Is sex the last thing on your mind these days? Does it take you forever to get aroused? Or has reaching orgasm become a herculean task? If so, you may have female sexual dysfunction — and you're not alone. An estimated 43 percent of women reported experiencing sexual dysfunction, according to findings published in the Journal of the American Medical Association, with problems ranging from not being able to have orgasms to having zero sexual desire.
Many things can interfere with sexual pleasure and function, from medical causes, such as certain medications, to psychological issues, such as relationship strife. Most often, sexual dysfunction is born out of a combination of the two. To help you pinpoint what's taken the sizzle out of your sex drive, we've pulled together 10 top libido killers and what your next steps should be to get your sex life back on track.
4. Poor body image: Feeling self-conscious about your curvy hips or less-than-ample breasts can diminish your sexual drive. "It doesn't matter if your guy is telling you you're the hottest thing," says Dr. Kellogg-Spadt. "Oftentimes the partner is raring to go and completely attracted. But if you don't feel beautiful, you're not going to be into it."
What you can do: Do a cuing analysis. Think of a time in your life when you felt sexually at the top of your game. What did you wear (for instance, your favorite little black dress or low-rise jeans), what was your workout routine, how did you eat, what perfume did you wear, what shoes did you slide on — and when was the last time you wore that, did that, ate that, etc.? These cues can help you get back into the mindset and habits of your sexy self. And if the little black dress doesn't fit anymore? It might be time to buy another dress you feel good in at your present weight or get back into an exercise routine. "Exercise has a direct effect on the chemicals in your brain that affect mood," says Jennifer Berman, MD, director of the Berman Women's Wellness Center in Los Angeles and coauthor of For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life. In addition, working out will shape up your physique and give you more energy. If these changes don't help improve your body image, it's time to consider professional counseling to get at the root of the problem.
5. Menopause: Menopause is marked by a whole host of changes in your body. There's a decline in ovarian function that leads to an abrupt drop in estrogen levels, which play a role in vaginal lubrication. What's more, testosterone production drops by up to half, which can trigger a sudden dip in your sex drive as well as diminished sensitivity in the clitoris and a weakened ability to climax, according to Dr. Berman. Growth hormone levels, which are associated with sexual function, energy, memory and mood, also decrease. "Touch perception changes and alters as we age," adds Dr. Berman. "It takes a little more touch to feel the same amount of erotic arousal." Add to that weight gain, fatigue and difficulty sleeping, and sex can become the last thing on a menopausal woman's mind.
What you can do: First and foremost, speak with your doctor to check for a medical cause, such as high blood pressure or cholesterol. If that's been ruled out, there are many options, including starting a doctor-approved exercise regimen to improve blood flow, using the botanical gel during foreplay, self-pleasuring to promote genital blood flow and incorporating fantasy work, such as doing some erotic reading or watching erotic videos 20 to 30 minutes three times a week. "This doesn't have to be done in the presence of your partner — sometimes it's better not to — but it's to put erotic thoughts back into your daily thoughts," says Dr. Kellogg-Spadt. To combat vaginal dryness, start exercising to improve blood flow and use a water-based lubricant that feels natural to you. Your doctor may prescribe a topical estrogen therapy, which increases vaginal lubrication and elasticity. Have open communication with your partner and explain to him that your body is changing. "Let him know that it doesn't mean you're not turned on by your partner just because you have to use a lubricant," she says. Using a vibrator, which is more intense than the human hand, can also help with dulled arousal. In some cases, physicians may prescribe testosterone (in pill, cream, suppository or lozenge form) to older women with low levels of the hormone who experience a loss of well-being. Oral and topical testosterone may help increase sexual urges, although no preparations are FDA-approved yet.
6. Medical conditions: Health problems such as high blood pressure, high cholesterol, diabetes, thyroid disorders and autoimmune disorders like lupus can all change a woman's sexual desire by affecting blood flow, nerve signals and hormone levels. A recent study of 417 sexually active women ages 31 to 60 found that women with high blood pressure were twice as likely to have sexual dysfunction than women with normal blood pressure. What's more, the older the women were and the longer they had had high blood pressure, the greater the chance of sexual dysfunction.
What you can do: Let your doctor know that you are feeling a change in libido. He or she may prescribe medication to treat the health condition, which generally limits sexual side effects. In the aforementioned study, women who took drugs to treat their high blood pressure but did not reach their target goal were more likely to experience sexual dysfunction compared with women who were not taking medication. However, women who had good control of their blood pressure through medication were much less likely to have libido problems. Your doctor may also recommend lifestyle changes, such as exercising regularly and eating healthfully, which may allow you to cut back on medication. To counter vaginal dryness, use a water-based lubricant or talk to your doctor about using a topical estrogen.
