Libido loss

Libido loss -
Feeling down because you aren’t “up for it”.  (By Marina Green. Originally published in Dischem's Benefits Magazine)

Libido refers to our interest in and desire for sex and is affected by many factors including our physical circumstances, psychological and emotional states. If your libido is flagging you are certainly not alone. An American Medical Association study in February 1999 found 43 percent of women between the ages of 18 and 59 experienced some sort of sexual dysfunction. In men, 31 percent suffered from sexual inadequacy. Our libido fluctuates and it is normal for it to change over the course of our lives. Occasional loss of desire in both men and women is fairly common but when the problem becomes persistent and interferes with our relationship and self esteem it is time to seek help.

Why the secrecy?
Although in western culture we are constantly bombarded with sexual images many of us still feel uncomfortable talking about problems with our own sexuality and intimacy. The media tends to present an idealized view of sex as spontaneous and easy and when our own experiences do not live up to this we may feel inadequate. The reality is that sexual function is complex and multi-layered and we are not “always in the mood for it.” Strict religious upbringing and cultural taboos can make it difficult for many of us to openly address our sexual problems and seek appropriate help.
Is it different for men and women?

Many women find that the stresses of daily living and worries about family, work and money lower their libido. More men today recognise the terrible burden of traditional male stereotypes and we need to deflate the myth that men are always “up for it”. An article by the AAMFT (American Association for Marriage and Family Therapy) warns us not to confuse the average guy with the Energizer™ Bunny. “Many men have low sexual desire, too. Just like women, lots of men know what it is like to feel pressured by their spouse’s larger sexual appetite.“

A drop in male libido can be caused by several factors and conditions including what is sometimes referred to as the male menopause and is a normal decline in testosterone levels as a man ages. Surveys have shown that “many aspects of sexual function including desire, orgasm and overall ability decrease” in men over 50. Loss of libido however is certainly experienced by men of all ages and for a variety of reasons.

Sexual dysfunction in men generally manifests in three ways:

• Erectile dysfunction (ED) or impotence is the failure to achieve or sustain an erection until sexual activity has been completed. Occasionally being unable to achieve an erection is common and is considered situational but it can result in a cycle of performance anxiety leading to impotence. Erectile dysfunction may be psychological, physical or a combination of the two. Risk factors for erectile dysfunction include obesity, smoking, inactive lifestyle, and certain medications. Drugs, alcohol, diabetes, multiple sclerosis, Parkinson’s disease, HIV, spinal cord lesions and other injuries can cause erectile dysfunction.
• Premature ejaculation is often associated with performance anxiety. It refers to a lack of control over ejaculation. Ejaculation occurs with minimal sexual stimulation and sooner than desired. Usually the man is unaware or unable to recognise the erotic sensations telling him that ejaculation is about to happen. Premature ejaculation is common in younger men with limited sexual experience and physical causes are rare. .
• Retarded ejaculation or male orgasmic disorder refers to the persistent involuntary delay in orgasm or the inability to reach orgasm. The cause is rarely physical and it is often associated with a traumatic sexual experience, strict religious upbringing, hostility, over-control, or lack of trust.
• As Dr. Laura Berman sex educator, therapist and author of For Women Only, mentions doctors have historically been quick to dismiss women’s sexual complaints as either psychologically or emotionally based. The book aims to help women and their partners lead fuller and more satisfying sex lives and lets them know that they are not “crazy, alone or fated never to have an orgasm or feel sexual again”. Dr Laura Berman and her sister Dr Jennifer Berman, an urologist with special training in female sexual dysfunction are founders and co-directors of the Center for Women's Urology and Sexual Medicine at the UCLA Medical Center. Dr Laura Berman explains that they have identified four types of sexual dysfunction in women.
• Hypoactive Sexual Desire Disorder: Lack of sexual desire with a persistent lack or absence of sexual thoughts or fantasies
• Sexual Arousal Disorder: An inability to attain or maintain adequate responses including lubrication or nipple sensitivity.
• Orgasmic Disorder: A difficulty reaching orgasm even after sufficient stimulation and arousal.
• Sexual Pain Disorder: Recurrent or persistent genital pain associated with sexual intercourse.

Starting points
Many factors can influence sexual problems. Physical conditions can play a major role in reduced libido and many illnesses may be responsible for loss of sexual drive. Usually the biological and psychological components interact so getting yourself checked out for underlying medical problems is a good place to start and if no medical condition is diagnosed then your doctor should be able to refer you to an appropriate therapist.

Both men and women can experience a loss of libido due to the following:

