DEAR DR MITCHELL,
I am 43 years old and have two children. They say that women my age should have a high libido, but I have no desire for sex at all, and this is causing a problem in my marriage. I could go months without feeling interested, to be honest. I'm not on birth control, not on any medication, and had my tubes tied after my last child. My only medical issues are anxiety and depression, but even when I'm not feeling depressed, I still have no interest in intimacy. Is there any medication that could help me?
The problem that you are experiencing with a low sex drive is a common problem that is seen in both men and women. This problem sometimes worsens as you grow older if the underlying problem is not addressed properly.
It is important to seek medical advice to determine the underlying cause of the low sex drive. A complete pelvic examination to check for physical changes, including thinning of the tissues of the vaginal wall, vaginal dryness, and tender areas in the vagina which can trigger pain during sexual activity, should be conducted. You should also get a blood test to check your hormone levels and check for thyroid problems, diabetes mellitus, high cholesterol, and liver problems. It might also be helpful if your doctor refers you to a counsellor or sex therapist who will help to determine if there are relationship and emotional problems that are contributing to your low sex drive.
Talking with a sex therapist and dealing with the problem of your low sex drive can actually help. The sex therapist or skilled counsellor will include education about your sexual response and techniques. Dealing with relationship issues can also help to increase your feeling of intimacy and sexual desire.
Some antidepressants, such as Paxil and Prozac, can decrease your sex drive. Switching to a different type of antidepressant such as Wellbutrin usually helps to improve your sex drive. The use of medications to boost your sex drive, especially if you are premenopausal, can help. This may be in the form of a pill taken once daily at bedtime or an injection that you will give yourself under the skin in the belly or thigh just before sexual activity is anticipated. There may be side effects associated with these forms of treatment and the use should only be undertaken if your doctor recommends it. Those medications are not approved for older postmenopausal women.
The use of an oestrogen and testosterone containing preparation can reduce vaginal dryness and increase your sex drive. These preparations are contraindicated in some women, especially if you have had breast cancer or at high risk for developing breast cancer, and should only be used when prescribed by your doctor who has done a proper evaluation of the risk factors.
Lifestyle changes can help to increase your desire for sex. Regular exercise, including aerobic and strength training, can increase your stamina, improve your body image, lift your mood, and boost your sex drive.
Decreasing your stress levels by finding ways to cope with work stress, financial stress, and keeping up with the daily demands can improve your sex drive. Improving communication with your partner in an open, honest way will improve your emotional connection. Talking about your likes and dislikes about sex can improve your sexual intimacy. Making intimacy a priority by scheduling sex into your daily routine can improve your sex drive.
It is also important to change your routine to reduce the boredom. Smoking, the use of illegal drugs, and excess alcohol can dampen your sex drive, so getting rid of these habits can help in boosting your sexual energy.
The use of over-the-counter herbal supplements can have side effects or interact with other medications that you are taking so you should always discuss this with your doctor before using them.
Low sex drive can cause problems for both you and your partner and lead to feelings of rejection which will further reduce your sex drive. Try not to focus all of your attention on sex and spend more time caring for yourself and improving your relationship.
Spend more time together and create time to go out on date nights. This will make you feel good about yourself and your partner and improve your sex drive.
Consult your doctor and make an appointment for both you and your spouse to discuss the problem and the best way forward.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to email@example.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
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