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Why Women Lose Interest in Sex

What Is Low Sexual Desire? continued...

Therefore, all of these aspects of sexual desire must be examined in order to determine the root of the problem.

Common causes for a loss of sexual desire and drive in women include:

  • Interpersonal relationship issues. Partner performance problems, lack of emotional satisfaction with the relationship, the birth of a child, and becoming a caregiver for a loved one can decrease sexual desire.
  • Sociocultural influences. Job stress, peer pressure, and media images of sexuality can negatively influence sexual desire.
  • Low testosterone. Testosterone affects sexual drive in both men and women. Testosterone levels peak in women's mid-20s and then steadily decline until menopause, when they drop dramatically.
  • Medical problems: Mental illnesses such as depression, or medical conditions, such as endometriosis, fibroids, and thyroid disorders, impact a woman's sexual drive both mentally and physically.
  • Medications: Certain antidepressants (including the new generation of SSRIs), blood pressure lowering drugs, and oral contraceptives can lower sexual drive in many ways, such as decreasing available testosterone levels or affecting blood flow.
  • Age. Blood levels of androgens fall continuously in women as they age.

Putting the Desire Back in Women's Sex Lives

Because a loss of sexual desire in women is caused by a combination of physical and psychological factors, it usually requires more than one treatment approach to fix the problem.

"For women, it is much more complex. They're not just complaining of one plumbing problem, says Shifren. "So we have to be more thoughtful in our approaches to treatment."

Once the factors causing low sexual desire have been determined, potential treatment options may include:

  • Sex therapy and/or relationship counseling. "Sex therapy is very effective for individuals and couples, and that is always at the top of my list," says Shifren. Sexual dysfunction usually affects both parties in a relationship and should be discussed together or individually with a mental health professional.
  • Changing medications or altering the dose. If the problem is caused by medications, a change of prescription or alternative therapies may be recommended. If an oral contraceptive is suspected as the culprit in lowering testosterone levels, a different formulation or nonhormonal birth control methods may be prescribed.
  • Addressing underlying medical conditions. Medical problems contributing to low sexual desire may require surgical treatment, such as the removal of painful fibroids or medication.
  • Vaginal estrogens. In postmenopausal women, vaginal dryness may be treated with vaginal estrogen creams.
  • Testosterone therapy. Although no hormone or drug has been approved by the FDA to treat sexual problems in women, many gynecologists recommend off-label uses of testosterone therapy for women with low sexual desire to restore testosterone to normal (pre-menopausal) levels.

In addition, several therapies involving testosterone pills or skin patches specifically designed to treat female sexual problems are currently being studied in hopes of FDA approval in the near future.

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