Where Did My Sex Drive Go? Wellness Tips for Women

By: Teodora Schellato, D.O., FACOS

One of the surprises of living a long life is that, with each passing year, our bodies tend to do something a little unexpected. For women, some of these changes involve something their ancestors rarely experienced: a longer sexual lifespan.

Back in 1850 (when Philadelphia was the fourth-largest city in the United States), a newborn girl had a life expectancy of about 39 years. Today, that same girl’s descendants can expect to live to 81 or longer. As a result, women now experience more years of sexual health changes.

As a woman’s body ages, it goes through stages that can affect sex drive. Menopause, for example, lowers levels of estrogen, a hormone that plays a key role in libido.

Low libido is common. Up to one in three women between the ages of 30 and 59 experience it at some point, compared with about one in five men. Yet only 42% of women seek treatment, according to AARP.

The good news is that changes in sexual desire are often treatable, and many women can regain a satisfying level of intimacy.

How to Tell If Your Sex Drive Has Changed

The most obvious sign of low libido is a reduced interest in sex. But it’s important to consider whether the cause is physical, emotional, relational, or lifestyle-related.

Other signs may include:

• Lack of interest in any sexual activity, including masturbation
• Fewer sexual thoughts or fantasies
• Reduced physical sensation during sex
• Distress or concern about decreased desire

These symptoms can point to social or psychological factors, such as performance anxiety, depression, or fatigue.

Physical Factors That Can Affect Sexual Health

Several medical conditions and physical changes can also interfere with libido, including:

• Chronic conditions such as diabetes, kidney disease, arthritis, and heart disease
• Certain medications, including antidepressants, blood pressure drugs, and cancer treatments
• Overactive bladder or incontinence, which may cause anxiety about leakage during sex
• Painful bladder syndrome (interstitial cystitis), which can make intercourse uncomfortable
• Vaginal dryness, often related to menopause
• Pelvic floor weakness, a condition in which the bladder, uterus, or upper vagina shifts out of position, sometimes making sex uncomfortable

Pelvic floor weakness is especially common, affecting up to 65% of women at some point in their lives.

Choosing the Right Treatment

If these symptoms sound familiar and you want to improve your sex life, there are several treatment options to consider:

• Pelvic floor exercises
  Kegel exercises can strengthen pelvic muscles, improve blood flow, enhance arousal, and reduce symptoms of incontinence.
• Medications and hormone therapy
  Prescription medications such as Addyi and Vyleesi may help treat low libido. Hormone replacement therapy can address menopause-related changes, while topical vaginal estrogen can relieve dryness and discomfort with fewer systemic effects. For conditions like painful bladder syndrome, treatments such as pelvic floor therapy or Botox injections may help reduce pain.
• Pessaries or surgery
  For pelvic organ prolapse, a pessary (a small device inserted into the vagina) can provide support. In more severe cases, surgery may be considered as a long-term solution.

MidLantic Urology offers a range of treatments for conditions that may affect libido. The first step, however, is starting a conversation with a healthcare provider. Urologists and other specialists treat these concerns every day, and effective help is available.

Interested in learning more? Read our recent blog on how urinary issues can affect sexual pleasure here. Find a convenient location to schedule an appointment with a specialist.