Hello! My name is Tori and I am a doctor of physical therapy who specializes in
pelvic dysfunction, which means I treat things that can go wrong
around the pelvis—and this includes sexual dysfunction.
If you haven’t, please check out the first video in this series as it introduces
what’s normal and abnormal around female libido and speaks more about
my intention behind the series—which is, in summary, to walk you through how I
would approach treating low libido as a patient who is also a pelvic health provider.
Today, we’ll be discussing how your physical body can relate to low sex drive. We’ll
break down the aspects of the physical body that can affect libido into three categories—nonsexual
disease, sexual dysfunction, and surgery—but we’ll focus primarily on nonsexual disease,
as I believe this category would be the most challenging to relate to low libido.
You can check the description below for
timestamps and links to any studies or resources mentioned today!
Let’s begin by talking about nonsexual diseases. Nonsexual diseases like arthritis,
cancer, diabetes, heart disease, chronic pain conditions, and neurological conditions can
all negatively impact libido. What can feel overwhelming and tricky is teasing apart if
and how that nonsexual disease is impacting libido—and identifying both are important because,
once you know that a nonsexual disease is a affecting your sex drive, and you know
how it is affecting your sex drive, you can seek the proper treatment.
So, if it were me, I would approach identifying that “if” by establishing a timeline. Establishing
a timeline—even a hazy one—can be a really helpful tool, especially if you’re managing
multiple conditions. How long have you been managing these conditions, and when did you
start to notice a change in your sex drive? The onset of the condition and the onset of change in
libido do not need to match up perfectly, you’re simply looking for a correlation.
Once you’ve identified any correlations, the next step is asking yourself, “if this condition is
affecting my sex drive, HOW is it affecting my sex drive?” I would approach identifying
that “how” by applying different “levels” of effect to my libido. Let me explain. In my eyes,
nonsexual diseases could affect libido on three different levels—primary, secondary, and tertiary.
Primary loss of libido would be a direct result of the disease. For example,
a brain injury causes someone to lose interest in sex.
Secondary loss of libido would be an indirect result of the disease. For example, arthritis
causes someone to have pain when assuming her favorite sexual positions, and, overtime,
her sex drive decreases. Or, fibromyalgia causes someone to have extreme fatigue,
and she is too tired to have sex as often as she used to, and, overtime, her sex drive decreases.
Finally, tertiary loss of sex drive would be caused by the psychological, social, and/or
cultural challenges of having the disease. For example, a chronic pain condition causes
someone to develop depression, which decreases her sex drive. Or, a stroke leaves someone
wheelchair-bound, which affects her body image and self-esteem, which decreases her sex drive.
Now, I know that establishing a timeline,
finding a correlation, and exploring these potential primary, secondary, and tertiary
losses of libido can feel difficult and foggy, and that you might not be sure of your answer.
That’s okay. Take your time, turn inward, and try to examine your previous experiences.
My hypothesis is that the majority of people watching’s libidos would
be affected on secondary and tertiary levels, so, assuming you’ve established a correlation
in your timeline, a really fruitful place to focus would be why did I lose interest in sex?
Were sexual positions uncomfortable? Was I too tired? Was I unable to concentrate on
pleasure? Was I sad? Was I distracted? Was I not feeling sexy or desirable in my body?
Again, take your time with this investigation because only you can know the answer. I know
that’s a double edged sword because on the one hand that responsibility can feel
heavy, overwhelming, and near impossible, but remember that,
on the other hand, that makes you incredibly powerful in this situation.
Once you identify if and how a nonsexual disease is affecting your sex drive,
it’s time to turn to the proper treatment!
If you’re experiencing a primary loss of libido,
your focus should be on how you can cure or better manage the disease.
If you’re experiencing a secondary loss of libido, your focus should be on how
you can best support your body to allow your libido to improve again. You might consider
movement specialists—like physical therapists, aquatic therapists, pilates or yoga instructors,
or any provider who can help you better learn to support your body so that you can enjoy sex. I
know how difficult this subject can be to broach, but, as a provider, believe me when I say that
clarity in your goals as the patient is crucial to effective therapy. Find the strength to tell
the provider you’re working with explicitly what you hope to gain from therapy. You can
use what we’ve outlined above as a guide. For example, “I noticed my libido decreased
a few months after I was diagnosed with and had been managing arthritis. I think it’s because the
arthritis limits my ability to feel comfortable in most sexual positions. My goal is to be able to
enjoy sex comfortably so that I can restore my libido, can you help me achieve that goal?”
If you’re experiencing a tertiary loss of libido, your focus should be on how you can best support
your mental health to allow your libido to improve again. You might consider psychiatrists,
psychologists, sex therapists, support groups, or any provider or outlet that can help you
better learn to support your mental health so that you can feel worthy and deserving
of a vibrant sex life—because you are. Again, try to find the strength
to tell any provider you work with exactly what you hope to gain from the experience.
As I’ve said in my previous videos in this series, remember that healthcare is a service industry.
And sometimes, well-meaning providers are more concerned with the nonsexual disease itself
than they are with your sexuality—because that’s how they’ve been trained. Try to find the courage
to speak up, and don’t hesitate to rack your provider’s brain for some local resources,
some other local providers that are more tailored, more specialized, in what you’re looking for.
Now that we’ve discussed nonsexual diseases and how they may affect
libido, I do want to say a few words in regards to sexual dysfunction.
Now, while it may be more obvious that sexual dysfunction can negatively impact libido,
finding the right treatment for sexual dysfunction can prove very difficult. I want to
remind you that, if you’re struggling with sexual dysfunction—especially painful sex—pelvic physical
therapy may be helpful for you. Whether that painful sex is caused by a pelvic condition—like
endometriosis or PCOS—or a pain condition—like vaginismus or vuvlodynia—or you’re struggling
with painful sex postpartum, or you’re struggling with painful sex and you don’t know the cause—a
good pelvic physical therapist would not only be able to tailor interventions to your unique
presentation to help you return to pleasurable sex, but could also be a well-networked wealth of
information. Even if a pelvic physical therapist
doesn’t have the tools to help you, he or she should be able to give you good, trustworthy,
local resources—pharmacists, physicians, chiropractors, therapists, you name it.
If you live in the Untied States, you can use this directory to find a provider near you.
I’ll link to it and other helpful provider directories in the description below as well.
Finally, I want to end on a note about surgery.
If you’ve recently had any surgical procedures to do with your pelvis, your breasts,
or any part of your body that you associate with sex or your sexuality—the process of healing,
the pain of recovery, and the change in the way you view your body could all affect your libido.
Try to give yourself the time and space to fully heal. Don’t hesitate to seek rehabilitation
if you’re not healing well, and, if you can, do your best to be honest with yourself
and your partner or partners about your relationship with your healing body.
On that note, thank you so much for watching! Let me know what you think of this video—I’m
approaching this series differently than other content I’ve created before, and I’m very open
to your criticism, feedback, and suggestions. So, if you found this video helpful, please
give it up a thumbs up. If didn’t, please give it a thumbs down. Feel free to comment feedback,
questions, requests, anything down below—I do try to read and respond to all of my comments.
Don’t forget to check meowt on instagram and finally, if you want to, please subscribe
to my channel for more content not only about pelvic things but also about life things.
I hope you have a wonderful rest of your day and I will see you in the next video. Bye!