To gain insight into the factors influencing your libido and to understand where you might stand in this spectrum, explore the Decreased Sexual Desire Screener. It's essential to recognize that sexual desire naturally fluctuates over time. What you experience today might not be the same tomorrow.
Factors contributing to sexual desire or lack thereofThe regulation of sex drive is a highly intricate interplay of biological, psychological, and socio-cultural factors. According to Sharon J. Parish, MD, a professor of medicine in clinical psychiatry at Weill Cornell Medical College in New York City, these elements converge to shape one's sex drive. She notes, "All of that comes together to create the sex drive. Some of it is not well understood, but we do know that certain conditions need to align."
Various factors can influence libido levels, including:
1.Abuse of alcohol and drugs
2.Anxiety, stress, and depression
3.Disease or chronic medical conditions
5.History of sexual abuse
9.Quality and novelty of the relationship
What is a normal libido? Is there a "normal" level?
Diagnostic conditions for low libido (hypoactive) and high libido (hyperactive) exist, yet the significance of libido levels—whether high or low—largely hinges on personal perspectives. According to Dr. Parish, "If a couple agrees on once or twice a month or once or twice a week, and that works for them, that’s fine. Even if there is a discrepancy where interests are different, it’s not necessarily pathological. I would only be concerned as a doctor if there has been a sudden change from their own normal."
What to do when your "mojo" is gone? Treating low libidoConsult your internist or primary care doctor for a comprehensive medical evaluation. Various diseases like diabetes, thyroid issues, cancer, and heart problems can contribute to decreased desire.
Discuss any medications, supplements, or herbs you're currently taking to determine if they might impact your sex drive. Some medications, including certain antidepressants like citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), and sertraline (Zoloft), as well as beta blockers and antihistamines, could potentially affect libido. However, alternatives may be available. For instance, bupropion (Wellbutrin) has been indicated in some studies to manage depression without significantly reducing sexual desire.
Inquire about medications that could enhance libido. Flibanserin (Addyi) is the first FDA-approved medication targeting premenopausal women. Dr. Becky K. Lynn mentions, "I have had good response to Addyi in my patients. It won’t give you a sex drive of a 15-year-old boy, but it will make you more receptive." It is primarily used in premenopausal women but has been utilized off-label in post-menopausal women, showing positive outcomes.
For men dealing with erectile dysfunction, sildenafil citrate (Viagra) might be beneficial.
Hormone therapy that can help you get your libido back
When testosterone levels decline, it can result in decreased libido in both genders, often considered a natural aspect of the aging process. Unlike menopause, where the effects of estrogen deficiency are well known, the clinical implications of declining testosterone levels are not fully established.
Here are the treatment options available:
Topical applications like testosterone gel or cream (AndroGel, Testim), or a testosterone transdermal patch (Androderm), can mimic the daily testosterone secretion. Additionally, injections such as testosterone cypionate or testosterone enanthate, which patients can self-administer at home, are viable options.
A newer product is the testosterone pellet, Testopel, which a physician places under the skin of the buttock under local anesthesia. It provides a controlled release of testosterone over three to six months. There is also an oral form of testosterone, Jatenzo, recently approved for use in the United States.
While the Food and Drug Administration (FDA) hasn't sanctioned testosterone supplements for treating low libido in women, substantial research supports its effectiveness, as evidenced in a study published in The New England Journal of Medicine. "Clinicians occasionally prescribe the gel or patch to women for off-label use. As in men, proper dosing and monitoring blood levels can help minimize the adverse effects of testosterone therapy," notes Parish.
Interpersonal problems: causes and solutions"Often, the underlying issue is simply boredom within the relationship. The absence of novelty can be detrimental to human sexuality," says Lou Paget, a certified sex educator affiliated with the American Association of Sexuality Educators, Counselors, and Therapists, and author of The Great Lover Playbook.
Other contributing factors encompass communication gaps, lack of trust and intimacy, unresolved resentments, and body image insecurities.
Many of these concerns can be addressed through open, direct conversations while you're upright rather than in the heat of the moment when lying down. Engaging in discussions such as "These are my preferences, and this is how I feel" can be beneficial. Alternatively, seeking guidance from a trained sex therapist may involve exploring emotional issues that might contribute to sexual challenges through methods like cognitive-behavioral therapy or mindfulness therapy.