October 22, 2017 9 min read

By Catriona Ross, for Women's Health Magazine. Has your sex drive packed up and headed for the hills? Whether the reason’s medical or you simply need the right touch to get into the mood, you’re not alone. So, while having lunch at your desk, you suddenly you recall how your man’s chest looked when he stepped out of the shower this morning, sculpted and glistening. Maybe he’ll be up for sex when he’s home from work, you speculate. I could greet him wearing only high heels… You’re smiling, already glowing with the mere anticipation of sex. Sound familiar? Well, probably not, since statistics show that the norm for many women, especially those in long-term relationships and those with kids, is that they’re generally not in the mood for sex. The National Health and Social Life Survey, published in the US, showed that approximately 32% of women surveyed had experienced lack of libido. Alexia* used to be proud of her healthy sex drive. An attractive working mom in her thirties with a five-year-old son, ruggedly hunky husband and a love of fast cars, she says her lusty libido has waned over the years and, at times, disappeared completely. ‘I had a lot of resentment towards my husband at one point and I didn’t want him to touch me with a barge pole. Also, having a child definitely affected our sex life and my libido. Eleven years into our relationship, the passion has gone in the bedroom,’ she admits. There’s a multitude of physiological and psychological reasons why we may lose interest in sex, from high blood pressure to insufficient blood flow to the clitoris, to domestic boredom – but low libido may also simply be the standard mode for women in long-term relationships, experts believe, and your best bet is to cultivate an open mind.

When medication messes with your mojo

‘A few years ago, when I went onto antidepressants, I completely lost my libido, and yes, my husband did complain,’ says Jenna*, 34. ‘I couldn’t feel anything; it was like a local anaesthetic to my nether regions. The medication worked for the depression but not for my sex life: I didn’t want to have sex at all, but we were trying for a baby, so I had sex anyway. Mentally, I couldn’t function properly on this medication either. I told my psychiatrist, and as soon as he changed me to a different type of medication, things came right. It took about two weeks for the new medication to work and the old one to wear off – and all sensation came flooding back. It was lovely!’ Certain prescription antidepressants have a dramatic affect on one’s sex drive; a US report suggests that 33% of women taking antidepressants will experience a loss of libido and difficulty achieving orgasm. ‘The standard class of anti-depressants, SSRIs such as Prozac, are terrible for your libido as they affect your sex hormones,’ says Dr Elna Rudolph, sexual health physician and head of MySexualHealth.co.za. Other drugs that may suppress your sex drive include antipsychotics, antiepileptic drugs, antihypertensives and diabetes medication, antihistamines taken daily (for hayfever, for instance) and pain medicine that’s taken daily. Of course, not taking medication you need, whether it’s for diabetes or depression, is dangerous, and potentially damaging to your libido. Depression, for example, affects your brain hormones, reducing levels of dopamine which affects your drive in general and therefore lowers libido. Beware the contraceptive connection. ‘The better your Pill is for your skin, the worse it is for your libido,’ warns Rudolph. ‘The same applies to the patch, and the injection is the worst of all.’ As the authors of a 2011 US study into the Pill’s effects on clitoral and vulvar sensation explain, many women taking low oestrogen-dose combined oral contraceptive pills (OCPs) complain of decreased libido and arousal. OCPs result in decreased biologically-available testosterone, an important factor influencing female sexual drive. In the study, those women on OCPs were found to have significantly lower levels of free testosterone – approximately 38% lower – than those not on OCPs. What you can do about it:According to Rudolph, anti-depressants such as Agomelatine, Bupropion and Trazodone have a neutral effect on the libido, but it’s essential to consult a professional before changing your prescription. Libido-wise, a better contraception option is the vaginal ring called the Nuva ring, the new oral contraceptive Qlaira, or Mirena – the T-shaped, hormone-releasing intrauterine (IUD) device, which works by not allowing sperm to enter the uterus and doesn’t affect your natural testosterone levels, although that’s not guaranteed for everyone, and it costs a few thousand rand. A copper T IUD device costs approximately R80 and doesn’t influence libido, but increases bleeding significantly, she adds.

The downside of having a baby

Tara*, 34, has been with Jerry* for seven years. They have a toddler, and she’s five months’ pregnant with their second child. ‘Sometimes I wonder, “Will I ever be up for sex again?” she sighs. ‘For the first year after our son was born, I was desperate for sleep, with just enough energy to survive each day; sex was superfluous. Each night I’d go to bed anxious, worrying about how many hours of sleep I could get before the baby woke up. I was so not available at night – night was sacred, for sleeping – so if we had sex, it had to be in the daytime.’ ‘I felt resentful of Jerry, and I know he felt rejected, that I loved our baby more than him. We had our son in our bedroom for over a year, then we realised we needed to reclaim the marital bed and moved into the guest room downstairs, where we did have some fun times.’ Pregnancy and new motherhood are legendary libido killers – after all, ‘you’ve moved from being primarily a lover to primarily a mother,’ Rudolph notes. The strong hormonal changes associated with pregnancy and breastfeeding, combined with sleep deprivation and being under so much stress, will cause the natural libido to be suppressed in most women.’ What you can do about it: Make the marriage, and sex, a priority, Rudolph advises. ‘Take time out from your baby, make yourself look pretty and go on a date.’ It also helps not to have your child sleeping in your room. But don’t panic about the lack of sex, she says: ‘You could also choose to see yourself as just giving sex a break for a few months.’

