Are you really never in the mood to have sex with your partner? Do you find yourself avoiding
situations where you might have to be alone with them and they might try to have sex with you?
Well, I'm Dr. Rena Malik, and today we are talking about low libido or low sex drive.
If you're new here, we talk all about urologic health, bladder education, sexual education,
and much much more. I know that a large portion of my audience is male and thank you guys all
so much for being a part of this community I do hope that you will share this video with your
female partners and friends just so they can learn more about their libido and if there's
something wrong and they should see someone about it this video is launching a new section of videos
that I'm going to be talking about women's sexual health as well as male sexual health
so please if you are male watch this video learn something and share it with your female friends
in this video I'm going to focus in on what are the causes of low libido in women and in the
next video following this I'll talk about what we can do about it but to start off what exactly is
low libido how do you define it well the medical term for it is hypoactive sexual desire disorder
or HSDD this is clinically defined as a lack of motivation for intercourse either with lack of
responsiveness to spontaneous desire meaning that you're having lack of response to sexual
thoughts or fantasies or a lack of motivation from responsive desire meaning that when you're
actually having some erotic cues from your partner you're just not that into it and lastly
you have a lack of desire to either initiate or participate in sexual intercourse and often time
in these people will find that women are avoiding situations where they might have to have sexual
activity with their partner or they're really only participating out of fear or concern for
their relationship and another thing that really defines us as a problem is that it's a change from
what you were before not something that you've always been but that you've all of a sudden
notice that this has changed it's been lasting for at least three months but the most important
thing here is that this should be causing you some clinically significant distress and what i mean
is like you're really having relationship issues or personal issues from this problem some people
have really no issues they're just not that into it it doesn't bother them or their partner and
that's totally okay i also want to really clarify that this is different than mismatched desire and
what mismatched desire is is when your partner has a desire for sexual frequency that's more or
less than you that is a other condition entirely and does not mean that you necessarily have low
libido so how many people actually experience low libido well if you look at survey studies you'll
find that 40 of women do report some experience of low libido however only 10 to 12 percent are
really bothered by it so those are the people that we are talking about here if you're bothered by it
and if you're bothered by it this can be really significantly impactful it can cause decreased
self-confidence decrease self-worth and decrease self-esteem it's often more common in people with
a spouse or a partner and if you've been in a longer relationship it's actually been shown that
these sexual problems become more problematic over time in people with partners we find that over the
course of relationships as the relationships get longer and longer sexual activity and satisfaction
with sexual intercourse do tend to decline it's important to know that women with low libido will
often have other sexual dysfunction issues so they may have issues with arousal with orgasm
with lubrication and other issues like pain with sex and those can cause the low libido or
be kind of interlinked with low libido so fixing them sometimes will fix the issues with low
libido but before we get into that i want you to understand exactly how the brain works when you
are aroused because that will kind of explain why certain things are more likely to cause low libido
so when you're aroused certain areas of the brain are stimulated and those are called
sexual excitation pathways and they use certain chemical messengers or neurotransmitters
specifically a big one in sexual excitation is dopamine and when you're thinking about sexual
inhibition pathways or typically when you are not wanting to have intercourse or you're done having
intercourse and you're in that sexual refractory period is what we call it these pathways light
up and they typically use hormones or chemical messengers called serotonin and sometimes things
like opioids so when you're thinking about things that may cause low libido there's a couple factors
that are at play drugs or medical conditions that either decrease brain dopamine increase brain
serotonin or increase brain opioids will cause a decrease in sexual excitation conversely drugs or
conditions that either increase brain dopamine or decrease serotonin release can actually cause an
increase in excitation or a decrease in the inhibition pathways if you look at people
with hsdd or hypoactive sexual desire disorder will have either a predisposition to having more
activity in the inhibitory pathway or they may develop brain changes that kind of either decrease
