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Women's Health
"Where Did the Love Go"- A Gynecologist looks at Lost Libido
(What you might be embarrassed to tell your Gynecologist, and what your Gynecologist might be embarrassed to tell you.)
When I ask my colleagues what issue in Gynecology frustrates them the most, I almost always get the same answer.
Loss of sexual interest, also called lost libido, is a problem that affects hundreds of thousands of women. Women of all ages may complain about this problem, and it seems to worsen at about the same time that symptoms of the pre-menopause and peri-menopause are also becoming a problem.
There is no doubt in my own mind that this problem is grossly under-reported. There are probably more women who “suffer in silence” because they are to embarrassed or inhibited to discuss this issue with their healthcare provider. Many physicians may also feel uncomfortable questioning their patients about their sex habits, or were not properly trained to do this during medical school or residency, and avoid questions about libido in their patient interviews.
There are multiple issues that can reduce sex drive in women. Part of the aging process gradually reduces the amount of estrogen and progesterone produced by the female. When menopause finally is reached, somewhere about age 50 in American women, the levels of circulating sex hormones are dramatically lower than they were during their 30’s and 40’s. There are emotional effects of this decrease, one of which is reduction in overall sexual interest. Women begin to fantasize less about sex, and begin to be less interested in having intercourse. There are also physical effects of this reduction of female hormone production. The vagina is an organ that relies on estrogen production to maintain its moisture and elasticity. Narrowing of the vagina and loss of lubrication may make intercourse unpleasant, uncomfortable, and sometimes downright painful.
Let’s also consider the fact that the male counterpart of decreased libido in women is E.D., or erectile dysfunction in men. While a male may be just as embarrassed discussing E.D. with his healthcare provider, one thing is certain. When a male has this discussion, there are THREE products that be prescribed to help him. You don’t need to be reminded of the names of these products. If you watch television, ride a bus, read a magazine, or listen to the radio you’ll be reminded of these products at least once an hour, sometimes more frequently. For males there is choice- Viagra, Cialis or Levitra.
So why not try these products in women and see if they, too might benefit? There have been clinical trials of all three. The bad news is- none of them work.
If that is not a frustrating set of circumstances for the gynecologist, nothing is.
What does a prudent and sensible gynecologist off to his patients faced with decreased or absent libido? There are a few things that I have suggested to my patients over the past 28 years that seem to work. I’d like to share them with you.
First off, you must get comfortable discussing loss of libido with your physician. One of those commercials for E.D. that I mentioned above has a guy talking to his mirror “practicing” for the conversation with his doctor. Once you get the courage to discuss your issue with your healthcare provider, make an appointment and go for it. When you are there, look for any signs that he or she may be uncomfortable with your conversation, or questions. If you sense this, find a new provider.
Next, you are going to need to get very comfortable discussing this issue with your sexual partner. You’ll need to be vocal about what hurts, and what doesn’t hurt. You may also need to be able to tell your partner when YOU are feeling sensual. You may also need to do a bit of “damage control” and remind your partner that you DO still love him. Men need to hear that some times. Give it a try. Every relationship is a two-way street. Communication is the key.
Lubricants and prescription hormonal creams may relieve many of the symptoms of vaginal dryness that are present. Though I am not a proponent of oral hormone replacement, I do believe that estrogen creams are extremely beneficial to restore not only lubrication, but to make the vagina more elastic. If there is pain in the vagina during intercourse because of lack of lubrication or failure to “stretch”, the vagina will narrow, making any further attempt at intercourse very uncomfortable. If there is enough discomfort, just the thought of this pain will serve as a deterrent the next time around.
Get in the mood- you probably didn’t need to do this when you were 18, but you are not a teen-ager any more. Now I am not going to suggest exactly how you should get “in the mood”, you do what works for you. It may be reading something sensual, or watching something with your partner. Use your imagination correctly and you just might get your partner “in the mood” too.
Take better care of yourself. Eat well, try to stay in good physical shape, and look in the mirror from time to time. Feeling good about yourself is important. Part of this to be sure that you are getting the best nutrition. I am a firm believer in the use of vitamins and I try to be as holistic as possible. The folks at Beveragette have a series of products that address the nutritional needs of women. I helped develop their GEM “Keep it Cool” product to treat menopause and perimenopause. It may help restore libido too. You can start there.
Now I can’t guarantee that there will be a dramatic change in your libido, or that you’ll be chasing your partner around the house next week or that his supply of Viagra will need to be refilled much more often. Remember in life that sometimes quantity is not nearly as important as quality. Take good care of yourself. Talk to you again real soon
I wish you continued good health.
Robert James Gallo, M.D., FACOG
Medical Advisor, GEM “Keep it Cool”