Talking about sex drive is still as taboo as discussing politics at Aunt Karen’s birthday party.
That’s because sex drive is complicated, to say the least. So many factors play into a woman’s desire to have sex, including:
Hormones- Relationship factors
- Communication styles
- Emotional attachment
- Chronic medical conditions
- Fatigue
- Anxiety
- Depression
- What your family taught you about sex
- Pain during sex
- Children
And many more.
Now, the first step to improving sex drive is an awareness that sex is a normal, healthy part of life and that sex drive will look different for everyone. In fact, sex drive wades along a large spectrum. Nonetheless, there are a few ways to determine if your sex drive falls within a healthy range within the present chapter of your life. Let’s dive right in!
Hormones
Perhaps the greatest driver of sex, we must discuss the monumental impact of hormones and how their shifting levels affect the desire to have more or less sex.
Testosterone, prominent in males, is the main hormone of desire; hence why men are known as being more sexually driven. Women also make testosterone but to a much lesser extent than men. This is largely a good thing because if we did make as much as them, we’d grow beards, sport big muscles and, talk deeply.
But it’s certainly still important to produce enough. Many factors can affect a woman’s testosterone level. One of the most common contributors to low testosterone is the birth control pill. Low testosterone can lead to vaginal dryness, which can lead to painful sex, and if sex hurts, you’ll likely avoid it! Luckily, there are various non-oral birth control options that won’t decrease sex drive. Talk to your doc about other methods of birth control if you believe your current one could be diminishing your sex drive.
Painful sex
There are many reasons why sex could be painful, but one of the more common is endometriosis. Endometriosis occurs when there are bits of endometrium (the tissue you shed each month during your period) that implant outside of the uterus in the pelvis, like on the ovaries or your colon. It causes inflammation and scarring, which can lead to pain. one of the most classic symptoms of endometriosis is pain with deep penetration.
Unfortunately, one in ten women will develop endometriosis, but it takes on average up to seven years to get properly diagnosed. Endometriosis typically presents with terrible menstrual cramps— ones so painful women may vomit, faint, or regularly miss school/work each month. The treatment for endometriosis ranges from hormonal suppression to surgical removal of the implants to hysterectomy. Just know that if you have it, various treatments are available, and if you can stop having painful sex, you are much more likely to be in the mood when it comes time!
Another common reason for painful sex is vaginal dryness due to menopause, otherwise known as genitourinary syndrome of menopause. When the ovaries produce less estrogen, the vaginal tissue becomes thin and dry and loses elasticity. This leads to sandpaper-like sex, aka misery. This is where hormones arrive to help! Low-dose hormones are very low risk and can rejuvenate the vagina to lubricate, increase blood flow, and stretch properly.
No more painful sex, no more lack of sex.
Depression and Anxiety
When mental health suffers, sex drive drastically decreases. It makes evolutionary sense because nature doesn’t want stressed women to reproduce. Stress wreaks havoc within the body and creates an unfavorable environment for nearly all bodily functions, let alone reproduction. Instead, nature wants depressed or overly anxious women to focus on healing themselves first and foremost. Even if the goal isn’t reproduction, it’s still important to facilitate a healthy sex drive by addressing mental health concerns.
We can’t go without acknowledging that these past two years have been especially difficult for many women due to the pandemic, homeschooling children, caring for sick family members, not being able to socialize, and the like. Plus, many women are natural caregivers and tend to put their own needs last. But mental health is just as important as physical health, and they’re also inextricably linked. So if you’re feeling down or depressed, it becomes that much more important to take care of yourself, especially if you are responsible for taking care of others.
Although some women are able to overcome their depression and/or anxiety through methods such as journaling, meditation, exercise, yoga, or decreasing responsibilities, many need extra aid in the form of therapy. This is your encouragement to seek counseling, coaching, or therapy because you don’t have to do this alone.