the amount of excitation they get or increase the inhibition and once they looked at women with
hstd or without it and they had them watch erotic videos and they took brain scans and here you can
see that the brain scans are very different in the hsdd brain versus the non-hsdd brain so if you're
suffering from hsdd this is not something that you are doing this is because there is different brain
chemistry and different activation in your brain that's causing this as i mentioned earlier many
women who suffer from low libido also have issues in other areas of sexual dysfunction and so these
risk factors that i'm going to review are not necessarily specific to low libido but they may
cause other issues that can also cause low libido causes of low libido can include psychological
conditions such as depression and anxiety relationship issues with your partner fatigue and
stress can certainly play a role certain medical conditions and medications can contribute to these
symptoms and physical conditions that can make sex painful can also cause people to have low libido
so as far as psychological problems oh ha ha it's so funny my vagina is depressed a big one
that women suffer from is impaired body image so feeling like they're unattractive or their body is
not the shape they want it to be and so working on that can be helpful in increasing libido
also going through pregnancy and childbirth adds a lot of stress a lot of fatigue body issues and
there's hormonal changes and all of those things can affect libido in fact when they studied 400
women who had their first baby they found that at three months after pregnancy regardless of whether
it was a vaginal birth or a c-section 83 percent had issues with sex and at six months there was
still 64 of women who experienced some issues with sexual function so this is very very common you
are not alone if you're in this situation also just having children itself or struggling with
infertility those issues are linked and found to be correlated with low libido moving on to
medications there's several medications that are used for psychological conditions specifically
selective serotonin reuptake inhibitors or ssris which are commonly used for depression
can cause low libido and so if you are on one of those medications and you're struggling with low
libido talk to your psychiatrist and see if you can get those changed also some antipsychotic
medications and medications for anxiety called benzodiazepines can cause sexual dysfunction or
low libido another area that i think is really interesting is oral contraceptives so the data
is inconclusive that oral contraceptives cause low libido but i will say that i've heard this
so often that people on some sort of hormonal contraception can have changes in libido after
starting contraception so if you find yourself in that boat please talk to your gynecologist
about possibly changing your contraception in fact we're doing study right now where we're
looking at what people report on reddit about low libido and oral contraceptives were a big thing
that were reported on reddit and i will absolutely share those results with you if you are interested
once we publish them so medical conditions there are several uh medical conditions that
have been linked with low libido one is diabetes mellitus and the reason the thought process behind
that is that there may be changes in the nerve function because diabetes affects nerves all over
the body which can cause some genital numbness that's similar to certain neurologic conditions
like multiple sclerosis also parkinson's and some epilepsy or seizure disorders people can have low
libido associated with that we've also seen it in people with chronic renal failure on dialysis
and patients with high blood pressure and it may be either the high blood pressure or the
medications such as beta blockers that are linked with low libido people with chronic pain disorders
which kind of make sense if you're in chronic pain you're probably not that interested in sex
and also people who have been recently diagnosed or just finished cancer treatment can also have
low libido all those things kind of make sense as far as things that can make sexual intercourse
uncomfortable or painful things that include pelvic floor dysfunction or high tone pelvic floor
having a prolapse can make it uncomfortable or having leakage of either urine or stool
called urinary incontinence or fecal incontinence can obviously make
wanting to be intimate a little less desirable also in women who have chronic
pain in the pelvic region obviously that makes it less desirable or if you're post-menopausal and
you're going through what's called the genital urinary syndrome of menopause where you've lost
estrogen in the vagina and this causes the tissues to be very thin and less elastic can cause a lot
of pain during intercourse and i'm gonna make a video on that as well later on down the road
so if you're interested in learning more about that please make sure to let me know so i know
to make it sooner rather than later and lastly certain gynecologic conditions like fibroids or
endometriosis can cause pain with deep penetration and those that can also make be contributing to
some aspects of low libido i hope you guys found that useful uh stay tuned for our next video on
treatments for low libido as always we're going to take care of yourself because you're worth it