Factors That Affect Sex Drive

What’s Normal vs Not?

 

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 awareness that sex is a normal, healthy part of life and that sex drive is going to 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. There are many factors that can affect a woman’s testosterone level. One of the most common contributors to low testosterone is the birth control pill.  The pill is often prescribed for acne because it lowers testosterone levels. However, this can drastically decrease sex drive in the process. In turn, 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. In fact, 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 treatment is 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 make lubrication, 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, home schooling 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, there are some medicines that 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, there are several antidepressants that don’t affect your sex drive or are less likely to affect it.  Wellbutrin is one of those. In fact, there are a few small studies that show that Wellbutrin can improve sex drive, even in women who are not depressed.  If you think one of your medications, but especially antidepressants are 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 fulltime 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 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 it to talk 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 is affecting 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 is a gynecologist and the founder of the Evora Women’s Health. She is a North American Menopause Society Certified Physician who has been treating menopausal women for over 20 years. She is also a fellow of the International Society for the Study of Women’s Sexual Health(ISSWSH) and a former board member. Her practice is located in Chesterfield just outside of St. Louis, Missouri. Dr. Lynn offers a comprehensive midlife wellness program helping women lead healthy, happy and fulfilling lives. Go to evorawomen.com for more information about her practice or to schedule an appointment or send us an email at info@evorawomen.com