Low sex drive. It’s the sort of thing we whisper about or ponder via text with our friends late at night. “So, I just don’t want to have sex tonight, and I’ve got to be honest, I haven’t wanted to all week.” If this sounds familiar, know this: You’re in good company. As many as 27 percent of women who are pre-menopausal feel the same on a regular basis, and the numbers nearly double for women who have hit menopause. But every sexually active couple out there is having sex a different number of times a week (or month…or year). In one study, it’s estimated Americans in their twenties had sex an average of about 80 times per year, compared to about 20 times per year for those in their sixties. That there is no “normal” can sound either terrifying or comforting, depending on your situation. So what really constitutes a low sex drive? And if you’re feeling like yours is “low,” what can you do to kick things back into high gear? Let’s shed a little expert light into the bedroom, shall we?
What is low sex drive?
According to research from scientists at the University of San Diego, the amount of sex Americans are having is on the decline, especially for married or partnered Americans. Their study, published in the Archives of Sexual Behavior in 2017, shows that the average American adult had sex nine fewer times per year in the period from 2010 to 2014 than Americans in the same group did from 2000 to 2004. The number of times you have sex each week can depend on so many things. Are you and your partner both working full time? Are you working different shifts? Did one partner have their period? How about a stomach bug? The reasons a couple may not have sex on any particular day could go into the (hundreds of) thousands, so we won’t list them all here. Suffice it to say, scheduling sex into our busy lives can be difficult. But “low” amounts of sex and a low sex drive are two different things. You can have a healthy sex drive and just not have the time to get down and dirty with your partner. Sex drive comes down to desire, not whether or not we actually find time to do the deed. After all, you can want to have sex and not get to it because of your schedule, which means the number of times you experience that desire is what your doctor or healthcare provider will ask about if you seek out professional help regarding your sex drive. The medical community breaks low sex drive in females down into three categories, all of which are based on a woman’s symptoms, according to Melissa Juliano, MD, who specializes in vulvar disorder and sexual dysfunction and is the director of women’s health at OhioHealth Mansfield Hospital.
- Hypoactive Sexual Desire Dysfunction (HSDD): “This is a persistent or recurrent deficiency or absence of sexual/erotic thoughts or fantasies and desire for sexual activity,” Juliano explains.
- Female Sexual Arousal Dysfunction (FSAD): Unlike HSDD, FSAD is characterized by persistent or recurrent inability to maintain or an adequate genital response, Juliano says.
- Female Orgasmic Dysfunction (FOD): Juliano describes this as “A significant delay, change in frequency, or absence of orgasm or intensity of orgasmic sensation.”
For those who push for a “normal” number, Wyatt Fisher, a doctor of clinical psychology who practices in Boulder, Colorado, says low sex drive can typically be quantified by the medical community as “desiring sex only one to two times per month.” Even at those levels, it’s important to note that quantity and desire are only considered significant if they are deemed to be so by a couple. One couple may go months without sex, willingly and happily, while another may be turning to the medical community for help. Both scenarios, the experts say, are normal. “There are plenty of people who are just not that interested,” says Rebecca Levy-Gantt, an OB-GYN from Napa, California, “If it’s not distressing to them or to their relationship, it is not considered an issue to deal with.” But while there are no sexual quotas to meet to qualify as “normal,” having a low sex drive can be concerning for a woman who values sex as a piece of an intimate relationship. It can likewise be frustrating for a partner who feels disconnected and unsure why the sex they once enjoyed is no longer part of their relationship. “Sex and sex drive can be areas of serious sensitivity,” says Laurel House, a dating coach and resident sex expert for My First Blush, an adult toy and lingerie site. “It can create insecurity and draw out triggers.” That said, having a low sex drive doesn’t have to be a relationship killer, nor is it something she recommends ignoring. “Know that you’re not alone and just because you don’t have the same sex drive doesn’t mean that you can’t have fun, fulfilled, and satisfying sexual activities,” House says. “This is an opportunity to change it up.” It could even be an opportunity to improve your relationship. “[It] brings you closer as you explore areas of vulnerability and share sides of you that are scary,” she says. “As your walls drop and you explore yourself and each other, you will become closer and your relationship will deepen.” First step? Figure out why your sex drive has taken a dive.
What can cause a low sex drive?
How frequently someone wants to have sex with their partner is, like sex itself, personal. But that doesn’t mean that outside factors can’t be inhibiting us. Dubbed “libido” by the medical community, our sex drive can be ruled by a number of factors. Are we attracted to the person we’re considering intimacy with? Are we feeling safe with them? If we’ve chosen the person as a long-term partner, those two questions typically (although not always) get an affirmative answer. So what else could cause us to roll over when someone is nuzzling our necks and running their fingers lightly up and down our backs?
Antidepressants are a common culprit when patients say they have a low sex drive, says Michael Ingber, an OB-GYN at the Center for Specialized Women’s Health in Denville, New Jersey. It’s a bit of a catch-22: Depression itself has been linked to a decrease in desire for sex. But the medications meant to treat depression can exacerbate the problem and wind up turning us off to engaging in sexual intimacy. “If you read the warning label on common antidepressant medications you will see that many of them cause low libido,” Ingber says. Birth control pills may also cause low libido for some women, Juliano says, because they can increase a sex hormone called binding globulin. “This globulin binds to free testosterone in the body, which would increase sex drive if it were free to bind to its receptors, but when bound to this globulin, it cannot do this,” she explains.
