more nuanced than a straightforward lab result. Relationship problems, stress, emotional well-being, and body image are all very important.
The women I asked earlier gave me a range of responses when I asked how often they were actually having sex: once a month to five times a week. “Five times a week” seems like a pretty good week to me, but she felt that was less than usual, which upset her.
Hormones may not always be the cause of low libido, but in certain cases they might be.
Irregular or absent menstrual cycles
Periods that occur regularly every 24 to 34 days are typically an indication of healthy ovaries and hormones. The most obvious sign that a woman’s hormones are off-kilter is irregular, sporadic, or nonexistent periods. More than 6 months without a period is especially concerning as it may indicate an estrogen imbalance. Not only can this negatively impact one’s ability to have sex, but it can also lead to other health issues and should be taken to the doctor.
Menopause
Women’s ovaries stop producing hormones after menopause, so their overall levels of estrogen and testosterone are very low or nonexistent. While many women experience no sexual problems during the menopause transition, others have low desire and dry vagina. The decrease in estrogen frequently causes painful sex, dryness, and thinning of the vaginal tissue. Women won’t want to have sex as frequently if it hurts and is unpleasant, and the less often they do it, the worse their symptoms get. Apply it or forget it! Certain symptoms can occasionally be relieved with basic lubricants like coconut oil or KY jelly. Prescription topical estrogen cream can usually restore vaginal tissue to its premenopausal splendor if that proves ineffective.
Although not FDA-approved for women, studies conducted “off label” have demonstrated that testosterone supplementation can improve libido in women approaching and past menopause, albeit not without adverse effects. Hair growth and acne are frequently bothersome, and additional side effects like elevated
Additionally, cholesterol has been noted, which may potentially contribute to heart disease in the future. I frequently prescribe testosterone cream to my menopausal patients, and the majority of them are quite happy with its benefits. However, I always make sure to warn them that there are no long-term studies on testosterone cream, so we are unsure of any potential long-term side effects.
The Pill
The birth control pill binds excess testosterone in the body, which can lower testosterone levels and impact libido in some women. See your doctor about a non-hormonal option if you think that taking your pill is making you less happy. But don’t just stop taking your medication; a new baby will deplete your sex desire even more than the pill does.
If you don’t experience any pain during sexual activity, have regular periods, and are not using hormonal contraception, it’s unlikely that “your hormones” are the only reason behind your low sex drive. For women with normal hormone levels, there are a number of medications in development. One such medication is flibanserin, which has been resubmitted to the FDA for approval. You may have heard some recent talk about it. However, unlike most men, most women’s sexual desire is not merely a matter of the body. Usually, the solution has as many facets as the issue.
