Low sex drive can be im­proved

Daily Freeman (Kingston, NY) - - YOUR DAILY BREAK - An­thony Ko­maroff Ask Dr. K

I’m a woman in my mid-50s. Lately I haven’t been able to be­come sex­u­ally aroused. What could be wrong?

Sex is com­pli­cated, but you prob­a­bly al­ready know that. Sex­ual de­sire surely re­sides in the head, but other parts of the body can af­fect de­sire as well. In par­tic­u­lar, the gen­i­tal or­gans com­mu­ni­cate with the brain. Like­wise, the brain com­mu­ni­cates with the gen­i­tal or­gans. De­sire in the brain causes changes in the pelvic or­gans. Per­ceiv­ing these changes can, in turn, en­hance sex­ual de­sire.

There is a con­di­tion called sex­ual arousal dis­or­der. Nor­mally, a woman be­comes aroused through thoughts and fan­tasies, touch, or a com­bi­na­tion of these things. In re­sponse, blood flows to her pelvic area. This causes the gen­i­tal tis­sues to swell and the vagina to moisten in readi­ness for sex­ual ac­tiv­ity. With sex­ual arousal dis­or­der, your mind de­sires sex, but your body does not fol­low suit.

Many things can cause or con­trib­ute to this dis­or­der. Med­i­cal con­di­tions such as hy­pothy­roidism and di­a­betes can dampen sex drive. Med­i­ca­tions, in­clud­ing an­tide­pres­sants and anti-seizure drugs, can have sex­ual side ef­fects. Emo­tional and psy­cho­log­i­cal is­sues also can pro­foundly af­fect sex­ual de­sire — and per­for­mance.

Sex­ual arousal dis­or­der in women of­ten oc­curs af­ter menopause, when es­tro­gen lev­els drop. This can cause vagi­nal tis­sue to thin and se­cre­tions to de­crease. Sex may be­come painful, re­sult­ing in less arousal. But even if sex is not painful, a woman may no­tice the ab­sence of the pelvic changes that oc­cur with in­creased blood flow and vagi­nal moist­en­ing. That can put a fur­ther damper on de­sire.

What treat­ments are avail­able to im­prove sex­ual de­sire and sex­ual func­tion? For years, drug com­pa­nies have been in search of a “fe­male Vi­a­gra.” The idea is that in­creased blood flow to the gen­i­tal area will trans­late into greater sex­ual de­sire. So far, stud­ies have not found this to be the case. Another is­sue might be vagi­nal dry­ness. For many women, over-the-counter lu­bri­cants and vagi­nal mois­tur­iz­ers are enough to re­lieve vagi­nal dry­ness. If these prod­ucts don’t help, low-dose vagi­nal es­tro­gen prod­ucts are avail­able by pre­scrip­tion. They come as creams, tablets or rings in­serted into the vagina. These raise es­tro­gen lev­els in the vagina, mak­ing vagi­nal tis­sue thicker and more elas­tic. Un­like higher-dose hor­mone re­place­ment ther­apy, they do not sig­nif­i­cantly in­crease blood lev­els of es­tro­gen.

The most widely stud­ied treatment for boost­ing fe­male sex­ual de­sire is testos­terone. Most stud­ies have found a ben­e­fit. Even though testos­terone is de­scribed as a “male” hor­mone, women also make testos­terone — but in much lower amounts than men. It does stim­u­late de­sire in women as well as men, along with arousal and or­gasm.

Another op­tion, if your prob­lem is not just phys­i­cal, is sex ther­apy. A ther­a­pist can help you iden­tify thoughts, feel­ings and be­hav­iors that might be in­ter­fer­ing with your sex­ual en­joy­ment. A ther­a­pist will also help you com­mu­ni­cate your needs and en­hance feel­ings of in­ti­macy be­tween you and your part­ner.

A loss of sex­ual de­sire and func­tion af­ter menopause is rea­son­ably com­mon. For­tu­nately, there are ther­a­pies that can help.

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