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Deconstructing Sex Drive What Your Libido Says About Your Health
While a change in your interest and desire for sex may signal a medical problem or side effect, it’s not considered a red flag. If you consider your libido levels too low, or too high, treatments are available. By Beth LevineMedically Reviewed by Allison Young, MDReviewed: February 14, 2019Medically ReviewedWhile a change in your interest and desire for sex may signal a medical problem or side effect, it’s not considered a red flag.
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If you consider your libido levels too low, or too high, treatments are available. Do you get in the mood for sex as often as you used to?iStock.comHow do you define or describe your sex drive?
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Also known as libido, sex drive is a nonclinical term that means enthusiasm or interest in sexual activity, either with a partner or by yourself. The presence of it (or lack thereof) can indicate the state of your mental and physical functioning. To get a sense of the factors involved, as well as an idea of where you may fall on the continuum, check out the Decreased Sexual Desire Screener.
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Keep in mind that sexual desire ebbs and flows naturally. What is going on today may not be going on tomorrow.
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Factors That Can Contribute to Sexual Desire or the Lack of Sexual Desire
What controls the sex drive is actually a very complex intertwining of biological, psychological, and social-cultural influences. “All of that comes together to create the sex drive.
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Some of it is not well understood, but we do know that certain ducks have to be in a row,” says Sharon J. Parish, MD, professor of medicine in clinical psychiatry and clinical medicine at Weill Cornell Medical College in New York City.
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Libido levels can be affected by:Abuse of alcohol and drugsAnxiety, stress, and depressionDiseaseFatigue levelHistory of sexual abuseLife circumstancesMedicationMenopauseQuality and novelty of relationshipReligious mandatesSensory stimuli
What Is Normal Sex Drive And Is There a ' Normal' Level
There are diagnostic conditions of hypoactive (low) libido and hyperactive (high) libido. But in general, libido levels (high or low) are only a problem if they are a problem for you or your partner.
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“If a couple agrees on once or twice a month or once or twice a week, and that works for them, that’s fine. Even if there is a discrepancy where interests are different, it’s not necessarily pathological. I would only be concerned as a doctor if there has been a sudden change from their own normal,” says Dr.
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Parish. What to Do When Your Mojo Goes Missing Treating Low Sex DriveGo to your internist or primary care doctor for a medical workup. Many diseases, including diabetes, thyroid problems, cancer, and cardiac problems, as well as disease treatments, such as radiation for cancer, can lead to low desire.
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Depending on what is found, your doctor may refer you to a specialist.To rule out drug side effects, discuss with your physician any medication, supplements, or herbs you're currently taking. Some can have a depressing effect on sex drive; but perhaps your doctor can find an alternative.
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For example, selective serotonin reuptake inhibitors (SSRIs), antidepressants such as Celexa (citalopram), Lexapro (escitalopram), Paxil (paroxetine), and Zoloft (sertraline), have been shown to reduce libido. But a study published in February 2015 in the journal Obstectrics & Gynecology suggested that a different type of antidepressant, named Wellbutrin (bupropion), can treat depression without negatively affecting sexual desire (1). Other drugs that can put a cramp in your sexual style are beta-blockers and antihistamines, and for women only, birth control pills.Ask about libido-enhancing medication.
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Addyi (flibanserin) is the first FDA-approved product that works on premenopausal women. “I have had good response to Addyi in my patients. It won’t give you a sex drive of a 15-year-old boy, but it will make you more receptive.
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I tend to use it in premenopausal women but I do use it off label with postmenopausal, and it seems to work," says Becky K. Lynn, MD, assistant professor of obstetrics and gynecology at Saint Louis University in Missouri.Men with erectile dysfunction may benefit from Viagra (sildenafil citrate). RELATED: Acupuncture Helps Boost Your Sex Drive, Life, and Pleasure
Hormone Therapies That May Help You Find Your Sex Drive
Testosterone Replacement Therapy br class lsbr
When the levels of the steroid hormone testosterone go down in either gender, so can libido.
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It’s a normal part of the aging process, but decline in testosterone can be related to surgical menopause and removal of the ovaries, as well as other medical conditions. You doctor can determine through a blood test if this has happened to you. Unlike menopause, where the clinical consequences of estrogen deficiency is known, the clinical consequences of testosterone level decline is not well established.
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Treatment options may include:
For Men
A topical testosterone gel or cream (AndroGel, Testim) may be used, or a testosterone transdermal system patch (Androderm) can be applied once a day to mimic the daily secretion of testosterone. Another option is an injection of testosterone cypionate, which patients can learn to give themselves at home.