When you’re programmed that way

Some people are genetically less wired for sex than others. Cherie*, a confident, outspoken woman in her forties, says, ‘I’ve never been interested in sex; once a month would be more than enough for me. This caused problems in my marriage almost from the start, especially after we had our two children. I’ve faked more orgasms than you can believe! I’m very independent, and my husband’s controlling ways also made me resentful, which had a huge impact on my already low libido. We had no sex for the last three years of our marriage. He’s a very good man – he remained faithful all those years and still loves me, but I can’t give him what he wants. I’ve been celibate for five years now and do not miss a sexual relationship at all, although I get plenty of opportunities. I like living alone; however, I miss the sharing, the closeness, the cuddling up in bed that a relationship brings. My ideal relationship would be with a man who doesn’t live with me, and who shares my low libido.’ What you can do about it: ‘Sex is all about hormones, and if your hormones aren’t in balance, you’re fighting a losing battle,’ says Rudolph. As a physician, her first approach with a patient is to stabilise her hormones to help her feel good, then suggest lifestyle changes. She runs through possibilities: ‘It could be more oestrogen, progesterone, testosterone, dopamine, being on the wrong pill, being menopausal.’ Also, be realistic about who you are. ‘If you’ve never been interested in sex, the chances of your becoming a nymphomaniac are not great,’ she says.

Body image blues

When you look in the mirror, do you see only your flaws? If so, chances are you’re obsessing over them in bed too. Women are generally very self-conscious about their bodies, explains clinical sexologist Catriona Boffard: if you have a negative view of your body, you probably won’t feel sexy and confident naked, ‘and it’s therefore less likely that you’ll want to take your clothes off in front of someone, even a long-term partner.’ For a woman, sex is about an emotional connection and feeling safe with your partner, she says. ‘Negative body image can have a direct impact on your libido by hindering your feelings of openness and emotional safety – even if your partner repeatedly tells you how beautiful you are.’ Lizette*, 27, says, ‘Last winter I picked up weight, and then put on more while on holiday in Mauritius. My boyfriend, Jaco*, and I stayed in a hotel where there were buffets, and we ate. My butt is big, man! I can feel my thighs are bigger, and I have cellulite. We were on beaches with people prancing around in their bikinis, and I felt self-conscious and not so attractive and sexually desirable. I need to feel that he desires me, as that turns me on. It’s affected my sex drive; I’ve told Jaco when I’m just not feeling it. He’s sporty and in good shape and he’s learnt not to say anything about my appearance. But when I complained recently about putting on weight, he said, “Maybe exercise a bit more? Go walking?”, whereas I wanted him to say, “You look fine,” and not try to fix me.’ What you can do about it: Get to know your body, intimate bits included, Boffard advises, as ‘understanding your body can help you feel more confident in your own skin. If keeping the lights on isn’t your thing, but your partner wants to see you, light candles and wear a sexy satin slip or lingerie that makes you feel more confident.’ But if deep-seated body issues from childhood are blocking you, book a few sessions with a psychologist.

Maybe you’re normal

For many women, feeling spontaneously horny is the exception rather than the norm, Rudolph says, so don’t think you’re abnormal or ill. Low libido may be a symptom of your too-rushed lifestyle: ‘Busy women see sex as a frivolous activity, so it slips down on your priority list, unless you realise how good it can be, and you see it as a form of stress relief.’ And perhaps it’s time the world stopped regarding low libido in women as a dysfunction. No, we don’t wake up with ‘morning glories’, but we certainly can get into the mood, given the right treatment. For us, the traditional male model of sexual functioning (first you feel horny, then you have sex) isn’t true. First, we need some sexy stimulation, then we start feeling like it. This alternative ‘circular model’ of female sexual response presented by Dr Rosemary Basson, a clinical professor in the department of psychiatry and director of the University of British Columbia Sexual Medicine Program: ‘…many of us, while sexually healthy and satisfied, agree they frequently begin a sexual experience sexually neutral,’ she wrote in a 2001 paper. Also, women consider that attraction, passion, trust and intimacy are more significant than their genital response, according to research by British biomedical scientist Dr Roy Levin. So, we need to feel happy in a relationship to have good sex – or any sex at all! What you can do about it: ‘If you’re a low-libido woman, don’t let sex go out the door,’ advises Rudolph. ‘Find ways of doing it for your own reasons, or you’ll eventually hate it if you’re only doing it for your husband’s sake. Besides, men hate “pity sex”; they want their partners fully involved.’ Make time to feed your brain, perhaps with movies or erotic literature that conform to your value system. (Don’t expect hard-core lesbian porn to excite you if you’re more of a romantic Mills & Boon type). This creates positive pathways in your brain regarding sex, making it easier for spontaneous desire to arise, Rudolph explains. A holiday or weekend away can work some sexy magic, as your mind isn’t cluttered with daily To-Do lists. Anxiety is a passion-killer: overthinking problems causes an overproduction of cortisol, which can actually make sex painful. It helps to accept that you often won’t feel like sex, but stay open to sensitive, satisfying stimulation from your partner that’ll warm you up. Says Rudolph, ‘If, after foreplay, you don’t get in the mood, you can either disengage – or choose to continue with sex because it’s a fun, intimate thing to do, using lube if you’re unlubricated, or participate in a sexual encounter without penetration.’ Teach your man how to touch you, and know where each others’ arousal hotspots are. Melissa*, 30, says, ‘My boyfriend used to do this really deep massage on my buttocks and my inner thighs, which was such a turn-off for me; the lightest, feather-like touch is what gets my erogenous zones going. It took me years to actually tell him.’
*Names have been changed.
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