Hi everyone! If you find yourself or your partner lacking motivation in the bedroom, then you’ve come to the right place!


June 2nd to June 3rd, our live conversation will be hosted by Bat Sheva Marcus, LCSW, MPH, PhD, our Clinical Director of Maze Women’s Sexual Health, and Nicole Tammelleo, MA, LCSW, Psychotherapist. They will be answering questions all about low libido/low sex drive, and more specifically, addressing the frequently asked question “Is there really medical help for low libido/low sex drive?”


Low sex drive/low libido can become a problem at any life stage. It’s not just about not wanting sex, but rather it can be about not being able to respond or not feeling sexy. It can affect so many elements of one’s life- relationships, self-esteem, and one’s interest in dating.


Have other questions about low libido/low sex drive? Click here to submit a question for our panelists to answer.  

Thank you to everyone who submitted questions for our first blogcast! Feel free to submit more questions throughout the next two days! Our panelist will be answering them throughout the day.


So lets get started with our first question, anonymous asked: "I have almost no desire for sex, and I feel like I have tried everything... testosterone, vibrators, Wellbutrin? Please help!"

So we get this A LOT. I’ve tried everything. Nothing is helping!! What gives? And it’s here that I’d like to challenge you. Usually when we hear that, it means that medical providers or therapists tried everything but not in high enough doses,  not for long enough and most importantly, without using them together, or where appropriate in conjunction. It is important that while you are trying medical approaches you are also dealing with the practical, behavioral, emotional pieces that get in the way. Think about knee surgery where there was no follow up physical therapy. Or physical therapy without having done the necessary surgery. The trick is to work with someone who will keep tweaking things, adding, changing or re-assessing until you actually feel like you are getting somewhere.

Next question submitted: "I am in my 70's. What can I do to get the feelings back... I'm tired of faking an orgasm! I really want to enjoy having sex with my partner!" 

Women's bodies change over time, as does their libido and ability to orgasm in the same ways we did when we were younger. There are numerous reasons why things change, but we have found specifically with post menopausal women that a decrease in hormone levels can adversely affect a woman's libido and her ability to orgasm.


Having your hormone levels checked would be a great place to start. In addition there are also medications like Addyi or Wellbutrin that can increase your ability to orgasm, and of course exploring new ways of getting turned on, positions, etc.


If you have experienced pleasurable orgasms in the past, it is likely that with a combination of medical and emotional support, you can do so again, and no need to fake!

 

I know it’s really tempting to fake orgasms when you can’t have them. You don’t want to disappoint your partner and sometime you end up just feeling so pressured! But in general, it’s probably not such a good idea.  Here’s why: When you fake orgasm, the message you are giving your partner is “everything is great! Keep doing exactly what you are doing (or did last time). It was perfect.”  So that’s not really the message you want to be sending them. Better would be to stop focusing on the orgasm, focus on what he or she does that makes you feel good and enjoy those sensations, at the same time you might be exploring other ways to actually bring back those orgasms!

The questions keep rolling in!! Want to submit one? All submissions are anonymous!! Submit your questions here

Here's our next question: "What can be done for a hypertonic pelvis that is contributing to decreased sensation /  sensitivity of the vagina?"

Pelvic floor physical therapy is one of the best ways to address decreased sensitivity in the vaginal area. A well trained pelvic floor therapist will be able to help you control the muscles in the pelvic floor. There is a myth that everyone should be doing Kegel exercises to tighten the pelvic floor muscles, but for many women that is the exact opposite of what they need, so it is important to work with a trained professional who can properly evaluate your specific situation and design a plan that is right for you.

Next question! Submitted anonymously: "What happened to my libido? Around 30 it started to wain. I had a child at 38 and I'm turning 40 in August it has almost vanished. I just don't think about sex or feel like bothering with it anymore."

What you are describing is incredibly common. As we get older we slowdown in hormone production. Our bodies start making less estrogen, testosterone and our neurotransmitters aren’t working as well either. This can also happen when there has been a hormonal shift from childbirth. This can feel as though someone has pulled the rug out from under us. What’s really frustrating is that often we get the message that we’re not trying hard enough. If we just relaxed a bit more, if we focused more, if we had date nights, then presto, our libido would come back. But to me that is just blaming the victim. Would we tell a 10 year old who had no libido to “try harder?” We’d get that they have no libido because their body isn’t making the stuff they need to have a libido. That’s probably what’s happening with you as well and you should check it out.

Anonymous asked: "I'm 30 years old. It is very hard for me to maintain any sort of sexual desire, and it has become a chore to have sex, but I try to do it so my husband will be happy. I enjoy it some of the time, but the desire to even try is not usually there.   My husband is very frustrated with my low desire to be intimate with him. I WANT to be intimate and start a family, but it seems like my brain and vagina are disconnected. I'm not sure what's going on or what to do?"

We hear exactly what you are saying from so many women all the time. They feel a disconnect between their physical self and their mental and emotional self. Unfortunately, they are often told it is "all in their head," and if they just "relax" or "have a drink" then they will "get in the mood." While relaxing is important, it is not likely to change much if your body's chemistry does not have what it needs to produce a healthy libido.

 

But there is help getting the body and mind in sync with each other. Whether you never had much of a libido or if it has diminished over time, it is important to have your hormones levels checked.  Testosterone plays a large role in a women’s sexual desire and ability to become aroused. However, women’s testosterone levels are almost never tested as part of a regular check-up.  Many women have low levels of testosterone and tweaking those levels can have a huge impact on the libido and interest in sex. Having your hormone levels (especially testosterone) checked would be a great place to start. Once that is regulated, you can begin to explore additional ways to connect the brain and vagina!