Dubbed female genital-pelvic pain dysfunction, Juliano says some women have a “persistent or recurrent difficulty” with vaginal penetration, vulvovaginal pain with intercourse, anxiety or fear of having this pain, and/or pelvic floor muscles that lack function or are over functional—with or without genital contact. It stands to reason that if it hurts, your desire for sexual activity will diminish, and for many sufferers, that’s true. Treating genital-pelvic pain typically needs to come before addressing sex drive itself.
If a doctor asks if you experienced sexual abuse or assault in your past, they’re not being judgmental. They’re just trying to ascertain what might be tied to a low sex drive. Studies have linked a history of sexual abuse to difficulty orgasming, lack of lubrication and, yes, lack of desire. For some, this ties into the issue of pain as well. “Many times, women who have had a history of abuse have pelvic floor muscle spasm, or tightening of the vaginal muscles,” Ingber explains. “This can cause pain with sexual activity and plays a role in decreased sex drive as well.”
It isn’t just past relationships or trauma that can cause a low sex drive, Juliano says. Sometimes it comes down to how you were raised. “What was your upbringing like?” she might ask patients. She says that myths you may have been told were true from a very young age in addition to cultural norms and expectations can all play a role in how often you want to have sex.
Lack of Sleep
If you’re feeling sleep deprived, it only stands to reason that it would be hard to get in the mood to get busy between the sheets. How much of an affect could your lack of sleep really have? Consider this: According to a study published in May 2015 in the Journal of Sexual Medicine, increasing sleep by just an hour increased participants odds of having sex the next day by a whopping 14 percent!
Pregnancy or Recently Giving Birth
The months before and after birth are among the most common times for a woman’s sex drive to take a dip, Levy-Gantt says, in part because there are so many factors at play. The last trimester of pregnancy, when most women see their sex drive dip, can be uncomfortable, with a mom-to-be struggling to sleep and the weight in her uterus throwing her body off balance. Then comes birth, and along with it a recommendation from doctors that a new mom abstain from sex for a while. For some women, that’s a relief! “Certainly a vaginal delivery is often associated with damage or pain in the vaginal area, and associating pain with sex can make anyone’s libido wane,” Levy-Gantt says. But if you’ve gotten the all-clear from your doctor and you’re still not feeling like jumping in the sack with your partner, you’re still far from alone. In a British study of more than 10,000 people’s attitudes toward sex, both having been pregnant in the last year and having one or more young children were associated with lacking sexual interest for women. The problem? It could be lack of partner support, at least if you take the results of another study, this one out of the University of Michigan, to heart. Researchers found that feelings of intimacy and closeness to participants’ partners were most likely to drive a new mom’s sex drive, followed by their partner’s interest. Not having that intimacy, on the other hand? It was a mood (and sex-drive) killer.
It may be a tiny gland, but the thyroid does a whole lot of work in the body. If it’s malfunctioning, you can end up with exhaustion, inability to gain or lose weight, difficulty tolerating heat or cold, and—surprise!—a low sex drive. “We check several different hormones and proteins in the blood when women (and men) complain of low libido,” Ingber explains. “One of the blood tests we check is TSH, which relates to thyroid hormones.” Getting that back in check can be key in helping combat low sex drive.
What to Do About a Low Sex Drive
Although there is no correct amount of sexual desire, sometimes a drop in sex drive can be a sign that something’s going wrong in your body. “If a lack in sex drive is sudden (like, two weeks ago, everything was great and now there’s no interest at all) that should definitely be investigated,” Levy-Gantt warns. “There are some issues such as tumors, vascular diseases, and side effects of medications that can cause a sudden change.” Even when there’s not an emergency, however, a visit to an OB-GYN is a good first step to finding your way back to your old libido—or forward to a sex drive that’s satisfying for where you are in your life. For women who are experiencing painful sex that’s putting a damper on their sex drive, getting to the root cause of the pain is important, Juliano says. “If there is vaginal dryness, [the solution] can be as easy as finding out if one needs to use a lubricant and what kind of lubricant to use,” she notes, “Or if your doctor sees that vulvar or vaginally there is dryness primarily due to lack of estrogen, topical estrogen (which is not hormone replacement therapy) is a very good option.” For women with HSDD, medications such as flibanserin, an FDA-approved drug created specifically to treat low sex drive in women, has shown promise in increasing “satisfying sexual events per month and increased daily desire in women,” Juliano notes. Other courses of treatment may take you out of the OB-GYN’s office and off to visit an endocrinologist to address thyroid levels or to visit with a therapist. Whatever their diagnosis and treatment, there is one thing you can do at home, too: Focus on yourself a little. If you’ve been tempted to try mindfulness techniques, now may be the time. Researchers at the University of California at Berkeley have found that mindfulness works for some women to improve not just their sexual desire, but their sexual satisfaction too. Even their lubrication was improved by the time they spent in mindfulness training. House suggests opening up to change in the bedroom can also make a difference for some women. “Add some new moves and maybe even some toys and outfits into the equation,” she suggests. “Sometimes all you need is a little spice to add excitement.”