Worried about a waning libido? It’s natural for a woman's sexual desire to fluctuate throughout her life. Libido issues can occur at every age. Highs and lows commonly coincide with the beginning or end of a relationship or a significant life change, such as pregnancy, menopause, or illness. Some medications can also lower sex drive.1,2

Still, no matter how natural or common, feeling a loss of sexuality can be distressing. The good news is that various treatments and lifestyle measures exist that focus on restoring libido. 

What affects a woman’s libido?

A woman’s libido is complex. It is influenced by biological, psychological, and social factors. There’s no magic formula to determine what is a “normal” libido. Some women are comfortable with less sex, while others desire more. 

Some of the most common factors that can impact a woman’s libido include:1-5 

  • Stress. Stress takes a toll on physical and emotional health. No matter the cause – work, family, life in general – stress can reduce libido simply because it takes your mind and energy away from being sexual. Long-term stress can disrupt hormone levels, leading to lower libido.
  • Pregnancy and breastfeeding. Hormone changes during pregnancy, just after having a baby, and during breastfeeding can hamper sex drive. Uncomfortable physical side effects and stress during this time can also lower libido – not to mention lack of sleep.
  • Relationship problems. Stress, conflict, or lack of trust within a relationship can extinguish sexual desire. And even in a healthy relationship, sex can become less exciting or desirable over time.
  • Health issues. Health conditions, such as heart disease, arthritis, diabetes, and depression, can lower libido, interfere with the ability to get aroused, and make it difficult to achieve orgasm. 
  • Medications. Although depression and anxiety can lower libido, antidepressant medications can sometimes hamper sex drive as well. Other medications that can adversely affect libido include those that treat high blood pressure and anti-estrogens for breast cancer.
  • Menopause: A decrease in estrogen during menopause can negatively affect libido and the ability to become aroused. Declining estrogen can also trigger vaginal dryness, reduce vaginal elasticity, and cause the vagina to narrow. Unless treated, such symptoms can cause pain during intercourse, further diminishing the desire to have sex.
  • Poor body image. A negative self-image or low self-esteem can result in intimacy issues with a significant other.
  • Birth control. Although not common, oral contraceptives can lower libido. In some cases, they cause chronic irritation in female genitals, leading to decreased sex drive.

Bringing back desire

If you're concerned by a low desire for sex, then consult with a health-care professional. The solution could be as simple as changing a prescription medication or improving a chronic medical condition, such as high blood pressure or diabetes. For many women, a combination of approaches works best to improve libido:1-4

  • Make a plan. Set aside time for date night or other bonding activities. Although spontaneous sex can be fun, having to plan sex might be more realistic. Figure out what needs to happen for ideal conditions, such as a good night’s sleep or the kids staying at their grandparents’ house – and then plan for an intimate evening.
  • Experiment. Massages, changing up sexual positions, and having sex in another part of the house and not the bedroom can spice things up. Vibrators and other sex toys can boost sexual satisfaction and libido.
  • Plan a trip – but leave the kids at home. Plan a dedicated vacation for you and your significant other. Don't go with other couples, which can be a distraction as you try to reconnect.
  • Communicate. Communicating about sex is important. Talking about your likes and dislikes can set the stage for greater sexual intimacy.
  • Enlist the help of a professional. A sex therapist is trained to help individuals and couples tackle sexual problems and enhance intimacy. 
  • Reduce stress. Try stress-reducing techniques, such as yoga or meditation. Finding a better way to cope with stress and daily hassles can reduce the stress you’re feeling, opening the opportunity to prioritize intimacy and sexuality.
  • Start an exercise program. Regular aerobic exercise and strength training can increase stamina, improve body image, lift mood, and boost libido.
  • Address vaginal dryness. Lubricants can reduce friction during sex, while long-term moisturizers can ease vaginal dryness. Both are available over the counter. 
  • Try a vaginal dilator. Under the guidance of a gynecologist or pelvic floor specialist, these devices can gently stretch the vagina when painful sex is due to its narrowing.
  • Investigate the side effects of medication. If a prescription medication is affecting your libido, then speak to your health-care professional about altering the dosage or switching to another medication.
  • Consider hormone therapy after menopause. Sex hormones, such as testosterone and estrogen, regulate libido. Talk with your health-care professional to determine if hormone therapy can address your specific concerns.
    • A vaginal suppository that contains a low dose of estrogen or the hormone dehydroepiandrosterone (DHEA) is sometimes prescribed to treat vaginal dryness and painful sex in menopausal women. 
    • Estrogen is also available in other forms, including pills, patches, sprays, and gels. Your health-care professional will help you understand the risks and benefits of each form.
    • Sometimes testosterone is prescribed off-label for postmenopausal women to help lift a lagging libido, although its use is controversial.

Libido issues can be challenging to deal with and talk about. But remember, fluctuations in sex drive are a normal part of every relationship and every stage of life. Try not to focus all your attention on sex. Instead, spend some time nurturing yourself and your relationship. Feeling good about yourself and your partner can be the best foreplay.

A word from Thorne

Anything that can adversely affect the balance of your vaginal microbiome can in turn adversely affect your libido. Thorne’s Women’s Daily Probiotic promotes a healthy microbial population in both the vaginal tract and the urinary tract.*

References

  1. Women’s wellness: experiencing changes in sexuality around menopause. Mayo News Network.   https://newsnetwork.mayoclinic.org/discussion/womens-wellness-experiencing-changes-in-sexuality-around-menopause/. [Accessed March 1, 2023]
  2. Shifren JL. Sexual problems in females. https://www.uptodate.com/contents/sexual-problems-in-females-beyond-the-basics [Accessed March 30, 2023]
  3. Let’s talk low libido. Mayo Clinic Health System. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/lets-talk-low-libido. [Accessed March 1, 2023]
  4. Low sex drive in women. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/symptoms-causes/syc-20374554. [Accessed March 1, 2023]
  5. Thomas HN, Hamm M, Hess R, et al. “I want to feel like I used to feel”: a qualitative study of the causes of low libido in postmenopausal women. Menopause 2020;27(3):289-294.