Living and Loving with Low Libido
Low libido is a topic that women are increasingly open to discussing. The progressive midlife women approaching menopause today are not only grappling with this issue in their own lives, they are also more open to discussing sensitive health concerns with their peers as well as with their health care providers.
Decreased libido is a common problem and an issue that can affect women of all ages. In addition, it is a complex issue with many contributing factors. Changes in a woman's sexual drive and satisfaction can have multiple influencing factors, including physical aspects as well as mental and emotional factors.
Approximately one-third of women over 50 report a decrease in sexual desire. This is matched, however, by an equal number of women who report improved sexual desire. Women related an improved sexual drive and satisfaction to increased privacy at home, greater time available for developing intimacy, and a decrease in other factors such as concern about pregnancy and untimely menses.
Perimenopause and menopause are specific times when women may experience a decrease in desire and begin to research their options for improving their libidos. A drop in libido at this time in a woman's life may be due in part to physical changes that can occur at menopause, including hormone changes, changes in vaginal tissue and lubrication, fatigue, sleep disturbances, hot flashes, night sweats, and increasing general health concerns. Mental and emotional contributors include stress, changes in body image, relationship issues, and changes in sexual expectations. Of course, these factors are all interconnected, for example, an expectation of pain with intercourse due to vaginal dryness and atrophy may considerably dampen desire.
Hormone changes that occur at menopause can affect several aspects of sexual desire. Dropping estrogen levels are associated with thinning of the vaginal mucosa, making it more susceptible to irritation, as well as a decline in vaginal secretions that act to moisten, lubricate and protect these sensitive tissues. Progesterone levels are also dropping at this time and can impact sexual desire as well as menopausal symptoms such as hot flashes. Although testosterone levels typically change the least as women enter menopause, some women may require supplementation, especially those who have undergone surgical menopause. Hormone testing can be utilized to determine what imbalances exist and when supplementation may be needed.
Many herbs have been successfully employed by women for improving libido, including damiana, Siberian ginseng, motherwort, ginkgo biloba, black cohosh, wild lettuce, and wild oats. Damiana has long been reported in herbal lore to improve sexual desire in women as well as men. Its Latin name, Turnera aphrodesiaca, lends credence to its historic use. Siberian ginseng and black cohosh have been found to exert hormonal effects, and have been shown in some research to improve the condition of the vaginal mucosa in much the same way estrogen does. Siberian ginseng has long been used in traditional Chinese medicine to improve sexual energy and stamina. Motherwort is specifically referenced in herbal texts for improving libido after menopause. It is also an herb noted for its calming effects. Ginkgo has been shown in research to improve sexual functioning in women and men, presumably by its influence on circulation. In fact, women were found to be more responsive to ginkgo's sexual enhancing effects than men. Wild lettuce has pain-relieving properties and may address vaginal discomfort. Wild oats has links to libido as noted in the adage, "to sow one's oats." This is likely a factor of its high mineral content. Some minerals that can influence sexual functioning include selenium, phosphorous, and zinc.
Regular exercise can also improve sexual desire on several levels. In addition to being a great stress reliever, aerobic exercise can improve blood flow to the pelvic area, helping tone and nourish vaginal tissues. Kegel exercises are another way to bring blood to the pelvic area and improve sexual response. Kegel exercises tone the pubococcygeus (PC) muscle, the muscle that contracts during orgasm and also supports the pelvic organs. Getting the PC muscle toned can also help with urinary incontinence. Another type of exercise, yoga, can support a healthy libido by increasing energy, strength, and flexibility, all vital components to healthy sexual functioning. Many women who practice regular yoga report an increase in sexual desire as well as an improved sexual response. In general, health alone is associated with better sexual drive and functioning.
Frequent sexual stimulation can also improve the health of the vaginal mucosa by retarding vaginal atrophy (evidence to support the "use or lose" theory). Additionally, allowing more time for becoming aroused can result in better lubrication, reducing irritation to the vaginal tissue. Frequent use of a vaginal lubricant or moisturizer during and between intercourse can further improve vaginal symptoms. It is also helpful to "go with the flow," and not limit sex to evening hours when the urge for sleep can win over the desire for intimacy. An interesting note is that testosterone levels tend to be higher in the morning than in the evening, further supporting working with your body to maximize sexual desire and response.
