A Woman's Guide to Reviving Sex Drive
As baby boomers age, more and more women report they've lost their sex drive. But experts say it may just be matter of knowing where to look.
By Colette Bouchez
Reviewed by Brunilda Nazario, MD
Has the "free love" generation lost its mojo?
If you talk to baby boomer gals, it seems the answer is yes. Indeed, as millions of women enter perimenopause and then transgress to menopause and beyond, many say they check their sex drive at the door - and most are not happy about it.
"I don't think a day goes by when at least one patient - and usually more - complain that their sex drive is dropping off and want to know what they can do about it," says Laura Corio, MD, a gynecologist and clinical instructor at Mt. Sinai Medical Center in New York City.
Clinically known as HSDD (hypoactive sexual desire disorder) Corio says she doesn't think more women are affected now than in the past, but she does believe more are coming forward -- prompted, at least in part, by the success male potency drugs like Viagra.
"The man gets a prescription for Viagra and he's ready to rock and roll while she's thinking 'Hey, where's my pill?' If she's not ready to jump in the old van and join him for a ride, there can be real problems," says Corio.
Discovering What's Wrong
While male sex drive is easy to define -- and relatively easy to restore -- that's often not the case for women. Because the female sex drive is multifactorial, the desire to make love is not only influenced by physical issues, but emotional ones as well.
"Part of the desire to make love is clearly physical, but part is also emotional - depression can make a difference, so can any emotional issue in a woman's life; female sex drive is very multidimensional," says Glenn D. Braunstein, MD, an endocrinologist and chair of the department of medicine at Cedars Sinai Medical Center in Los Angeles.
While emotions are frequently behind a loss of sex drive in younger women, doctors say it is frequently the aging process itself that's causes changes in desire in women over age 45.
"The very fact that a woman is no longer ovulating regularly, or not ovulating at all, automatically takes her sex drive down a few notches," says Steven Goldstein, MD, professor of ob-gyn and NYU Medical Center in New York City.
Nature's Design for Sex
Indeed, as many women are aware, Mother Nature built in a natural increase in the desire for sex beginning just prior to ovulation, and lasting several days afterwards -- not coincidentally, the only time of the month conception is possible.
Stop ovulating, says Goldstein, and you automatically lose that regularly scheduled boost in your sex drive that has been present since puberty -- and you're probably going to notice.
"There's nothing wrong with you; it's just the way nature works," says Goldstein.
Moreover, around menopause, when there is also less estrogen circulating in your body, that too can bring your sex drive down for the count.
"Estrogen is a mood elevator, it works in the brain to maintain interest in sex, but it also works at the level of the genitals, helping to increase sensation and just making sex more pleasurable," says Corio.
Without it, she says, not only can desire take a dive, vaginal tissue begins to dry and shrink. As a result, intercourse can become uncomfortable, or even painful. Problems with desire, say experts, are easy to understand.
"Who wants to make love when making love hurts?" asks Goldstein.
Moreover, he says, avoiding sex because of pain only leads to more pain. The old "use or lose it" theory really does apply.
"From a strictly physical standpoint, the less sex you have the more painful it is when you try to have it," he says.
Put the Sizzle in Sex
While estrogen levels are important, the latest research shows that the male hormone testosterone also plays a role in a woman's sex drive. Though present in only tiny amounts, some doctors say it's the seasoning that makes her sex drive sizzle.
Moreover, when levels become erratic, as they do at midlife, that sizzle can fizzle fast.