Symptoms of Low Sex Drive in Women, and Treatments Options

By: Darlene Gaynor, DO, FACOS

You might not think about your bladder when you’re preparing to get intimate. But for the many women who experience low sex drive, the bladder just might be the problem.

Urology-related conditions, including those of the kidneys, bladder, urethra, and pelvic floor, can contribute to low sex drive in women. Typically, this is due to painful or distressing symptoms. But it’s not unusual.

More than one in five women experience a low sex drive sometime in their lives, and many do more than once. But long-lasting or recurring low sex drive in women could be caused by symptoms of urological issues.

These underlying conditions can be addressed with a urologist or urogynecologist, yet just 42% of women who experience sexual problems seek treatment, according to the AARP.

Here’s why a urologist or urogynecologist can help.

How the Urinary System Can Lead to Low Sex Drive in Women

A woman’s urinary tract and sexual organs might operate separately, but they’re physically close – all nestled in the pelvis. In fact, the urethra, which is attached to the bladder, is part of the female genitals.

This proximity means symptoms of a urinary condition, such as an infection, can interfere with sexual desire by causing discomfort, pain, and a lack of confidence.

When low sex drive in women is long-lasting or recurrent, doctors refer to it generally as sexual desire disorder. An estimated 10% of all women experience at least one episode of sexual desire disorder, and nearly one-third of women may experience it for several months.

Key symptoms of low sex drive in women, other than low libido, are:

• Inability or difficulty getting aroused
• Pain during intercourse
• Anxiety and sadness when thinking of sex
• An absence of sexual thoughts or fantasies
• Cannot achieve orgasm or enjoy sex

Urinary Issues that May Trigger Low Sex Drive in Women

One of these four urinary conditions can be behind the symptoms of sexual desire disorders, as well as occasional low libido in women.

Loss of Natural Lubrication

The female sex hormone estrogen manages the menstrual cycle and produces lubricants that keep the vaginal walls elastic. When a woman enters perimenopause, her estrogen levels decline and she loses that lubrication, which can make sex painful. Prolonged sexual avoidance, as a result, can cause vaginal atrophy marked by inflammation, thinning, and dryness.

Treatment pathways include: As a first step, we advise pelvic muscle exercises (Kegels), to help strengthen the vaginal walls. Also ask about topical vaginal estrogen, which you can self-apply, and physical therapy. Natural lubricants such as coconut oil, sunflower oil, and shea butter also might help.

Urinary Incontinence

Up to half of all adult women experience urinary leakage, or incontinence, which can diminish sexual confidence. It occurs in two ways: stress incontinence, leakage caused by sudden abdominal movements such as sneezing, coughing, and laughing; and urge incontinence, or overactive bladder (OAB), the immediate and frequent need to go.

Treatment pathways include: Your care depends on the type of incontinence. Non-invasive approaches include Kegels, biofeedback, estrogen therapy, injections (Botox to relax the bladder muscles or Bulkamid to strengthen the urethra), and disk-shaped vaginal pessaries to support the base of the bladder.

Pelvic Prolapse

The muscles in your pelvis support the uterus, bladder, and bowel. If your body changes from giving birth, menopause, and/or advanced age, these muscles can grow weak and the body parts can slip into the vaginal canal, potentially bulging out. Close to half of all women ages 50 to 79 live with this condition, called pelvic floor prolapse.

Treatment pathways include: Kegel exercises, vaginal pessaries to hold the organs in place, and estrogen replacement therapy that strengthens the vaginal muscles. Surgically, the organs can be lifted back and secured with your own body tissue or mesh.

Attacks of the Urinary Tract

Urinary tract infections (UTIs) and painful bladder syndrome (interstitial cystitis or IC)can generate enough pain to make intercourse uncomfortable. Symptoms of UTIs – bacterial infections of that can spread as far as the kidneys – include frequent and burning urination. Signs of IC, which is caused by inflammation, bacteria, or an auto-immune dysfunction, include pain that can make sex hurt.

Treatment pathways include: For UTIs, you can ease symptoms with plenty of fluids, antibiotics, and vaginal lubricants or estrogen creams. You also can take supplements designed to improve urinary health, including vitamin C-fortified cranberry pills and D-Mannose, as well as probiotics. For IC, options include oral medications (often in combination to treat varying symptoms), biofeedback, Botox injections, and bladder retraining.

Other Factors Behind Low Sex Drive in Women

Drug side effects – Some medications, including those for depression, cancer, and seizures, can affect female hormones and sex drive. Ask your doctor about alternative drugs or reduced dosages, as well as about potential medications that might improve libido.

Mental or emotional strain – Depression, fatigue, and low self-esteem can make you uncomfortable in your body and shut down thoughts of intimacy. Therapy, including sex therapy, may help.

Alcohol consumption – A drink is fine, but too much alcohol can diminish your sex drive. Replace that second drink with a walk – regular exercising can improve your mood, body image, and libido.

Your Sex Drive Is Your Business – So Is Your Treatment

Some women prefer not to have sex, and that is their lifestyle prerogative. But if you experience any of the above symptoms, you should see a specialist to address potential medical conditions.

The urologists and urogynecologists at MidLantic Urology can help answer your sexual and urinary health questions, from your bladder to your pelvic floor.

You can read more about women’s urological and sexual health on our website. To find a doctor near you, visit our MidLantic Urology providers page, where you can learn how to schedule an appointment.