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The loss of desire can lead to relationship issues for many Indian women. Learn how to get your mojo back!
Is sex a chore rather than a pleasure? Do you think of ways and means to avoid sex? Is your sexual frequency with your partner once a month or less, and you would rather not do anything to improve your low sex drive? You might just be suffering from low libido.
Dr. Sulbha Arora, MD DNB, Scientific Director, Rotunda Blue Fertility Clinic says, “According to some studies, almost 40% of women experience low libido some time or the other. However, very often the cases are under-reported as women are not comfortable seeking treatment or consulting a doctor for this problem. Many do not even acknowledge the problem to themselves. Busy doctors and insensitive support staff complicate the issue.”
According to a survey conducted at the University of Chicago, the most common sexual problem in women is Hypoactive Sexual Desire Disorder (HSDD), more commonly referred to as low sex drive or libido (33.4%), followed by difficulty with orgasm (24.1%). Pain during intercourse – which occurs in 14.4% of women, was the only condition to show a relationship to age; it decreases as women get older.
HSDD is defined as a deficiency or absence of sexual fantasies and desire for sexual activity by the American Psychiatric Association (APA). Interestingly, libido is tied with happiness for women. Happier women think more often about sex than unhappy women. While this is a much debated issue, it is believed that the female libido is not driven purely by the physical, but upon a host of other factors as well.
Female sexual dysfunction usually needs a mix of counseling and medication, to be determined by a gynaecologist/sexologist upon consultation. Says Dr. Arora, “The main symptom is a low or absent desire for love making. However, this is something that is not easy to define and it cannot be quantified. What is low for one woman may have always been normal for another. Even between two partners, one may not always feel like having intercourse or even physical intimacy as often as the other. That does not always mean that one is normal and the other is not. Also, sexual desires fluctuate depending on moods and circumstances. Approach your doctor if your lack of sexual desire is beginning to bother you.”
Even between two partners, one may not always feel like having intercourse or even physical intimacy as often as the other. That does not always mean that one is normal and the other is not.
Some of the key physical causes of low libido in women are:
– Chronic diseases like diabetes, cancer, high blood pressure, kidney diseases and coronary artery diseases
– Medications like blood pressure medicines, antihistamines, antidepressants, antipsychotic drugs, chemotherapy drugs and even birth control pills
– Being clinically obese or severely underweight and thereby having an imbalance of sex hormones
– Pain during intercourse (dyspareunia)
– Surgeries on the breasts or genital tract
– Hormonal changes that take place premenstrually (PMS), during menopause and during pregnancy/breast feeding
The lack of estrogen after menopause tends to make the vagina dry and less elastic, making intercourse painful and unpleasant. This adds to the mood swings that some women may experience, further decreasing the desire for sex. Over the counter vaginal lubricants will help tackle this problem.
Adds Dr. Arora, “During pregnancy and lactation, it is not only the hormonal changes that can cause lack of libido. It is aggravated by fatigue, low self esteem due to weight gain and compounded by psychological factors if the wife feels the husband does not help her in looking after the baby and comes to her only when he needs sex.”
While loss of libido after childbirth usually resolves itself in a few months, in some cases, when coupled with Postpartum Depression, it can continue for years unless the woman seeks medical assistance.
Apart from physical causes, low libido could also be due to psychological causes. According to Dr Arora, “In most cases low libido stems from psychological causes (anxiety, depression, work stress, fatigue, low self esteem, history of sexual abuse in the past) or relationship issues (ongoing fights at home, problems with the husband or in-laws, poor communication of sexual preferences, suspicion of infidelity etc).” It could also be the result of psychological stressors like stressed out urban lives, multitasking, exhaustion and lack of adequate sleep. Indian women who have experienced sexual or emotional abuse through childhood or have had abusive relationships are also susceptible.
The first step to take if you suspect low libido is to consult your family doctor or talk to your gynaecologist. They should go through the possible medical causes, change medications or prescribe blood tests to figure out if the cause is physical. Simple things like prescribing iron tablets for low iron levels which can impact libido.
Dr. Arora states, “Unfortunately there is no simple pill that women can just pop, forget about their problems and get their sex life back to normal. The treatment therefore depends on identifying the underlying problem and treating that first. If the culprit is an underlying medical disorder such as diabetes, it should be treated first. If the cause is medication, it would need to be changed. Gynaecological problems such as endometriosis can cause painful intercourse and lead to lack of libido. This condition can be diagnosed by your gynaecologist and treated by laparoscopy or GnRH analogue therapy. If it is due to recent weight gain, then dietary modifications and an exercise regime would help. Even 3-4 kg of weight loss can make a remarkable difference to the way you feel about yourself and boost your confidence.”
Unfortunately there is no simple pill that women can just pop, forget about their problems and get their sex life back to normal. The treatment therefore depends on identifying the underlying problem and treating that first.
If hormonal imbalances are detected, the gynaecologist could prescribe hormonal therapy to treat this. Continues Dr. Arora, “Hormonal treatments include estrogen patches or sometimes testosterone replacement therapy. However, the incidence of side effects is high and it needs to be closely monitored under medical supervision.”
If all physical causes are ruled out, you might be asked to consult a therapist or a counselor. Common relationship problems like control issues and lack of intimacy might be the causes. The therapist might assign you some home assignments to enhance communication and intimacy levels and may recommend using sexual stimuli or fantasizing to help improve libido levels. If low libido levels are the consequence of childhood abuse, trauma or conditioning, doctors would recommend psychotherapy.
Concludes Dr Arora, “Often the remedy just involves the husband and wife communicating with each other and discussing their problems. They could take a small holiday together where they can spend some time with each other alone, away from the hustle & bustle of everyday life, work & in-laws. This can work wonders to rejuvenate their relationship. If this is not always possible, they should at least try and take some time out for intimacy and just being with each other. Sometimes just talking about it helps.”
Don’t let the lack of sexual desire deprive you of fun or drive a wedge between you and your partner. Sex is a natural function and essential to a healthy relationship. Get the right treatment and have the will to work through this together with your partner’s support and hopefully, low libido will soon be a thing of the past.