What’s killing my libido?

Have you noticed that your sex drive has been flagging recently? If so, you’re not alone.

Low libido or lack of interest in sex is surprisingly common, though perhaps more so among women. In a 1999 study Sexual Dysfunction in the United States – Prevalence and Predictors, 22% of women across the age spectrum reported low sexual desire, compared to 5% of men.

However other studies have shown far higher rates for men.

In 2007, Dr Konstantinos Hatzimouratidis published a global review of research relating to male sexual dysfunction. He found that the rates of men reporting a lack of interest in sex varied hugely depending on where surveys were carried out. In France just 3% and in Iceland 4% of men reported a lack of interest in sex, compared to 16% in Sweden and the USA and 25% in Australia. The reasons behind these disparities are unclear but may relate more to pride or embarrassment than any significant differences connected to lifestyle or genetics.

If you’re reading this article because you’re worried about a dip in your libido, I assure you it’s nothing to be ashamed of. Of course, a reduction in sex drive may be a signal of an underlying problem that needs investigating, such as diabetes or cardiovascular disease, which can reduce blood flow to the genitals. And the side effects of prescription medicines can also include a drop in libido. So don’t feel embarrassed about seeking help if you do have concerns.

A reduction in sex drive may be a signal of an underlying problem that needs investigating, such as diabetes or cardiovascular disease, which can reduce blood flow to the genitals.

But as a general rule, a dip in your sex drive is only a serious concern if it’s making you unhappy or causing problems in your relationship with your partner. And many of the factors that cause it can be addressed with simple changes to restore your interest in and enjoyment of sex.

Below I describe a few of the possible causes and some things you can do to help…

Causes of low libido and what you can do about them

Relationship problems

For many people, the strength of their libido is intimately linked to their relationship with their partner.

If there are simmering tensions or a lack of trust in your relationship, this can affect your interest in sex. For some women in particular, emotional distance from their partner can kill their libido. Conversely, for many people of both sexes, the comfortable familiarity of being with the same partner for years, combined with the day-to-day routine of life as a couple, can make it hard to get in the mood for sex.

It can be difficult to broach the subject with your partner, but sometimes all it takes to reignite the spark is a conscious effort to make things special from time to time and to inject an element of fun back into the relationship.

Age

Dr Hatzimouratidis’s global review showed that, up to the age of 60, the level of interest in sex appears to fluctuate independently of age but then declines sharply. A US study published the same year found that over a quarter of men and half of women aged 57-85 experienced a lack of interest in sex. 65% of men and 61% of women questioned said that this bothered them.

A US study published the same year found that over a quarter of men and half of women aged 57-85 experienced a lack of interest in sex.

Unfortunately there’s nothing we can do to halt the ageing process, but it’s likely that, especially for men, much of the effect is due to a general decline in health and wellbeing, rather than increased age on its own.

By keeping active, cutting out smoking and eating healthily you’ll maximise your chances of staying fit and well and boosting your libido.

Hormonal imbalances 

Testosterone plays a major role in regulating the libido for both men and women. It’s no coincidence that many of the other factors that can influence levels of interest in sex are linked with reduced levels of testosterone. It’s a complex causal network, but as a general rule, low testosterone goes hand-in-hand with low libido.

In men, testosterone levels naturally decline by around 2% per year from the age of 40 and there is a gradual drop-off in women’s levels too, even before they reach menopause.

Scientists at the University of Siena recently revealed the results of an intriguing pilot trial. Men experiencing a lack of interest in sex were exposed to bright light for half an hour each morning, using a light box. After two weeks their testosterone levels increased by an average of 1.5ng/ml, accompanied by a three-fold increase in sexual satisfaction score. That’s good news for those of you living in the sunny climes of the UAE!

For women, the fluctuating balance of sex hormones can play a major role in how sexual they feel at any given time. Many studies show that a woman’s interest in sex tends to increase mid-cycle, around the time of ovulation, when their fertility is at its monthly peak. This is probably sparked by luteinising hormone, which is released from the pituitary gland to prompt ovulation.

On the other hand, women who use hormonal contraception may find that that affects their libido. A review of 36 studies found that 15% of women using such methods reported a drop in their sex drive.

Reaching the menopause can have very different effects on the libidos of different women. Some experience a renewal in their appetite for sex, while others find themselves avoiding it, perhaps due to lack of lubrication and decreasing body confidence, in addition to the impact of falling testosterone levels.

Menopausal women who turn to hormone replacement therapy (HRT) for help may find that their interest in sex wanes even further, due to the suppression of testosterone. Studies suggest that this may be offset with a drug called tibolone, which helps to reset the hormonal balance and restore some youthful vitality.

Other women find that herbal supplements, such as red clover or soy isoflavones, help to smooth out the hormonal turmoil of the menopause without knocking their testosterone levels. Exercise can also help.

