How to "Treat" Low Libido

I was compelled to write this blog after hearing numerous patients report low sexual desire during GYN visits. If you’re feeling this way in your relationship, you’re not alone.  As I have learned, sexual response is a complex and multifactorial subject and there is no magical libido pill.

To fully understand sexual desire, lets start by exploring a common relationship trajectory.

A relationship begins filled with passion. You're having sex in the back of the car because you can't even wait to get upstairs kind of passion. Everything you do in the beginning of a relationship revolves around sex. Where you'll go to dinner, what time you'll go dancing, what underwear you'll wear, how many drinks you’ll have… The “honey moon phase” of a relationship is really just synonymous with “when sex wasn’t a guarantee and therefore both parties worked hard for it to happen, and for it to happen well.”

The sexual desire in the beginning of a relationship builds from a longing to see each other. It builds from being apart and then reconnecting. When couples are apart, imagination increases sexual desire. Then, when they reconnect, they live out their imagination. This is why ironically, the best sex happens after a fight, or after being away from your partner for a while. Uncertainty and longing. But this cycle is not sustainable in long-term relationships because the building blocks of a deep love are closeness, safety, reliability, predictability and security. Our passionate lovers turn into our companions, our best friends, our safety net and our security.

So can you have novelty, danger, risk and longing with the same person that you have dependability, reliability and predictability with? Absolutely. Here is how.

Foreplay. Foreplay isn’t something you do a few minutes before the act; rather foreplay should start at the end of the previous orgasm. Erotic couples look at each other, smile at each other, touch each other, throughout the entire day. It’s hard to be in the mood to have sex if you feel like you haven’t had any time to connect with your partner.  Remember, the mind is the most powerful organ in the body.

Commitment. Healthy relationships understand that passion waxes and wanes. It's pretty much like the moon, it has intermittent eclipses. But erotic couples know how to bring sexual desire back and the commitment it takes to one another. They understand that sexual desire will not just fall from the sky one day randomly while they’re washing the dishes. They work at it and commit to it. This includes committing to spend time with each other, dating each other, and working hard to not revolve their relationship entirely around responsibilities, errands and bills.

Evaluate yourself first. Instead of thinking “my partner turns me on when they do...” or “my partner turns me off when they do...” I encourage you to take a moment to think “I turn myself on when…” and “I turn myself off when...” Sex for women is extremely mental. Maybe a woman “turns herself off when” she didn’t perform well at work, or feels like she hasn’t had any time to herself. Maybe it’s when she feels self conscious, or stressed and tired. Maybe she feels she doesn’t have the right to receive pleasure. These are all just hypothetical examples, but when you place the accountability on yourself (as well), you can explore more attainable solutions that you have control over. Similarly, when you explore the things that put you in the mood, you take the responsibility off of your partner and onto yourself. I encourage both partners to do this exercise. That way, two people go to bed with their glass full, rather than empty and hoping the other will fill it.

Compartmentalize. This is a skill that medical research has shown men to be much better equipped with than women. That is why sex for men is more physically driven than mentally.  Meaning, that if men are physically able to have sex, they are better able to set aside any other clutter or thought they have on their minds. I call this a skill because it can be very difficult for women to focus and prioritize sex when the mechanism of a female brain is to hold many thoughts at once so she can multitask. Strategies for compartmentalizing include relaxation therapy (meditation, yoga, acupuncture, sleep) as well as cognitive behavior therapy. Alcohol, in moderation, doesn’t hurt either…

Time Sex. If fatigue is what gets you, perhaps try sex in the morning, or on the weekends. Some couples find it helpful to schedule sex. I once heard a therapist say “f*** first, and then go out.” He accurately described how the stomach fullness, wine, and fatigue that come at the end of a date, doesn’t always set you in the mood for sex. He believed the date should go backwards. Burn your calories first, and then go out to eat.

Mind your medications and health. We know that some medications, such as antidepressants and certain types of birth control pills can decrease libido. Talk to us if you feel like you are on a medication or suffering from a medical condition that is decreasing your libido.   Talk to us about anything that you feel could be affecting your sexual desire. We are here to listen.

Yours,
Serena, WHNP, MPH, CLC