Lastly, open discussion with one's partner with regard to needs, desires, and expectations can greatly improve intimacy and sexual response for both partners. A healthy sex life can be achieved at any age when one takes the time and effort to attend to all aspects of one's sexual health.
Laux M, Conrad C. Natural Woman, Natural Menopause. HarperCollins Publishers, New York, NY, 1997.
Sorrel PM. "Sexuality and menopause." Obstet Gynecol 1990;75(4 Suppl):26S-30S; discussion 31S-35S.
Northrup C. Women's Bodies, Women's Wisdom. Bantam Press, New York, NY, 1994.
Northrup C. Women's Bodies, Women's Wisdom. Bantam Press, New York, NY, 1994.
van Lunsen RH, Laan E. "Sex, hormones and the brain." Eur J Contracept Reprod Health Care 1997;2(4): 247-51.
Weiss F. Herbal Medicine. Ab Arcanum, Gothenburg, Sweden, 1988.
Weiss F. Herbal Medicine. Ab Arcanum, Gothenburg, Sweden, 1988.
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Lieberman S. "A review of the effectiveness of Cimicifuga racemosa (black cohosh) for the symptoms of menopause." J Wom Health 1998; 7(5):525-9.
Kim C, Choi H, Kim CC, Kim JK, Kim MS. "Influence of ginseng on mating behavior of male rats." Am J Chin Med 1976;4(2):163-8.
Cohen AJ, Bartlik B. "Ginkgo biloba for antidepressant-induced sexual dysfunction." J Sex Marital Ther 1998; 24(2):139-43.
Tyler VE. "Boost your brain and your libido: ginkgo: this ancient herb may improve memory and (surprise) wake up your sex life." Prevention 1998; 50: 91(3).
Holt S. "Natural approaches to promote sexual function." Alt Comp Ther 1999;Aug:204-208.
Murray M, Pizzorno J. Encyclopedia of Natural Medicine, Rev 2nd Ed. Prima Publishing, Rocklin, CA, 1998.
Northrup C. Women's Bodies, Women's Wisdom. Bantam Press, New York, NY, 1994.
By power-surge.netntributor:
Dr. Deborah Moskowitz
Chat with other women about sexual libido and vaginal dryness
Power Surge Midlife Sexuality, Relationship Experts...
Check the Power Surge Web Site's Library for transcripts of guest chats with experts in the area of sexuality. These guests have been part of Power Surge's, "My Menopause, My Sexual Self Series" started in 1995. Every author is listed in the Library alphabetically.
Click on the guest's name below to go to their transcripts.
Dr. Sandra Pertot, the author of Perfectly Normal: Living and Loving With Low Libido.
Dr. Marianne Brandon, the author of Reclaiming Desire: 4 Keys to Finding Your Lost Libido.
Dr. Susan Rako, the author of
"The Hormone of Desire: The Truth About Testosterone, Sexuality and Menopause." Dr. Rako is an M.D. / Psychiatrist who's spent years researching testosterone.
Dr. Sandra Scantling, the author of
"Extraordinary Sex : A Couple's Guide To Intimacy." Dr. Sandy is Power Surge's Ask The Intimacy Expert.
Steven Carter, author of the international runaway bestseller, "Men Who
Can't Love," "What Smart Women Know" and This Is How Love Works. You'll also want to check out Steven Carter's, Ask The Power Surge Relationship Expert.
Dr. Alan Altman, OB/GYN and Power Surge guest, co-author with Laurie Ashner
of Making Love The Way We Used To ... Or Better.
Nancy Friday, author of numerous sexuality books including, The Power of
Beauty: Men, Women and Sex Appeal Since Femninism.
Judith Sachs, author of numerous books including The Healing Power of Sex.
Joan Irvine, Ph.D., author of Recipes for Hot Sex.
Lonnie Barbach, Ph.D. , author of The Pause: Positive Approaches To Menopause
and numerous books on women's sexualty.
Sharyn Wolf, therapist and author of numerous books on sexuality and
relationships, " How To Stay Lovers For Life" .
Mira Kirshenbaum, author of Too Good To Leave, Too Bad To Stay.
Lee Raffel , family psychotherapist and author of "Should I Stay or Go? How Controlled Separation (CS) Can Save Your Marriage."