• Fatigue and tiredness often as a result of overworking.
• Lack of time due to the demands of work and home. Intimacy with your partner is often dropped to the bottom of the list of priorities.
• Illness and disease including anaemia, kidney failure, liver disease, malfunctioning glands, depression, thyroid, diabetes, hormonal imbalance, multiple sclerosis, high blood pressure and hormonal problems.
• Menopause is a natural event in a woman's life cycle. Reduced desire may be one of the symptoms experienced around this time. Pregnancy and a year or two after giving birth are also commonly times of reduced sexual desire.
• Stress hormones have been shown to diminish desire and sexual responses.
• Some medications can aggravate the problem. These include drugs for high blood pressure, anti-histamines, anti-epilepsy drugs, anti-depressants, sleeping pills and anti psychotics. This does not however mean you should stop taking your medication but that you need to discuss the difficulty with your doctor.
• Misuse of drugs such as alcohol commonly reduces libido. Alcohol and cannabis reduce the production of androgens, male hormones produced by both sexes that contribute to our sex drive and general sense of well- being. A man who is drunk will probably reduce his testosterone production by between half and two thirds over the next 48 to 72 hours. Alcohol is small amounts may free a person from inhibitions but in larger quantities curbs desire and function.
• Performance anxiety can lead to an avoidance of sex to prevent the problem, for example premature ejaculation or painful intercourse, from being repeated.
• Trauma or abuse. A traumatic incident or distressing experiences of a sexual nature such as harassment or rape can seriously impact on libido.
• Relationship problems in other areas frequently spill over into a couple’s sex life.
• Anger and other negative emotions. Resentment towards a partner for something she or he did can lead to anger and pain which if unresolved make it hard to be intimate. The brain is one of the most powerful erotic zones and anger is a strong libido dampener so communicating is vital.
• Familiarity. Generally the intense desire experienced during the early part of a relationship wanes and couple’s appetite for sex declines with time.
• Smoking: In one study, male smokers with high blood pressure and/or other risk factors were more than twice as likely to have complete Erectile dysfunction than those who didn't smoke.
• Psychological aspects including the conflicting cultural messages one learns about sexuality. Gender messages are especially influential and impact on how women view themselves sexually including their body image, sexual identity, sense of power and her role in the relationship.

Depression and loss of libido
Depression is characterised by low self-confidence, feeling hopeless, helpless, tired, and a decrease in sex drive. Fortunately there are several highly effective medications on the market that help to relieve the symptoms of depression. The newer generation of anti-depressants, which includes Fluoxetine (Prozac™), has fewer side effects than earlier medicines.

One of the most common ones is unfortunately sexual dysfunction, with 30-60 percent of men and women who take these drugs experiencing some form of sexual problem. These include; erection and ejaculation impairment in men, loss of lubrication in women and in both a reduction in libido and orgasm. For most people, alleviating their depression outweighs the side effects of the drugs but depression is in any event a dampener of libido and as the depression lifts their sex drive may also spice up.

Getting back that loving feeling
You deserve to have a pleasurable sex life and although sexual problems are multifaceted there are ways of getting back that loving feeling. Relaxing and allowing yourself to de-stress can make a big difference. Communicating your concerns and understanding how your body responds to sexual stimulation are important steps toward regaining your sexual health.

For women, sexual response often involves a mind-body connection that has as much to do with feelings for their partner as it does with more direct sexual stimulation. Emotional intimacy, such as touching and holding hands, is an essential introduction for sexual intimacy. Talking regularly and openly with your partner about your feelings may help you reconnect and discover each other.

Today we are fortunate to have access to information and professional therapists. Dr Laura Berman suggests that we let go of the “goal-oriented approach and instead focus on sensuality. “Orgasms are not the centre point of sex. Once we let go of becoming orgasm-focused, sex becomes much more of an act of intimacy, connection, eroticism and arousal.” VENIS- Very Erotic Non Insertive Sex, an alternative to intercourse is a programme developed by Dr Berman that teaches ways to give sexual pleasure and orgasm through activities that do not require erections.

Trying “too hard” with sex often leads to a lack of success and a return to simpler pleasures will often lead to increased enjoyment followed by an improved libido. Addressing lifestyle issues to deal with fatigue and boredom are as necessary as is prioritising quality time to reconnect with your partner, such as going on “dates”.

Reduce stress and anxiety by finding a technique such as meditation, yoga, dancing or a walk on the beach- whatever works for you. Stop smoking. It not only causes cancer and emphysema but also affects blood circulation to the genitals and can damage the blood vessels.

Sildenafil (Viagra™) is a prescription medicine that has been used by over 16 million men around the world to treat male erectile dysfunction. Viagra™ improves erections by increasing blood flow to the penis. It works within 30 minutes of being taken and lasts for approximately four hours.

In cases where medications such as antidepressants are inhibiting libido it may be possible to switch to another drug which has less side effects or to take a “drug holiday” under the supervision of your doctor.
Viagra™ has not been approved for use in women. Topical creams that contain Estrogen and testosterone may be effective in women lacking lubrication and sensation. The Bermans recommend them for increasing genital sensation but not specifically to treat libido problems.

Manufacturers of herbally based topical creams such as Vigorelle™ claim that they enhance sexual energy and stamina and increase stimulation. They contain ingredients such as Damiana, Motherwort,Gingko Biloba, and Wild Yam. Pelvic floor (Kegal) exercises are also useful to strengthen the female responsiveness but all these methods need to address the underlying reasons for the loss of libido.

Ylang Ylang, Neroli and Patchouli are essential oils that may be aphrodisiac in nature. Natural and herbal remedies include Yohimbine, Damiana, Saw Palmetto and the aptly named Horny Goat Weed. Ginkgo Biloba may increase blood flow to the sexual organs. It purportedly heightens excitability and makes orgasms more intense.

Siberian or Korean ginseng can help you cope with the other pressures life throws at you. It has not been proved whether these herbs act specifically on libido or act as general tonics increasing energy and improving your emotional state to make the idea of sex more appealing.
Its understandable that you may feel some embarrassment when talking about sexual issues but recognising that you are experiencing problems and seeking the help of a professional is the first step towards reconnecting with your libido. A good sex life is an important part of your health and well-being.

Article written Marina Green and published in Dischem's Benefits Magazine