Anyone can experience low libido at any point in their lives. For women, low libido might present itself as early as the time of puberty. This is normally due to a genetic disorder. On the flip side, it can develop suddenly around the menopause years as levels of hormones change and re-adjust. Low libido can sometimes develop slowly over a period of time so it’s not as noticeable and feel like a gradual decline. This is normally due to a chronic disease. Another reason for low libido is after a person experienced sexual trauma. In this case it appears suddenly. Low libido is also referred to as low sex drive. It can be generalized (with every partner and in every situation), or situational (affected by personal or partner related issues).
It may be a lifelong disorder or have developed after months or years of satisfying sexual encounters. A woman’s libido is variable from situation to situation. However, it’s important to understand the underlying condition that is causing it.
The following medical conditions are known to cause low libido:
Adrenal gland disease (Cushing syndrome)
AIDS cachexia
Anemia
Autoimmune diseases, especially lupus and scleroderma
Birth defect (e.g. chromosomal abnormality)
Brain tumor causing hyperprolactinemia
Brain, spinal cord or nerve damage
Breast cancer
Cirrhosis of the liver
Chronic pain
Depression
Diabetes
Drug abuse
Dyspareunia (pain during intercourse)
Early menopause
Excess sex hormone-binding globulin (SHBG), which does not allow existing testosterone to work on tissues
Fatigue
Fibrosis (scar tissue)
Genetic disorder
Hardening of the arteries (atherosclerosis)
Heart disease
Hypopituitarism
Kidney failure
Lack of accurate sexual training
Multiple sclerosis
Oophorectomy (removal of the ovaries)
Pelvic injury
Pelvic surgery
Testosterone deficiency due to a hysterectomy
Thyroid gland disease
Tuberculosis
Vaginismus and other pelvic floor problems
Vulvar nerve problem
Vulvodynia (burning and stinging in the outer female genitals, but no disease can be identified through testing)
Workplace or environmental exposure to estrogens causing estrogen dominance (e.g. a pharmaceutical or plastics manufacturing plant, or a farm)
The prescription drugs most likely to cause loss of sexual desire are:
Amphetamines (stimulants)
Antidepressants (all types)
Anabolic steroids for body-building
Anticholinergics to treat Parkinson’s disease
Antihistamines for nasal congestion
Antihypertensives for high blood pressure
Antipsychotics for schizophrenia, paranoia, and bipolar disorder
Anti-ulcer drugs, especially histamine H2-receptor blockers and promotility agents
Appetite suppressants
Benzodiazepines for relaxation
Beta blockers to control congestive heart failure
Chemotherapy drugs to control breast cancer
Colchicine for gout
Cyclosporin and azathioprine, immunosuppressives to prevent organ rejection in transplant recipients
Danazol and GnRH agonists for menstrual problems
Fluoxetine, an antidepressant
Hormone replacement therapy HRT (especially oral dose forms, tablets, and pills)
Indomethacin for arthritis
Ketoconazole for fungal infections
Lithium for bipolar disorder
Monoamine oxidase inhibitors (MAOI) for depression
Morphine for pain
Methyldopa for high blood pressure
Narcotics for sleep
Birth control pills
Paroxetine, an antidepressant
Phenytoin, an antiseizure medication for epilepsy
Prednisone, prednisolone and cortisone to prevent inflamma- tion
Sertraline, an antidepressant
Selective serotonin reuptake inhibitors (SSRI) for depression
Trazadone, an antidepressant
Tricyclic antidepressants (amitriptyline, desipramine, imipra- mine, nortriptyline, and protriptyline)
The above list is only partial. Over 200 prescription medications are known to cause the side effect of low libido.
Who Develops Low Libido?
Studies show 33 – 43% of all women between the ages of 18 and 59 report some degree of sexual dysfunction
21% of these women name low libido as their number one problem
25% of women who have had a hysterectomy and did not have previous sexual problems develop low libido after surgery
Women who undergo oophorectomy (removal of ovaries) experience an immediate 50% reduction in blood testosterone levels which usually results in a decline in desire and libido
18% of women report lack of arousal
24% of women are unable to achieve an orgasm (sexual climax)
14% of women experience pain during sex
1% of women have vaginismus
Testosterone is the hormone responsible for libido (sexual desire) in both men and women. A woman in her 40s will have half the testosterone levels in her blood than when she was in her 20s. Women tend to be more sexually motivated, more easily aroused, have higher libidos and are more sexually active in their 20s than in the following decades.
In the case of men, testosterone levels generally decline from about age 45 to 50 onwards. There is usually also an associated decline in male libido, sexual activity and performance.
When Should I Be Concerned?
Low libido is only assessed in women 18 years of age and older. If you are a minor, you shouldn’t be concerned about your lack of desire because your hormones have not yet settled into their mature pattern. wait a while and see if your body catches up. If you have a genetic disorder that contributes to lifelong low libido, such as Turner syndrome, talk to your doctor about starting hormone therapy before you turn 15.
Sexual desire is a very personal, individualized feeling that changes with the situation. If your lack of sexual desire does not bother you personally, but does disturb your partner, then it is not a basis for a diagnosis requiring treatment. However, you both may benefit from counseling.
Low libido must extend over at least four weeks to be considered a persistent problem. Low libido can be expected as a transitory effect of late pregnancy, childbirth, sleep deprivation, workplace stress or systemic illness. Do not be concerned about your libido until these life events have concluded at least one month.
There is no right or wrong number of sexual events per week, month or year. There are multiple events and circumstances that contribute to the sexual motivation of women. Sexual inactivity or lack of desire to engage in sexual thoughts, fantasy or activity should only be addressed if it causes distress to the woman. If you are genuinely interested in sex every two weeks or so, then your doctor will probably not treat you for low libido. Women who have sex very infrequently (e.g. twice a year), provided they are compatible with their partners and not distressed by the long intervals between copulations, generally need no interventional treatment.
Failing to orgasm during sex is not necessarily a sign of low hormone levels or low libido. Only and estimated 50% of women orgasm during penetrative sex. However, most women can reach orgasm through direct stimulation of the clitoris. Try changing your technique and trying other ways of stimulation to see if it helps.
Understand more on low libido in women:
Why and who develops low libido?
Signs and Symptoms of Low Libido in women. When should I be concerned?
Treatment options for low libido in women
Female Sexual Function Questionnaire
The information in this article has been taken with permission from the official Lawley booklet on Understanding Low Libido in Women.