It’s not just sex hormones that play a role in regulating your libido. People suffering from hypothyroidism (an underactive thyroid gland) often find that their interest in sex has dropped. Unfortunately treatment with synthetic or natural thyroid hormones may not reset this balance. Some people find taking a tailored combination of bioidentical thyroid hormones is more effective, while others experience significant improvements from simply changing their diet and exercising more. 

Diet 

There are strong links between poor diet and low libido. For sexual wellbeing, it’s important to keep your weight under control and eat a balanced diet, with plenty of antioxidants, vitamins and minerals. All the usual dietary factors that can lead to a decline in general wellbeing, such as trans fats and excess sugar, salt and alcohol, are likely to impact your sex drive as well.

Some people swear by a paleo diet, which is based on wholefoods but cuts out dairy products, pulses and grains, to mimic the diet our ancient ancestors would have eaten before the advent of farming. However, while this seems to work wonders for some women, many men experience the opposite effect. This may be due to the fact that men need to take in more carbohydrates than a paleo diet allows in order to maintain their levels of testosterone.

Some experts suggest that a Mediterranean diet, rich in fresh vegetables, pulses and olive oil, with a little fish and lean meat, may be beneficial. It’s certainly good for your cardiovascular system, which has a strong connection with sexual wellbeing, and has been associated with a reduced risk of developing type 2 diabetes.

For women in particular, it’s important to ensure an adequate intake of omega-3 fatty acids from oily fish or plant sources.

And while you’re planning your healthy meals, it wouldn’t hurt to incorporate some foods with a reputation of being aphrodisiacs. Many, such as oysters, asparagus and avocados, do contain nutrients linked with good sexual wellbeing. Chilli consumption has recently been credited with increasing levels of testosterone, and watermelon may even have some Viagra-like effects thanks to the presence of citrulline, which helps to relax blood vessels.

For both sexes, it might be worth adding the Andean superfood maca into your diet. Reputed to boost energy, stamina and mental clarity as well as libido, it contains p-methoxybenzyl isothiocynate, which is believed to have aphrodisiac properties. It certainly provides high levels of magnesium, selenium and calcium as well as healthy fats, which are all vital for sexual health. It’s also a rich source of plant sterols, which are important for keeping cholesterol levels under control.

Stress, anxiety, exhaustion and depression

A 2006 study found that stress, particularly internal daily stress and that caused by critical life events, has a strong connection with hypoactive sexual desire in both men and women. The authors recommended that treatment should focus on helping individuals improve their stress management skills and addressing any issues causing stress within their relationship.

In this situation it’s also a good idea to plan some time off. For women in particular, studies show that taking time off work for a holiday increases interest in and frequency of sex.

A 2013 Indian study found that for men, sexual desire was compromised by the emotional impact of issues such as unemployment and low income, while for women the most common stressor was previous sexual trauma. In either case, faced with such stressors it’s essential that the other partner is patient and supportive.

Stress and anxiety can also affect both the duration and quality of sleep, which can have a knock-on effect on the libido. One study showed that sleeping for no more than five hours per night for just one week reduced the testosterone levels of young men by 10-15%. Exercise and spending more time outdoors may also help to calm your nerves and promote restful sleep.

One study showed that sleeping for no more than five hours per night for just one week reduced the testosterone levels of young men by 10-15%.

If you know or suspect you have depression and have noticed a reduction in your libido, it’s important to discuss it with your doctor. Up to 80% of people suffering from depression experience reduced libido and some antidepressants can exacerbate the problem.

Having children

If you have young children you’ll be familiar with the exhaustion caused by a succession of nights with interrupted sleep. As we’ve already seen, lack of sleep in itself can lead to a drop in libido. However there are other important ways that becoming a parent can affect your sex drive.

For women, the physical and emotional impact of the birth and subsequent breastfeeding can drastically change their body image. These psychological factors combined with physical changes can certainly decrease a woman’s enjoyment of sex, with an obvious impact on libido.

Men too can sometimes feel overwhelmed by complex emotions about their partner’s new role as a mother, which can also affect the relationship between the couple. More surprisingly, studies of men in China and the Philippines have shown that levels of testosterone drop significantly when they become fathers. Presumably this is nature’s way of ensuring new dads stick around and care for their young; however it is also likely to dampen their desire for sex.

As with many relationship problems within a couple, the best solution is to plan quality time together to rekindle the lost spark.

Mark Janowski

About Mark Janowski

Dr. Mark Janowski (MD, USA) completed his medical training at Georgetown University Hospital in Washington, DC in 2001. As a fully licensed internal medicine specialist, he focuses on the diagnosis and management of hypertension, diabetes, hormone disorders, gastrointestinal issues, cardiac issues, weight control, depression and anxiety. He is also experienced in bio-identical hormone replacement for men and women, and in conducting comprehensive medical check-ups to detect and reverse early heart disease and diabetes, as well as to reduce stroke risk. You can read more about our programmes HERE
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