Jessica had always had a good relationship with her husband. They were truly partners and had built a life together that was full of love and adventure. For years, they had a fire-filled romance, and sex was a common feature—part of the landscape of their lives. But recently, something had changed. While her husband’s desire never waned, Jessica felt her sex drive slipping away until it nearly disappeared entirely.
There was no obvious cause. She was not bored with her husband. She didn’t find him less attractive as the years went on. She wanted to want sex. But she just didn’t. Was it an inevitable part of aging? Did desire naturally die out over the course of marriage? Was that chapter of her life closed? This disappearance of her sex drive left her feeling alienated in her relationship and unsure of who she was. She felt isolated in a way she had never before experienced.
But she wasn’t alone. Nearly 1 out of 3 women between the ages of 18 and 60 experience a diminished or lost appetite for sex, often with painful emotional consequences. Unfortunately, too many women suffer their loss of desire in silence, ashamed to seek help or not knowing where to begin. But today there are more types of treatment for low sex drive in females available than ever before—including hormone therapy—and more practitioners who understand the importance of restoring desire.
If you are struggling with low sex drive, understanding the underlying causes of your feelings and seeking the right supports can give you back your sense of self and allow you to be the person you want to be.
The Pain of Low Sex Drive in Women
For most of us, sex is part of who we are. It is part of how we relate to others and bond with our partners. It is part of our identities, informs how we understand ourselves in the world, and shapes our experiences throughout our lives. That’s why losing your sex drive can be so devastating; it can change the way you see yourself and alter your most important relationships in fundamental ways. It can feel like a loss of personal autonomy and a betrayal by your own mind and body.
Understanding why your sex drive is falling often involves taking an honest inventory of your emotional and physiological health as well as the health of your relationship—all of which can be difficult when dealing with such a deeply personal and sensitive issue. But while such self-examination may be intimidating, it is critical to helping you find the right path for moving forward.
Causes of—and Treatment for—Low Sex Drive in Females
Determining what constitutes a low sex drive is not easy. What is a low for one woman could be considered normal by someone else—that’s all part of the panoply of human sexuality. However, if you are experiencing less desire than you want, that may be cause for concern, and the reasons behind your lack of desire should be explored.
Of course, there are virtually endless reasons for sex drive to diminish. However, most can be broken into four broad categories.
This is, admittedly, a complex one. For some couples, sex is just not a big part of the relationship. For others, however, a lack of desire arises from problems within the relationship itself. Often, these issues involve:
- Lack of communication about sex
- Lack of trust
- Unresolved issues
- Poor overall communication
All of this can make sex seem unpleasant, make you feel distant from your partner, and can lower your sex drive. Sometimes these issues are evident right away; sometimes they take years to develop. Either way, they must be addressed in order to repair your relationship and allow you to have a healthy sex life.
Individual therapy and couples counseling can be invaluable to resolve relationship issues that are interfering with a fulfilling sex life. With the support of a compassionate therapist, you can gain a deeper understanding of yourself and your partner, learn new skills to improve your partnership, and resolve conflicts in a way that is healing for both of you.
Illnesses, medications, accidents, and physical changes can compromise your sex drive—sometimes unexpectedly. These include:
- Medical conditions. Many medical conditions—including arthritis, cancer, diabetes, high blood pressure, coronary artery disease, and neurological issues—can lower sex drive as an unexpected side effect.
- Substance use. Drugs, alcohol, and nicotine can all lead to lowered sex drive, especially after chronic, long-term use.
- Exhaustion. Long days at work, intense childcare, terrible commutes—when you’re exhausted, sex often takes a backseat.
- Surgery. Surgeries can lead to physical discomfort as well as self-image issues that strip you of your desire for sex.
- Medication. Many medications, including SSRI antidepressants, can drastically reduce sex drive and interfere with your ability to experience orgasms.
When physical issues interfere with sex drive, there are often no easy answers. This is particularly true when it comes to those that are intimately tied to psychological issues. However, it is important to talk to your doctor about how your medical condition or treatment is interfering with your sex drive; they may be able to create a treatment strategy that allows you to restore your desire.
Psychological issues, including mental health disorders and trauma, can have a significant impact on sex drive. The following can all be psychological barriers to sexual desire:
- Stress (work, money, family, social)
- Low self-esteem
- Body dysmorphia or other body image issues
- Sexual abuse history
- Negative prior experiences with sex
- Other mental health disorders
Seeking the guidance of a mental health professional is critical to both addressing your underlying psychological issues and renewing your sex drive. Depending on the specific issue, treatment may involve medication, psychotherapy, group therapy, and/or mind-body practices that help you cope with stress, deal with trauma, and help you develop a healthier relationship with yourself.
Hormones are undeniably a part of physical health, but they play such a central role in human sexuality that they deserve a category unto themselves. Estrogen, progesterone, and testosterone—and the interplay between them—all impact your sex drive throughout your life. When hormone levels drop or become disproportionate, your ability to experience sexual desire may be significantly compromised.
As a woman, you can expect to experience a number of significant hormonal changes throughout your life that may cause low sex drive, including:
In addition to these, you may experience a wide variety of other hormonal fluctuations and imbalances that interfere with your desire for sex. All of these may also make you more vulnerable to the effects of other phenomena that diminish your sex drive.
Hormone replacement therapy is widely recognized as the best treatment for perimenopause and menopause symptoms as well as many hormone imbalances affecting women. Typically, this treatment involves supplementing your body’s supply of estrogen and/or progesterone to restore hormonal balance and alleviate symptoms, including low sex drive.
Women who are experiencing perimenopause or menopause may need hormonal support even if hormones are not the primary cause of diminished sexual desire. In these cases, restoring hormonal balance can allow you to fully benefit from other treatment modalities by ensuring your body is able to respond in a healthy way.
While hormone replacement therapy can be a life-changing option, there is no one hormonal cure. That’s why it is crucial that you connect with a practitioner who specializes in hormone health and hormone replacement therapy. They will conduct the assessments needed to determine the best course of action and create a treatment plan tailored to your unique needs. They can also provide nutrition and fitness counseling and support you as you make any lifestyle changes necessary to facilitate greater hormonal balance.
Taking the Next Steps
Sex is not trivial. It is a core part of who we are and how we relate to the world around us. If you are struggling with low sex drive, do not hesitate to reach out for help. By getting the physical, hormonal, or psychological help you need, you can regain your sexual energy and desire and rebuild intimacy. Most of all, it can connect you with the person you want to be—and the person you want to be with.
If you are struggling with low sex drive related to hormonal changes, BodyLogicMD can help. The BodyLogicMD network is comprised of top medical professionals specializing in hormone health and hormone replacement therapy. A BodyLogicMD-affiliated practitioner will design a personalized treatment plan to address your symptoms and help you achieve your health goals using the best therapies available today. Contact a local practitioner to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz today.
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.
Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.