Sex Drive (Libido)

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• QDoes testosterone affect a woman's libido?

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  A Dr. Jan L. Shifren, MD , Reproductive Endocrinology, answered

  Many people don't realize that women also produce testosterone naturally, and this hormone affects libido in women as it does in men. The natural decline of testosterone that accompanies aging can affect a woman's sexual responsiveness, although a clear link has never been found between testosterone levels and low desire or other sexual problems in women. Although some healthcare providers prescribe testosterone, information on its safety and efficacy for women is limited.
• QHow might cholesterol medications affect sexual activity?

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  A SecondsCount.org answered

  Fibrates and statins may cause impotence (the inability to maintain an erection). If you experience this side effect, your physician may recommend a medication change or dosage adjustment, when possible. Statins may be less likely to cause sexual problems than fibrates, although the risk of sexual problems from either is very low.
  Keep in mind that any cholesterol medications you take are for the benefit of your cardiovascular health. Even if these medications may be impacting your sex life, it is important NEVER to stop or change any of your medications without first talking to the doctor who prescribed the medication.
• QHow can fear after a heart attack affect sexual activity?

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  A SecondsCount.org answered

  After you or your partner has a heart attack, it is only natural that you may be worried about whether sexual activity may trigger another heart event. When you are afraid that sex may cause health problems, you are not likely to want to engage in sexual activity. Counseling can provide reassurance of the low relative health risks of having sex. Sexual activity is like any physical activity; once your physician has cleared you for physical activity, it is likely that you may also resume sexual activity. Be sure to speak with your physician both about when it is okay to resume sexual activity and where you can access counseling resources.
• QHow can I support my partner with less interest in sex after a heart event?

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  A SecondsCount.org answered

  When your partner has heart disease, it can make you nearly sick with worry if you let it. Additionally, you may find that your relationship is strained by a new fear of intimacy. Look for ways you can channel your concern into support for your partner. Here are some tips that may be helpful to your loved one.

  • Talk honestly and openly with your partner. Choose a time and place when you are both relaxed. Share your feelings while avoiding blame.
  • If your partner seems to have lost interest in sex, do not take it personally. Having heart disease and/or recovering from a heart event can be a physical challenge as well as a scary, overwhelming, emotional experience.
  • Initiate other forms of intimacy with your partner. Take the pressure off your partner by letting him or her know that you are not trying to rush engaging in sexual activity before he or she is ready.
  • Encourage your partner to seek professional help to discuss concerns and questions relating to your sexual relationship. If he or she will not seek help, seek professional help for yourself. It sets a good example for your partner and may help you both begin the process of identifying some problems and potential solutions.
• QHow does pregnancy affect sex drive?

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  A Portsmouth Regional Hospital answered

  Pregnancy causes many changes in a woman's body, which may lower sex drive. Being pregnant causes changes in hormone levels, especially estrogen and testosterone. Because these hormones are so closely tied to sexual desire, these fluctuations may lower sex drive. Pregnancy also causes other changes that may affect body image, and these psychological factors may lower some women's libido. Feeling tired, anxious, or stressed often come along with being pregnant, so these factors may also lower women's sex drive.

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• QAre there creams to increase female libido?

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  A Patricia Geraghty, NP , Women's Health, answered

  Female libido is very complicated; affected by lifestyle, stress, relationships, general health, and hormones. The hormone that improves libido for both men and women is testosterone. Women's bodies make testosterone from estrogen. Testosterone is also sometimes given to women in the form of a cream. There are no FDA approved testosterone creams for women. But, with a prescription from your health care provider, you can get a testosterone cream from a compounding pharmacist. This is a pharmacist with a special license to make medications.
  While studies have shown that testosterone supplementation in women is effective in increasing libido, we don't yet have the results of studies looking at the safety of long term use of testosterone in women. The decision to use testosterone in a cream or any other form should be carefully made with your health care provider.
• QWhat product can be used for female libido?

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  A Patricia Geraghty, NP , Women's Health, answered

  The sexual response cycle is broken down into libido, arousal, and orgasm. Libido is the desire for sex. Libido and problems with libido have not been well studied in women. This allows for much discussion and theorizing while we wait for more evidence to develop. Various professionals have given us input and ideas to think about.
  The sociologists look at a woman's role in life. Does she have multiple jobs as in paid employment and homemaker and caregiver for young children or elderly parents? Does she have enough relaxation time? They propose that sex can seem just like another chore if her life is filled with too many chores already.
  The teaching learning theorists point out that sex is a physical or motor skill and that we don't get better at motor skills unless we actually practice them. You can't play the piano from listening to recorded music or play football from watching TV on a Sunday afternoon. They recommend a minimum frequency of sex to improve libido.
  The hormone-based folks have actually already shown in clinical trials that testosterone supplementation improves libido in women. Women do make small amounts of testosterone naturally. Adding to this amount, or supplying it if the woman is not making her own, improves libido. However, this product is not yet available from your pharmacy as safety studies are currently in progress. We do not know the effects if women supplement their testosterone over a long period of time. A healthcare provider can provide you with a prescription for testosterone cream to be made by a compounding pharmacist.
• QWhat medications affect sex drive?

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  A Dr. Jack Merendino, MD , Endocrinology Diabetes & Metabolism, answered on behalf of The Best Life

  Just as some medications reduce erectile function, others may actually diminish libido. Probably the most common are antidepressants in the SSRI (selective serotonin reuptake inhibitor) family: fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), and others. These drugs tend to lessen sex drive, and they can lead to difficulty with orgasms in both men and women. If the problem is significant, sometimes the addition of buproprion (Wellbutrin) will help, or a change in treatment may be necessary.

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• QDoes low sex drive make sex painful?

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  A Dr. Madeleine M. Castellanos, MD , Psychiatry, answered

  Lower sex drive does not directly make sex painful, but you are asking about two different symptoms that are related to each other.  Although sex drive can be decreased for many different reasons, some physical, some psychological, and some related to your relationship, low sex drive and painful sex for women are an indication that either her estrogen or her testosterone may be too low.  This happens naturally with age, especially after menopause. But it can also happen with use of hormonal birth control methods.  Since testosterone is responsible for both sexual desire as well as maintaining the woman's erectile tissue and allowing her to lubricate properly with sexual arousal, decreased levels of testosterone can severely impact a woman's drive and feeling during sex. If a woman is not properly lubricated during sex, either naturally or by using a lubricant, sex could be painful for her.
  There are women who have pain related to impairments in their estrogen or testosterone levels, or for other reasons such as vaginismus (contraction of the muscles at the opening of the vagina), vestibulodynia, or certain infections.  Once a woman starts to experience pain on a regular basis, she begins to avoid sexual activity because she wants to avoid the pain.  Consequently, her desire will begin to drop as well. 

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• QAs a woman with a normal libido, how can my partner's low libido affect me?

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  A Dr. Madeleine M. Castellanos, MD , Psychiatry, answered on behalf of Good In Bed

  The misconceptions surrounding male sex drive can be harmful to you, your partner, and your relationship. If you're a woman with a healthy sex drive, it can be beyond frustrating to have a guy who's less than enthusiastic about getting it on. Because society tends to view men as sex-obsessed aggressors who always make the first move, it's easy to take it personally when he'd rather balance his checkbook than check you out. You feel rejected, disappointed, hurt, and start to wonder if he really is attracted to you or not.
  
  There's no doubt about it: Being constantly turned down by your guy in the bedroom can be a major blow to your self-esteem.