Hi Anonymous.  I just want to add something to Nicole's terrific answer. Sometimes people mix up "low desire" (not wanting to have sex, with "arousal problems" (not getting turned on once you start having sex.) They are obviously related in many ways but they may indicate different physiologic problems that can be treated differently. So I would just make sure that you see someone who understands the distinctions and can help you fix the specific problem you might have.

That's it for today! Please join us tomorrow as we continue to answer questions regarding low libido / low sex drive. We will be starting tomorrow morning and will be posting throughout the day.


Thank you for submitting your questions!


You can continue to send in your questions here

Welcome back everyone! We're going to jump right into the first question of the day: "Help, I am 49 and have absolutely no desires and no sex drive, and nothing turns me on. And it's not because of menopause because I have been this way for years. What can I do?"

So... in general I am amused when people say "it's not because of X,"  because they are so right. And so wrong. Rarely, if ever, is lack of sex drive a result of ONE thing. It's often a combination of things: exhaustion, hormonal shifts, changes in the way we think, bad habits, other medication, pressures in our lives, not recognizing changes in other areas of life, life changes that can effect blood flow and responses, the way we look at our body, changes in the way we are stimulated. In the end, I don't imagine your lack of sex drive is directly a result of menopause. But, if I was seeing you as a patient, I would be more interested in fixing the problem then figuring out what caused what and when. Low libido can be addressed, but all the variables have to be taken into account, including menopause!

Yes, Bat Sheva is so right!  What we thought in our 20's was a low libido might be very different than what think of as low libido in our 40's.  What is important is how you are feeling right now, and how you want to feel today and tomorrow and forever!  

         "Was wondering what help would be available for me if I can have an orgasm by a vibrator but not a penis. Is there any pills I can take? Should I go see an urologist? Desperately seeking help. Thank you"

Hello Desperately Seeking Help,


Like so many of your wonderful questions, we hear this from many, many of our patients.  While the movies and popular media continue to spread the myth that all women can easily orgasm from intercourse… the reality is very different. Only 30% of women reach orgasm from intercourse alone. Most women need stimulation directly on or near their clitoris which is located outside of the vagina.  For many women the position and stimulation of the clitoris, during sexual intercourse is not conducive to orgasm and there is no way that intercourse alone can produce an orgasm. In terms of medication, there are no medications that will help you specifically obtain an orgasm through intercourse. If you are having trouble reaching orgasm at all, from any type of sexual activity there are some medications that can help bring blood to the vulvar/vaginal area, but will not specifically help with orgasms during intercourse.  


However there are lots of options to having an orgasm!  Your partner can stimulate you manually during intercourse or you can stimulate yourself manually during intercourse. It seems you have already started to use a vibrator, which is great! There are many different kinds that can be used during intercourse, and it is fun to explore what works for you!  

I'm a big fan of vibrators. Heck, I did my PhD thesis on them. And I often wonder why, we as a society, have decided that "penis induced orgasms" are more valuable than ones you have using a vibrator. It doesn't make sense to me.  BUT I get that's how people see it done in the movies and books and so that becomes a goal. However, I will often say to women... how do you think I should respond to a man who says he really wants to have orgasms by having his balls (testicles) stroked. Really??? That is kind of unlikely! I am sure you realize that only 3 in 10 women have an orgasm from penile stimulation alone. And just like I would like to be 5 inches taller, you can wish for a different body, but you probably can't make the wish come true. However, if what you want is to have an orgasm during intercourse, while that penis is in your vagina (rather than as a direct result of intercourse), there are ways to do that. Use your hands while having intercourse, use your vibrator during intercourse, or buy a smaller vibrator that is meant specifically for that. Sometime changing positions can help, because you can choose a position that has his pubic bone rubbing against your clitoris, or if the penis goes in deeper, may stimulate the internal portions of the clitoris. So there are suggestions, but really what i want to tell you is try to stop getting hung up on how you are having orgasms and just enjoy them, however they happen. There is no one right way to have an orgasm!

Anonymous Question: "Although I enjoy intimacy, I have never experienced an orgasm. I have a very low libido, and would like to know how to improve it. I have never been abused or injured. Everything 'works', except orgasm."

There are, believe it or not, drugs that can help you with your orgasm! So don't despair. But you want to make sure you have done all the "non-drug" work first... make sure you are not experiencing some type of orgasm and have unreasonable expectations or not being aware when they happen, or not stressing yourself out or stopping yourself for some reason. But the statistics are that 93.4% of women can have orgasms. You are probably in that group!

Thanks for noting that you were never abused or injured as that is a myth society perpetuates when women have a low libido or difficulty with orgasm. They are often told that “something” must have happened to them when they were young and are also told “it is all in their head,” and spend years in therapy trying to figure it all out.

It sounds that actually everything is not” working” as well as it could be. You note a low libido, which is most likely related to a combination of factors including: hormone levels, relationship with a partner, emotional state, physiological issues, etc.  All of these factors (and many more) can affect libido, so it would be best to find help that addresses your low libido in a comprehensive way, and looks at the whole picture.  As for the orgasms, having a low libido can’t be helping with that issue.  Have you masturbated recently? Tried out a vibrator?  Watched or read erotica?  Many women find these helpful techniques to increase their libido and start becoming more attuned to their own “sexual self” They are  a good way to explore what turns you on, and can help you achieve orgasm,. There is no one right way to have an orgasm, and experimenting with what feels good and turns you on is a good place to start. Remember most women have orgasms through clitoral stimulation, so there are many ways to explore with or without a partner.

That's all for our blogcast today! Thank you Bat Sheva and Nicole for your expert advice!


Thank you to everyone who submitted their questions, and for those of you who tuned in!


We will announce the topic and date of our next blogcast in our newsletter and on our Facebook page! So keep an eye out!


- The Maze Women's Health Team