Lorraine: Dr Hilary talks about low libido
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There’s no ‘normal’ libido, but if your lack of desire for sex is distressing you, it is a problem. A reduced sex drive can affect your relationship and mental health, so it’s important to get to the bottom of the problem and resolve it. Express.co.uk chatted to Dr Deborah lee from Dr Fox Online Pharmacy to find out why you sex drive is lower.
Loss of libido means losing your sexual desire.
It’s not uncommon for your sex drive to wax and wane from time to time, but when it’s severe, has been present for at least six months, and threatening your relationship, it is known by the proper medical term hypoactive sexual desire disorder (HSDD).
Dr Lee explained: “HSDD affects between 26 to 43 percent of women and around 20 percent of men.
“It should be noted that erectile dysfunction (ED) is considered a separate condition.
“These figures are probably an underestimate as in general, people are often too embarrassed to go to the doctor, and it is frequently underreported.”
The first step to improving your libido is to find out the cause, Dr Lee said.
She explained: “ It may well be that there is more than one cause.
“If you go and see the doctor, they will ask lots of questions to try and work out what might be underlying the problem.”
No clue what the root cause is? Dr Lee has suggested 13 common culprits.
Causes of low libido
Relationship difficulties
It’s incredibly common for difficulties within a relationship to result in sexual problems.
Dr Lee said: “Resentment, lack of communication, and anger are often at the root of the problem.
“Relate offers relationship counselling, and some couples benefit from sex therapy.
“You could try taking the online sex and intimacy quiz.”
Stress and anxiety
Life stress of any type – for example work, financial, personal issues, and bereavement or any other – all increase your stress and anxiety levels, Dr Lee said.
The expert noted: “This causes levels of the stress hormone, cortisol, to rise.
“Raised cortisol levels have been associated with poor response to sexual stimuli, meaning stress can have a negative effect on sexual arousal.”
Depression
When you are depressed, you lose your ability to anticipate or feel pleasure.
This interferes with the process of sexual arousal. Some antidepressants can also reduce libido as a side effect.
Medication
Many different types of medication can cause loss of libido, such as:
- Anti-anxiety – such as benzodiazepines, for example, diazepam
- Anticonvulsants – such as carbamazepine, and phenytoin
- Antidepressants – such as SSRI’s, SNRI’s, TCA’s and MAOI’s
- Antifungals – such as ketoconazole and fluconazole
- Antihistamines – such as diphenhydramine and chlorpheniramine
- Some types of hormonal contraception
- Drugs used to treat the prostate – such as tamsulosin, and finasteride
- Drugs used to reduce stomach acids – such as cimetidine
- Cancer treatments – including chemotherapy and radiotherapy
- Drugs used in heart disease – such as B-blockers, ACE inhibitors, thiazide diuretics, and statins
- Opioid analgesics – such as oxycontin
- Steroids – such as prednisone
- Anabolic steroids – such as stanozolol, and oxandrolone
Alcohol
Alcohol can affect every part of the sexual pathway, according to Dr Lee.
She said: “It causes erectile dysfunction in men and is often linked to poor arousal in women with vaginal dryness and difficulty with orgasm.”
Menopause
Low and fluctuating oestrogen levels around the time of menopause, often have a negative effect on sexual function, frequently resulting in vaginal dryness, poor lubrication, and painful sex.
Dr Lee explained: “Changes in testosterone levels can also dampen libido.
“Unpleasant menopausal symptoms such as hot flushes and night sweats can interfere with sleep causing tiredness, stress, and anxiety.
“Men can also suffer from low testosterone levels, which can occur with ageing.
“However, the relationship between testosterone levels and sexual desire in men is complex and not well understood.”
Tiredness
Around one in four adults claim they are too tired for sex.
Dr Lee explained: “It may be that loss of libido and tiredness are symptoms of the same condition – when you are tired you don’t want to have sex, and when you don’t want to have sex, you feel tired!
“Loss of libido is very common in those suffering from chronic fatigue syndrome (CFS), who are so overwhelmingly fatigued, they don’t have the energy for anything, let alone sex.”
Obesity
Obesity has been linked to many chronic medical conditions including sexual dysfunction – which includes loss of sexual attraction and desire.
Dr Lee explained: “The reasons are complex but are thought to be due to the interaction between obesity, and low self-esteem, negative body image, anxiety, and stress.”
A sedentary lifestyle
Taking part in regular exercise has been shown to enhance sexual satisfaction.
Dr Lee said: “This is likely to be because exercise stimulates the sympathetic nervous system, improving responsiveness, as well as improving cardiovascular health and promoting a positive body image.”
Smoking
Smoking has been found in many medical studies to be a major risk factor for erectile dysfunction.
Cigarette smoke is known to damage the endothelium (lining of blood vessel walls) and prevents the nitric oxide-induced dilation of blood vessels needed to create an erection, Dr Lee pointed out.
Chronic illness
Heart disease, diabetes and cancer can all put a strain on the body and result in loss of libido.
Dr Lee said: “The fatigue linked to these diseases is often the underlying cause.
“Diabetes can have specific effects on nerves and blood vessels.
“It is a common cause of erectile dysfunction and difficulty with sexual arousal in women.
Pituitary tumours
Hyperprolactinemia is a rare, usually benign, tumour of the pituitary gland that produces an excess of the hormone prolactin.
Dr Lee said: “Symptoms in women include absent periods and milk excreted from the nipples.
“In men, it causes erectile dysfunction. In both sexes, it is typically associated with loss of libido.”
Hypothyroidism
An underactive thyroid gland can also cause loss of libido. It is also linked to weight gain and obesity.
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