Ask the Doctor: I’m worried about my lack of sex drive

By | August 11, 2020

Q I’m in my late forties and peri-menopausal and while I’m active and healthy and in the best shape of my life, I’m worried about my sex drive, or lack of it. I love my husband and we have a great relationship but I feel we are in a funk at the moment that neither of us can get out of. We have no children, no financial worries and we are really happy together, but since lockdown we’ve been working from home together and I thought we would be having sex all the time, but that’s not the case. I realise sex-drive comes and goes at this age, but is there anything I can do to get the ‘urge’ back?

A Loss of libido is a common complaint in both males and females over 40 years old. Normal sexual function is multifactorial and relies on the vascular, neurologic, hormonal, and psychological systems. Often temporary work-related stress, family stress or inter-personal relationship difficulties adversely affects libido.

Thankfully, you have not mentioned vaginal dryness, discomfort or pain during sexual intercourse as a limiting factor for you.

Commonly women with a history of sexual abuse, poor mental health (e.g. depression/anxiety), pelvic organ prolapse, urinary or faecal incontinence often suffer with loss of libido. You appear to be fit and healthy. Therefore, I assume you are not on any medication and do not have any underlying medical conditions that may affect your libido. I suspect you have attended the nurse in your GP practice for recent blood tests to confirm you have normal iron stores, liver, kidney, thyroid and heart function.

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You mentioned that you are peri-menopausal, which unfortunately means you have declining levels of oestrogen. This phase in life can last up to 10 years and can be associated with changes in sexual function. It is certainly worthwhile discussing your symptoms and your menstrual cycle with your GP, who can help determine if an oestrogen replacement therapy may be indicated or if it is something you might consider once you are post menopause.

Have you discussed your loss of libido with your husband? For many women in long-term relationships, sexual desire may not be present prior to any sexual activity but may increase with arousal in response to pleasurable activity.

Is your husband suffering with the same complaint? I am, once again, assuming your husband does not suffer with erectile dysfunction and is also fit and healthy. Sexual activity varies greatly depending on your gender and age, typically declining slowly with every decade over 40 years old.

I suggest you seek out a good relationship counsellor with experience in sexual health. It’s important to go through a detailed sexual history pertaining to your relationship with your husband, and to discuss how it has evolved over time.

As you can imagine, every individual and every couple’s ideal frequency and sexual preferences vary greatly.

⬤ Dr Jennifer Grant is a GP with the Beacon HealthCheck

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