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Low libido is very, very common, it affects about 40% of women, but only 12% of women are really bothered by it. If there are medical conditions or medications that you’re on that might be impacting your sex drive, certainly you want to tackle those issues first, because fixing those can potentially fix the issues of libido.
What are some lifestyle changes that can maybe increase libido? So it sounds pretty straightforward. But things like fatigue and stress are big contributors to low libido. So working on improving those things can be really helpful.
But what can you really expect during couples therapy? Well, it depends. If you go to a sex therapist, most people will generally work on first educating the couple on what the normal sexual response cycle is, address any specific religious or cultural concerns that you may have about having sex, what is a normal expected frequency for you as a couples to have intercourse ,and maybe even including some specific exercises and offering resources like books, visual aids devices like vaginal dilators, and specifically focusing on mutual sexual pleasure. A lot of times women don’t even really focus on their pleasure when they’re so focused on their partner’s pleasure and that at least 85% of women do need clitoral stimulation to achieve orgasm. Making sure that your partner is aware of that and incorporates your pleasure into the relationship and into intimacy time can be valuable for low libido.
Another type of therapy that’s offered is called sensate therapy. And this is a therapy that’s focused on touching, and it starts with touching non genital areas, and slowly advancing to touching in more erogenous areas. It’s meant to reduce anxiety and reduce the avoidance of sexual intimacy and improve intimacy. And particularly for women who have concerns about pain with penetration, this can be helpful.
Also, you can engage in cognitive behavioral therapy, which is focused on the thoughts and behaviors that come in the way when you’re about to have intimacy or sexual relationships with your partner. It focuses on what if those thoughts and behaviors are getting in the way of proceeding with sexual intimacy.
If you’ve tried all these things, and your relationships great, and you’re super healthy, and there’s nothing else going on that might be causing this low libido, there are two FDA approved medications for low libido in women. The first one is called Flibanserin, or brand name is Addyi. It’s a medication that’s taken once a day at bedtime. And what it does is it works on serotonin receptors to increase the brain dopamine. Dopamine is a key neurotransmitter or chemical messenger that causes sexual excitation. It’s taken once a day at nighttime because it does cause some drowsiness it’s specifically only approved for women who are pre-menopausal, meaning they have not yet gone through menopause. You do need to give it an eight-week trial to see if it works. And there are some side effects to be aware of specifically being very sleepy, that’s why you take it at night and there are low risks of getting low blood pressure dizziness, or fatigue. As the hours are commonly seen in the studies, however, in the studies, only 13% of people stopped the medication due to side effects. You do need to be careful taking this with alcohol because both of those together can make drowsiness much more significant. It’s not recommended to take it with alcohol at the same time. Certainly, you need to delay for a certain amount of time after having one or two drinks. Or if you have three or more you shouldn’t take your dose that night. In this study, they found that libido increased about 54 to 58% for all women who were on this medication, so certainly not a homerun but certainly can have many, many women who are suffering from low libido specifically if you’re pre-menopausal.
Another medication that’s available for those who are pre-menopausal is called Vyleesi. Vyleesi is an injection that you give yourself before you want to have intercourse, you need to give it to yourself about 45 minutes before you want to have intercourse or engage in sexual activity of some kind. And in the studies that showed improvement in sexual satisfaction and desire in about 51 to 57% of participants. It shouldn’t be used if you have uncontrolled high blood pressure or if you have cardiovascular disease. And the most common side effect is nausea with the injection, but the nice part about it is you just take it before you want to use it. You also do need to be on some sort of contraceptive or using some sort of protection if you’re using this medication because it can cause unwanted side effects or harm to a developing fetus.
There are also some off label treatment options. One is using topical testosterone for women who are postmenopausal. This is for postmenopausal women. Well another couple of medications that have been shown off label to help are Bupropion, which is an antidepressant and buspirone and anti-anxiety medication and so those are all used off label for the use of low libido in women if you have tried other things have a normal healthy relationship and no other issues that need to be addressed.
Learn more:
Why you’re just not that into it? | Causes of Low Sex Drive in Women | Low Libido: https://youtu.be/J03NFx0Nji8
Sources:
Hypoactive Sexual Desire Disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) Expert Consensus Panel Review https://www.mayoclinicproceedings.org/article/S0025-6196(16)30596-1/fulltext
Overview of sexual dysfunction in women: Management https://www.uptodate.com/contents/overview-of-sexual-dysfunction-in-women-management?search=low%20libido%20&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Contact Dr. Malik for speaking engagements, press, partnerships, or collaborations
Quick Links
Out-of-State telehealth provider for Florida
