Every few weeks, Dr. Vanessa Cullins, a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America, will be answering your questions here. To ask her your own question, click here.
Dear Dr. Vanessa,
Is there a safe, medical way to improve my libido? Is there a Viagra for women? I want to want it, but I just don’t. (I’m married, 40, with a kid.)
–Sparkless
Dear Sparkless.,
In the United States, lack of sexual desire is more common in women than in men. Some surveys in the last 15 years suggest that as many as one out of three women experience it some or most of the time. The causes can be complex. Often there is more than one cause. Here are a few of the possibilities:
- Situational causes: Many women have too many things to do during the day and are just too tired to entertain sexual fantasy and become aroused. Challenging stresses at work, in relationships, or in their families can also dampen sexual desire. Some women find that their potential partners are not very attractive.
- Psychological causes: Some women have sexual histories that include sex-negative family attitudes, sexual assault, sexually indifferent partners, painful intercourse, or other experiences that can inhibit sexual desire. Some women suffer from depression, which can reduce sexual desire.
- Medical causes: Certain medical conditions, like diabetes, or side effects of certain medications, like some depression medicines, can inhibit sexual desire. (When lack of sexual desire is a side effect of a medication, your health care provider may be able to prescribe an alternative medication.)
- Hormonal causes: Women may not have enough of one or both of the two key hormones associated with the sex drive in women. The first is estrogen. The second is testosterone, which is also associated with the sex drive in men. Natural or surgical menopause is the most common cause of such hormonal depletion.
Identifying the cause of lack of sexual desire is important to successful treatment. Start with your current health care provider to evaluate the possible medical or hormonal causes. To explore other causes and solutions, you could turn to a psychotherapist experienced in sexual issues or to a qualified sex therapist. The American Association of Sexuality Educators, Counselors, and Therapists has a list of certified sex therapists. Or your health care provider may be able to give you referrals.
If a woman is postmenopausal and no other causes are found, the first line of treatment is estrogen replacement therapy. If a woman has sufficient estrogen (for example, if she is premenopausal or if she is postmenopausal and is taking estrogen) and she has no other cause for lack of sexual desire, her physician may suggest trying testosterone supplements — creams, gels, injections, pills, or skin patch. This therapy has been successful for some postmenopausal women. More long-term studies are being published about potential benefits for postmenopausal women, but no testosterone product has been specifically FDA-approved to increase a woman’s libido to date. A few small studies have found testosterone may help premenopausal women, too. Whether pre- or postmenopausal, there are possible side effects to watch out for. So you and your doctor want to consider the testosterone alternative carefully.
Whatever the causes, thousands of women have found ways to rejuvenate sexual desire in their lives, and they have found that the effort it takes is very worthwhile.
Best wishes for finding a solution and for continuing good sexual health,
Vanessa
Planned Parenthood
Vanessa Cullins, MD, MPH, MBA, is a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America.