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The newest product available is a testosterone pellet, Testopel, that’s placed by a physician underneath the skin of the buttock under local anesthesia. It offers a time-released dosage of testosterone over three to six months.
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Oral forms of testosterone aren’t yet available in the United States, but some are under development. For Women
The Food and Drug Administration (FDA) hasn’t approved testosterone supplements as a treatment for women with low libido, but there is substantial research supporting its efficacy in women, including a study published in the New England Journal of Medicine. “Clinicians sometimes prescribe the gel or patch to women as an off-label use.
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As in men, the adverse effects of testosterone therapy can be minimized with proper dosing and following blood levels,” says Parish. Relationship Problems Causes and Solutions
“Many times, the problem is simply that the couple is bored. There is no novelty, which is the kiss of death to human sexuality,” says Lou Paget, a sex educator certified with the American Association of Sexuality Educators, Counselors, and Therapists and author of The Great Lover Playbook.
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Other problems include lack of communication, trust, and intimacy, pent up resentment, and body insecurity. Most of these problems can be dealt with through honest face-to-face conversation when you’re vertical — not horizontal. Why?
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Because when you’re horizontal you often have heat of the moment involved. These conversations may include comments like "This is what I’d like to try, this is how I feel,” or be part of counseling with a trained sex therapist, in which you will explore emotional issues that may contribute to sexual dysfunction through cognitive behavioral therapy or mindfulness therapy. Lifestyle and General Health Factors Behind Sex Drive
These are what Parish calls “modifiable risk factors.” If you aren’t getting enough sleep or exercise, if you never have privacy, or if you aren’t making your relationship a priority, your sex drive is going to take a hit.
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Also, do you drink or smoke too much? If you can’t work these issues out with your partner, a licensed therapist can help. A Complementary and Alternative Medicine CAM Approach to Sex Drive
Some people find success by taking a complementary approach using herbal supplements.
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Just be sure you don’t add any supplements, vitamins, or herbs without talking to your physician first, since some can interact with your medication. RELATED: 8 Natural Cures for Erectile Dysfunction
Herbal Aphrodisiacs What to Consider
“Herbal aphrodisiacs are the earth’s medicinal gifts to your libido, and you have a cornucopia to choose from.
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Some may increase your levels of ‘feel good’ brain chemicals, known as neurotransmitters; others stimulate nerves in your genitals, or support your adrenal glands, lifting your libido by helping your stress levels. Many herbs increase your nitric oxide (NO) levels, which increases blood flow to your genitals,” says Laurie Steelsmith, ND, acupuncturist and coauthor of Great Sex, Naturally.
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She recommends these:
HerbsChinese ginseng. “I use this a lot with both sexes; men do well with ginseng along with the L-arginine to support their frequency and intensity of their erections,” says Dr. Steelsmith.CordycepsDamianaGingko bilobaMacaMuira puama
Supplements
L-arginine can be taken as a supplement or a cream applied directly to genitals.
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A small study published in the journal Archives of Sexual Behavior found that 6,000 milligrams (mg) of L-arginine as a dietary supplement (along with 6 mg of yohimbine) notably increased physical female sexual response. (2) Another study, published in the Journal of Sex & Marital Therapy, showed that more than 70 percent of women who took the product ArginMax For Women — which contains L-arginine, ginseng, ginkgo biloba, damiana, vitamins, and minerals — experienced increased sexual desire, higher frequency of sex and orgasm, enhanced clitoral sensation, decreased vaginal dryness, and improved overall sexual satisfaction, with no significant side effects. (3)
Note: An earlier version of this story oversimplified an issue regarding sex drive.
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That section of the story was removed on 2-14-19. NEWSLETTERS
Sign up for our Sexual Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. Editorial Sources and Fact-Checking
Kingsberg SA, Woodard T.
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Female Sexual Dysfunction: Focus on Low Desire. Obstetrics & Gynecology. Feburary 2015.Meston CM, Worcel M.
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The Effects of Yohimbine Plus L-arginine Glutamate on Sexual Arousal in Postmenopausal Women With Sexual Arousal Disorder. Archives of Sexual Behavior. August 2002.Ito TY, Trant AS, Polan ML. A Double-Blind Placebo-Controlled Study of ArginMax, a Nutritional Supplement for Enhancement of Female Sexual Function. Journal of Sex & Marital Therapy. 2001.Show Less
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