‘Not tonight, dear’
Not interested in sex anymore? A low libido can be caused by many things, both biological and psychological.
YOU’VE had days when your partner is in the mood for romance and intimacy, but no matter how hard he tries, you’re just not up for it.
All you want is to put on your most comfortable pyjamas, remove all your makeup and let everything hang loose.
Don’t worry, you’re not alone. Women everywhere experience a loss of libido for a variety of reasons.
One key and rather unavoidable reason is the occurrence of hormonal imbalance, especially when age catches up.
Here’s how a decline or imbalance of hormones can cause your sex drive to go down the toilet:
● Oestrogen
Oestrogen increases the level of neurotransmitters in our system that improves mood.
A lack of adequate oestrogen means that happiness-inducing hormones like serotonin, dopamine and beta-endorphins are missing in the right amounts, and can lead to irritability and insomnia.
Oestrogen deficiency in menopause also causes dryness of the vagina, which can lead to painful sex.
● Progesterone
Progesterone increases your sex drive during the luteal phase of your monthly cycle (the 12 days after your period).
Less progesterone is produced as you get older, which may also cause hormonal imbalance.
In younger women, stress, poor diet and over-exertion in exercising can hinder the production of this hormone.
● Cortisol
Someone who is stressed out is also living with overworked adrenal glands that are unable to cope with the body’s demands for cortisol, the hormone produced in response to stress.
Adrenal fatigue causes a person to be physically tired, lose their libido and cause hormonal imbalance.
● Thyroid
Impairment of the thyroid directly affects the production of sex hormones like oestrogen, testosterone and progesterone.
Hypothyroidism affects energy levels that in turn, lowers libido.
● Testosterone
Testosterone is the primary influencer of sex drive in both genders.
When a woman undergoes ovulation, testosterone levels are at an all-time high, creating sexual desire in women.
Changes to the body, such as menopause or going through a hysterectomy (surgical
removal of the womb), drastically reduces testosterone production and your sex drive as well.
There are other causes of low sex drive or dysfunction, including chronic conditions and prescription medications:
Medications
● Hormonal contraceptives, such as birth control pills, vaginal rings and the patch.
● High blood pressure (hypertension) pills.
● Medicines to treat an enlarged prostate like dutasteride and finasteride.
● Antidepressants and antipsychotic prescriptions.
Chronic conditions
● High blood pressure, which affects blood circulation.
● Cancer treatments like chemotherapy and radiation.
● Addiction to alcohol or drugs.
● Diabetes, which can cause nerve damage when blood sugar levels are not well-controlled, resulting in erectile dysfunction and decreased blood flow to the genitals that results in difficulty in reaching arousal.
● Poor mental health, where depression, tiredness, lack of self-confidence and anxiety causes a person to lose interest in sex.
● Osteoarthritis, which can be demoralising to those who find that stiffness and pain in the joints make sexual activities more difficult.
● Heart problems slow circulation and reduces blood flow to the genitals, decreasing sexual arousal.
And while it isn’t a chronic health condition, a troubled relationship will naturally affect intimacy in the relationship.
Poor communication, frequent arguments and lack of trust or support wipes out any desire for sex with a partner.
Treating your libido
Treating a diminished libido is dependent on what’s causing the issues.
Doctors will often prescribe hormone replacement therapy or bio-identical hormone therapy when the cause of low libido is due to menopause or hormonal imbalance in both women and men.
This treatment can be administered via pills or topical delivery such as creams.
A patient who may not require hormone therapy yet will likely receive basic advice that includes a change of habits and lifestyle.
This might include changing a medication that might be wreaking havoc on your sex drive, or treating a medical condition that may be interfering with your sex life.
Lifestyle changes – including better sleep, cutting out excessive alcohol, quitting smoking and working on weight loss – might all be part of recommendations to help become healthier and improve libido.
Certain supplements like amino acids, zinc and vitamins D and E, or herbal supplements such as horny goat weed, tongkat ali or ginseng, can improve sexual health.
Certain foods like tuna, oysters, chili peppers, celery and dark chocolate can also elevate testosterone levels, which will help increase sex drive.
Others may respond well to talk therapy or sex therapy.
This form of treatment helps patients to face their fears or past trauma with sexual issues, while building self-esteem and identifying ways to form better relationships with their partner.
Similarly, cognitive behavioural therapy and mindfulness is another form of mental conditioning that helps women to overcome non-hormonal related sexual problems.
Such therapies are effective in changing a person’s mindset about sex, helping them to focus on the positive and pleasurable aspects, and reducing negative thoughts and impressions.
When to see a doctor
Knowing when to see a doctor about low libido can be tricky, but here are some symptoms to pay attention to when deciding whether or not to check in with your doctor:
● When little or no progress is made with increasing libido after you’ve tried many non-medical methods like lifestyle changes and taking supplements, as this may indicate hormonal imbalance.
● Consistent stress, fatigue or low mood that decreases your overall life quality.
● Poor communication or frequent conflicts with a partner.
Most importantly, it’s critical to remember that talking about problems regarding low sex drive is not a reason to feel embarrassed.
It occurs for any number of reasons and at almost any stage in life.
Low libido is a common condition and it should not be dismissed as being unimportant or ignored out of shame.
There are potential treatments to overcome low libido.
Seek a doctor or sexual health specialist with whom you can work the problem out, and let’s get you back on the path to a healthy and functional sex life.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist, and a functional medicine practitioner. For further information, email starhealth@thestar.com. my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.