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Your Mental Health

Low sexual desire: a common problem

Phrases like “I have a headache” or “I’m too tired” are so common they are a cultural cliché.

Most of us chuckle when these are re-hashed over coffee with friends or when they come up as humorous interludes in movies or television programs. We all know the bearer of such a saying is not interested and the recipient isn’t about to get any action.

But have you ever thought about underlying reasons for the ubiquity of these sayings? Why is it that women often have low or non-existent interest in sex?

Today I’d like to talk about a relatively common condition called hypo-active sexual desire disorder (HSDD), which may occur in up to a third of all adult women.

At its core, HSDD is fairly self-explanatory. It is characterized by a deficiency or absence of sexual desire causing marked distress or relationship difficulty. However, the causes of this condition are varied and can be complex.

Obviously, there are many factors playing into a woman’s sexual desire and these can range from lifestyle issues such as relationship tensions or fatigue from a busy life to medical conditions. Certain events in a woman’s reproductive life can also impact sexual interest including menstrual cycles, the postpartum period, lactation or menopause. Surgical removal of the ovaries can also cause this problem.

Medication use is another factor that can interfere with sex drive. Many commonly prescribed drugs such as blood pressure medications, antidepressants and contraceptives have the potential to disrupt sexual function. Sometimes adjusting dosage or switching to a different kind of medication can help when the medicine is to blame for lowered sexual desire.

Underlying depression is also a major cause of decreased libido among both men and women. Not only does the illness lower sex drive, but having a lower sex drive can also make the depression worse – so it becomes a negative cycle. Treating the depression generally improves sexual function except in cases where the antidepressant medication is a problem.

Menopause is one of the most common reasons for women to experience hypo-active sexual desire disorder. With the onset of menopause comes a gradual decline in hormones such as estrogen, progesterone and testosterone. In particular, decreased testosterone can lead to a decline in libido.

Sometimes, the conventional hormone replacement therapy prescribed to treat symptoms of menopause (replacing estrogen and progesterone) actually makes HSDD worse for post-menopausal women.

The most common and effective treatment for HSDD among post-menopausal women is testosterone. Testosterone can be taken in a variety of ways and options can be discussed in detail with your doctor.

Treatment options for HSDD resulting from other causes can include lifestyle changes, marital therapy, treatment of co-existing medical or psychiatric disorders or adjusting or discontinuing medications which might be contributing to the problem.

One of the biggest barriers to treatment is an unwillingness to discuss sexual problems with your doctor. This is the first step to discovering why HSDD exists and finding the best way to deal with it. 

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