Decreased Libido

Lee Gynecology Offers Diagnosis and Treatment of Women with Decreased Libido.

Decreased libido usually occurs with aging and can be addressed effectively. Some young women experience decreased libido due to hormonal birth control.
– Dr. Michael J. Lee

While sex and sexual health are a normal part of a woman’s life, many women report issues with sex at some point. Sexual problems can sometimes be solved alone or with your partner; but if you continue to have issues, it may be helpful to talk to Dr. Lee.


How Women Respond to Sex

For many women, sex does not follow the course from desire to arousal to orgasm that may be true for men.  Women’s sexual responses are often more complex, and physical desire may not occur until sexual activity has begun. A woman’s motivations often involve the need to feel close or intimate with her partner. If she does not respond sexually, she may not feel safe or the situation may not feel right.

Many women also report that physical and emotional sensations of sex can be pleasurable without orgasm. If the lack of orgasm is a concern for you, there are solutions.  Some women need more stimulation to achieve orgasm than sexual intercourse provides. Kissing, caressing, stroking and touching sensitive areas, such as the breasts and clitoris, can help a woman achieve orgasm if penetration alone does not work.

Causes of Sexual Problems:

Forty percent of American women report sexual problems at some time. There can be many causes:

  • Aging: A woman’s libido (her interest or desire in sex) can decrease with age.
  • Hormonal Changes: Interest in sex can decrease, increase or fluctuate during the normal hormonal phases of a woman’s life, including pregnancy, menopause and the menstrual cycle. Research suggests that a woman’s hormone levels are a key factor in her interest:
    • Androgen: This hormone is produced by the adrenal glands and ovaries. When androgen levels decrease, desire and arousal may also decline. Decreases in androgen levels can often be caused by removing the ovaries, using birth control pills or certain medications, or the effects of some diseases.
    • Estrogen: Decreased estrogen levels may cause vaginal dryness, which may reduce a woman’s interest in sex. Decreased estrogen occurs naturally as a result of perimenopause or menopause.
  • Other influences: Stress, anxiety or depression can decrease women’s libido. Relationship problems or past negative sexual experiences can too. Some illnesses or prescribed medications may also interfere with sex or sexual arousal.

Types of Sexual Problems:

These four conditions often overlap:

  • Desire: Women commonly report a lack of desire, especially once a relationship has progressed past initial dating. A lack of desire may be a disorder if a woman doesn’t want to engage in any type of sexual activity, including masturbation; does not have or rarely has sexual thoughts; and is worried about it.
  • Arousal: Arousal occurs when a woman experiences physical or emotional changes due to stimulation, including an increase in blood pressure, heart rate and temperature; the expansion and lubrication of the vagina; and an increase in sensitivity around the nipples, labia and clitoris. An arousal disorder occurs when a woman does not feel mentally or physically stimulated or excited from sexual activities. Some women may sense mental excitement but lack a physical response while others may dislike or be indifferent to being aroused. Arousal disorders often overlap with problems with desire.
    Remember that arousal can be affected by many factors, including: certain medications, drugs and alcohol, medical conditions, stress, anxiety or past negative experiences with sex.
  • Orgasm: While some women report a satisfying sex life without orgasm, others may see it as a problem. Women with orgasmic disorders may:
    • Have never had an orgasm
    • Have previously had orgasms but can no longer achieve them
    • Orgasm during masturbation but not with a partner
    • Have a decrease in intensity of orgasm
Orgasmic disorders can also be caused by poor body image, a fear of losing control or a lack of trust in one’s partner. Orgasm and arousal problems are often linked.
  • Sexual Pain: Pain during sexual intercourse is referred to as dyspareunia and includes pain that occurs during:
    • Partial or complete entry into the vagina
    • Thrusting
    • Urination after sex
While many sexually active women have experienced pain during sex at some point, if it happens often or is severe, speak to Dr. Lee.


If you’re worried or distressed or if this affects your well-being or your relationship with your partner, there are many steps you can take alone or with your partner:

  • For Enhanced Desire:
    • Discuss these issues with your partner and work toward resolving any relationship concerns or stresses about sex.
    • Focus less on intercourse or penetration and more on intimacy with your partner.
    • Improve your sex knowledge. Educate yourself by reading books about sex. Learn about your body and what arouses you.
    • Make time for sexual activity and focus on enjoying each other’s bodies.
  • For Increased Arousal
    • Be sure you’re well rested and getting enough sleep.
    • Increase foreplay or try nonsexual intimate activities like massage.
    • Try using a vaginal lubricant if you’re experiencing dryness.
    • Do regular Kegel exercises where you contract and relax your pelvic muscles. This strengthens muscles related to sexual function.
    • Avoid smoking, which decreases blood flow to sexually stimulated areas.
  • To Increase Orgasms
    • Increase foreplay and sexual stimulation before penetration.
    • Try sexual toys.
    • Use mental imagery or fantasies during sex.
  • To Decrease Pain
    • Allow plenty of time to become aroused before penetration.
    • Use a vaginal lubricant.
    • Empty your bladder prior to sex.
    • Try different positions or engage in sexual activity that doesn’t include intercourse.
    • Take a warm bath to relax your muscles.

Seeking Dr. Lee’s Help

If the above advice doesn’t help, see Dr. Lee. Sometimes physicians don’t ask directly about your sex life, so don’t hesitate to bring it up yourself. Being open and trying to overcome embarrassment will make it more likely that Dr. Lee will know how to help.

Keeping a journal of your symptoms may help you to be more specific when asked about your physical and mental health. You might even be asked questions about your past or if you’ve experienced any type of sexual abuse. Though it may be difficult to answer, be honest. These questions can give Dr. Lee important clues about the cause and the best approach for you.

If you’re experiencing pain during sex, you may be asked to undergo a physical or a pelvic exam to check your reproductive organs. Dr. Lee may need to recreate the pain by touch to diagnose the cause. Depending on your symptoms, you may have a blood test to determine your hormone levels. If a hormone imbalance is the cause, hormone medications may be prescribed for you.

Lee Gynecology Welcomes You!

…And don’t worry. We won’t limit the number of medical issues you can bring for evaluation at your appointment.

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