Why some women have a low sex drive, how to increase libido, and four reasons sex is so important
There are many reasons why some women have a lack of interest in sex, and it can happen at any age. A new medication, Addyi, promises to increase desire, but there are other physiological and psychological ways to boost arousal
Lack of libido, or female sexual arousal disorder (FSAD) as it’s technically known, is, says Hong Kong-based certified sex therapist and couple’s therapist Nikki Green, “a common reason women come to see me”.
It can happen at any age and for a variety of different reasons, she says.
“Many women are not from families who were comfortable with helping them create healthy sexual identities. and as a result haven’t really learned how to enjoy their own sexuality, especially independently.
“If you don’t become aware of how your body works and what turns you on, it’s more difficult to guide your partner towards truly satisfying sex in the long term.”
As a result, she says, “many women I speak to don’t really see the true value in sex for themselves and see it more as something that they are ‘doing’ for their partner”.
That may be about to change. In June this year, the US saw the relaunch – at half the price – of Sprout Pharmaceuticals’ Addyi. Unlike Viagra and similar drugs that treat sexual dysfunction in men, such as erectile dysfunction, by increasing blood flow to the penis, Addyi claims to treat the brain.
The active ingredient, flibanserin, was originally developed as an antidepressant; it decreases levels of serotonin (which is responsible for sexual inhibition) while prompting production of dopamine and norepinephrine, chemicals that influence motivation and desire.
But the drug is not a magic pill – studies suggest that though women using the medication reported higher levels of desire and lower levels of stress than women taking the placebo, this translated only to between 0.5 and one additional sexually satisfying event per month.
Nor is it without side effects, which can include dizziness, nausea, and intense sleepiness and a potentially dangerous drop in blood pressure if mixed with alcohol.
The brain is often considered a woman’s more important sexual organ; much of her sexual response cycle originates in her brain.
Nikki Green agrees. “In my opinion, women need to feel loved before they can have sex and men need to have sex to feel loved,” she says. She feels this partly propels the belief that men have much higher libidos than women, “though testosterone has something to do with it, too”.
Women can experience a flagging sex drive at any time during their lives but “the most common times to experience libido problems”, she says, “are after having a baby or as women approach menopause. It’s no coincidence that these are both times when hormones are being affected.
“Women with babies or young children tend to be less interested in sex, often due to exhaustion. Hormonal fluctuations and the fact that so many demands are made on them physically can also leave them lacking the wherewithal for sex”.
As one of her clients confided tearfully to her: “Everywhere I turn, whether it’s the baby, my two-year-old, my five-year-old or my husband, someone is trying to use my body to get one of their needs met. I feel bad for my husband, as he is the one usually at the end of the queue.”
The reason menopause can affect libido, says Dr Sue Jamieson of the Dr Sue Jamieson Integrative Medical Practice in Hong Kong’s Central district, is that the amount of hormones produced in the ovaries, including testosterone, declines after the age of 35, and more dramatically after the age 45.
Jamieson, who has specialised in hormone replacement therapy for years, was among the first doctors in Hong Kong to import bio-identical testosterone in the early 1990s.
“Having less testosterone,” she says, “has three effects and different women notice the deficiencies in different ways. This may be a lower sex drive, generally low energy levels, and also reduced muscle mass; some women notice that even though they exercise to the same extent, go to the gym, still the muscles become more flabby and less firm.”
Jamieson advocates the use of tailored testosterone – prescribed as a skin cream, which, she says, if prescribed to fit a woman’s weight and physiology, “works within a week or two”. She warns there can be side effects – slight hairiness and possibly liver issues.
Greene explains that the decrease in oestrogen experienced by menopausal women “causes the lining of the vagina to become thinner and lubrication to decline, which can lead to uncomfortable, even painful, sex.
“The vagina may also become less elastic as muscle tone decreases, sometimes causing difficulties climaxing. Declining hormone levels can often lead to a lack of libido and weight gain – which serves to make women feel less attractive”.
Vaginal dryness can often be alleviated with the use of lubricants, and vaginal laxity with regular pelvic floor exercises in the form of Pilates or yoga.
Greene encourages her clients to adopt a healthy lifestyle to try to combat the weight gain that often accompanies menopause (and makes women feel less sexy) and energy issues.
She urges women “not to be defined by the belief that with menopause comes a decline in the libido and instead focus on the many wonderful things that come with age – for example, increased confidence, more wisdom, a better ability to communicate and ask for what you want and to enjoy it when you get it”.
She adds: “Creativity and a lack of inhibition helps. It really is a case of use it or lose it, and research shows that women who enjoy sex, find it important and look after their health, are able to keep having richer, more nuanced yet vitality-affirming sexual experiences their whole life.”
Jamieson reveals a surprise: taut 20-year-olds may not be the most sexual. She says sex drive is “totally random” when it comes to age and “it can actually increase around the time of the menopause”.
The important things to remember are that flagging libido is common and that it can be dealt with both physiologically and or psychologically.
Jamieson encourages HRT when menopausal women lose their sexual mojo because “I have seen so many examples over the past 20 years of it really helping women, and sex is really important for the health of a relationship”.
Greene urges couples to “specifically make time for each other, where you’re not talking about work or the children but you’re really focusing on each other at a deeper level”. She suggests it may be helpful to get away from home to do this, “or at least ensure that you have some time and space to refocus”.
In some relationships, one partner’s “love language is physical”, which probably explains why almost every father she speaks to tells her “in one way or another how lonely he felt when the baby came along and how it would be selfish to say too much about it to his wife”.
Sadly, she says “instead it often comes out in hurtful, demanding or resentful ways or at the very least causes him to start shutting down” – which comes back to men’s need for sex to feel loved and women’s need to feel loved to have sex.
One of the best ways to ensure a healthy sex life is to have a healthy body. Good sex needs a good blood supply and healthy nerves. Just as good health makes for better sex, so better sex makes for good health. Here’s how:
1. It helps you live longer
A study conducted in Wales two decades ago asked men aged 45 to 60 about orgasm frequency. A decade later they tracked those men down. Those who enjoyed less than one orgasm a month were 50 per cent more likely to have died than those who said they had an orgasm more than a couple of times a week.
2. You’ll look younger
About 3,500 volunteers were screened for their age. Researchers guessed volunteers’ ages. Those judged to be ‘super young’ were at least seven years younger than their real age. And they all had sex three times a week – more often than older looking others.
3. It may boost immunity
Research has shown that having regular orgasms can strengthen the immune system. In a study of 112 male and female US college students, researchers found that students who had sex once or twice a week had antibody levels 30 per cent higher than peers who abstained.
4. Provides natural pain relief
A number of studies show that sexual arousal and orgasm can increase levels of endorphins – natural pain killers. Regular sex has been shown to reduce pain of arthritis, menstrual cramps, backache and migraine.