With that said, some medicines can affect your sex drive, and one of those is a class of antidepressants. SSRI antidepressants like Celexa, Lexapro, Prozac, Zoloft, and Paxil can lower your sex drive and/or make it harder to reach orgasm. Unfortunately, many women aren’t told this when first prescribed, which can lead to feelings of inadequacy, low self-esteem, and extra stress.
However, some antidepressants don’t affect your sex drive or are less likely to affect it. Wellbutrin is one of those. In fact, a few small studies show that Wellbutrin can improve sex drive, even in women who are not depressed. If you think one of your medications, but especially antidepressants is contributing to your lack of sex drive, it’s OK and even encouraged to talk to your provider about changing medications.
Strength of Relationship
Take a minute to ponder how you’re really feeling about your relationship.
Do you feel loved, heard, and appreciated? How attracted do you feel to your partner? Are there major underlying problems in the relationship that could be contributing to your lack of desire?
If there are big stressors and strains, sex drive can plummet. Once again, nature doesn’t want us to reproduce with someone incompatible. This is not to say your relationship is doomed, as no relationship will be perfectly compatible one hundred percent of the time. However, if relationship issues are the reason for having less sex, it may help to seek a therapist. Having a non judgemental third party help you work through some of these issues might just be the spark that rekindles sexy time.
Fatigue
If you’re a new mom, well, need I say more? But even if you’re a long-time mom, a full-time mom, or a mom with a full-time career, fatigue plagues us all. Our current culture and society practically idolize it! Yet, humans, and especially women, aren’t robotic machines with Energizer bunny battery life. To mitigate fatigue, be sure to practice self-care, take naps as needed, eat a nutritious diet, exercise, ask for help, and manage responsibilities well.
In addition to addressing the one or many root causes of fatigue, it’s also important to consider how fatigue may affect the timing of sex. Although late at night seems to be the most popular time for sex, it may not be the best time for busy parents who go, go, go all day, and then crash in the evening. In reality, this formula often equals no sex at all.
Thus, it’s worth talking to your partner about better times to have sex that fit into your current lifestyle. Having sex releases happy hormones, so perhaps it’s time to switch to the morning. It’s also completely encouraged (and normal) to plan sex dates. Pick days and times that work the best and schedule them on the calendar. Truly!
What is normal? What is not?
Spoiler alert: there is no “right” amount of sex drive. All of the above factors and more interact with each other to dictate baseline sex drive. Sexual desire also tends to shift throughout the lifecycle and not necessarily linearly. Thus, consider creating your own unique spectrum to gauge your unique healthy sex drive level. And when it wanes, take healthy measures to address the root causes because sex is important … and fun when you want to do it!
Again, awareness of the above factors is the first step to improving and enhancing sex drive. Consider how each affects you at this point in your life, and then brainstorm ways to address the limiting factors. You can also reach out to a sexual medicine specialist in your area. The International Society for the Study of Women’s Sexual Health (ISSWSH) is another great resource for information if you are worried about your drive. So go ahead, have drive, have sex, and thrive!
Dr. Becky Kaufman Lynn, MD, MBA, IF, NCMP is the Director of the Evora Women’s Health. She is an Adjunct Associate Professor of Obstetrics and Gynecology at Saint Louis University, as well as a certified Sexual Counselor. She is a past board member and Advocacy Chairman of the International Society for the Study of Women’s Sexual Health and a Past President of the St. Louis Gynecologic Society. Dr. Lynn is an international and national speaker in Women’s Sexual Health.
Dr. Lynn completed medical school at Georgetown University School of Medicine in Washington, DC, completed her residency at Washington University in St. Louis, and practiced at the University of Missouri, Columbia, before joining the faculty at Saint Louis University in 2015. She completed her sexual counselor training at Sexual Medicine Associates in Florida. In addition to practicing medicine, Dr. Lynn received her Masters in Business Administration from Saint Louis University. Dr. Lynn enjoys running, foreign language, and travel. She once rode her bicycle from London to Paris to raise money for Breast Cancer Care.
