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Libido Problems

Many women complain of low libido. This can be for lots of reasons: too hectic a schedule, tension between partners, tiredness from childrearing or work, depression, poor physical fitness, low estrogen in the menopause, or because they are tired of having sex that was never really very rewarding to them before. The remedy for the first three causes is to fix your schedule and keep your relationship in good repair, perhaps with counseling for either or both of you. Hormones are addressed below and extensively in other sections of the website.

Many women have trouble reaching orgasms in partner sex, and 10% simply never do have orgasms. While some 25% can achieve orgasm from vaginal thrusting activity, over 75% of women require direct clitoral stimulation by fingers or mouth to achieve orgasms. The average time for a woman to reach orgasm is over 20 minutes with direct clitoral stimulation. Women secrete less lubrication and take longer to climax as we age. Ask yourself: are you getting enough quality stimulation? Many are afraid to require our partners to take the time we women naturally need for an orgasm. If you don’t like your partner or spouse any more, you won’t have much libido within your relationship. Lack of achieving regular orgasms can also reduce the drive for sex. Lack of orgasms can come from never receiving what one needs to have an orgasm, feeling unable to communicate to your partner what you need done to have an orgasm, or having a partner that is unable to learn to do what is needed to generate orgasms in us. In these situations the remedy is to learn what makes an orgasm happen in yourself by practicing it on yourself (Yes, Joycelyn Elders was right on!) and then communicating this information with clarity and love to your partner. While many partners think they are great at giving sexual pleasure, they may not know what you love the most to have done to you, and they may need to hear that from you. There are great books in bookstores for teaching yourself to become grandly sexual, and for teaching your partner what you need to become jointly grandly sexual.

Low libido is also caused by poor fitness and by low body-self-concept. We are under constant influences in our society that tell us we should look like a playboy bunny, when none of us do. So get content with your aging body. Maybe in therapy. But much more importantly, get fit in your body by exercising, stretching and making that place inside of which you live a proud and fun place to play in. Do whatever it takes to feel physically great, starting with exercise and stretching. Exercising with your partner has the best effects on libido.

If you are menopausal, with no hot flashes, and have low libido and dry vagina, consider vaginal estrogens to make certain that your vagina feels fresh, resilient, moist and happy to play. If your ovaries are working regularly with regular ovulations, then your drop in libido is not because of hormone loss, so consider other life influences. Most women retain their normal libido on oral estrogen alone, but some may benefit from transdermal estrogen (patch or ring) as these routes do not bind the available testosterone. Some women may also need a little added testosterone to get their sexual urges back to their normal. In such cases, testosterone in intermittent and very low doses can help restore libido. A few women will notice mild hot flashes or new onset of mild acne as a side effect of the androgen dose and may want to alternate with a plain estrogen tablet (without androgen) every other day or every two days. If there is no acne, however, then worries about androgen-induced excess facial and body hair, lowering of the voice, balding or clitoromegaly are entirely unfounded. Some women have found improved libido from applying an androgen cream to their clitoris nightly. A 2% testosterone cream can be compounded by local pharmacies. Let me know if we need to talk about this…It is healthy to have healthy great sex, so go for it.