“Hypoactive sexual desire disorder (HSDD) is a common form of sexual dysfunction when women have no or a low desire to have sex. They may not even think about sex, or when they have sex, it may not be pleasurable or [it’s] a bad experience,” says Lauren Streicher, MD, founder and medical director of the Northwestern Medicine Center for Sexual Health and Menopause. “Women may feel panicked or anxious and be nauseated by the idea of sex.” HSDD can manifest from both physical and psychological elements.
Conservative estimates say that 10 percent of women have HSDD, but some research suggests the condition is under-diagnosed and affects closer to 33 percent of women, says Heather L. Beall, MD, a gynecologist at Northwestern Medicine McHenry Hospital. Find out some more medical reasons for low libido.
Signs you might have HSDD
You’re on birth control
Some women taking birth control find that their arousal and ability to orgasm dip when they’re on “the pill.” Talk to your doctor about other birth control options, and try these 31 natural libido boosters.
You’re on antidepressants
Antidepressants greatly decrease your sex drive and your ability to orgasm, which is a side effect not often talked about, considering one in eight Americans takes antidepressants. “They may not realize the impact it can have on [their] sex drive,” says Dr. Beall.
You’re closing in on menopause
“I would say 90 percent of perimenopausal women have decreased sexual desire,” says Dr. Beall. “It can be a huge problem if your partner is still active.” Learn more about the real reasons your partner doesn’t want to have sex.
Age has a lot to do with your lowered libido. Your estrogen levels drop as you age, according to the Mayo Clinic, which may lower your desire and increase vaginal dryness.
You’ve had traumatic experiences in the past
“[HSDD] can stem from past trauma,” says Dr. Streicher. “Either molestation, rape, or perhaps being brought up in a very religious atmosphere where sex was deemed bad. It’s usually not about not liking sex, and it doesn’t happen with just one sexual partner, but all.” In fact, HSDD used to be in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders; it has since been lumped together with another syndrome as sexual interest/arousal disorder. Find out which 14 sex problems you should take seriously.
Sex is painful for you
One cause of HSDD may be painful sex, creating fear or an aversion to having sex. “Women with endometriosis, pelvic inflammatory disease, or other infections may have painful intercourse,” says Dr. Streicher. It’s important to see your gynecologist to treat any preexisting conditions or to discuss when sex starts to become painful—don’t accept this as normal.
How to treat hypoactive sexual desire disorder
The only FDA-approved treatment for HSDD is Addyi (flibanserin), which is nicknamed “the female Viagra” because it increases sexual desire or response. It does have some limiting factors, though: “Women cannot drink alcohol while on it, and it is not for women who have already gone through menopause,” says Dr. Beall.
As another option, Dr. Beall suggests vaginal estrogen, especially for postmenopausal women. “Decreased sexual desire and dryness is a recipe for never having sex again,” she says. “As women age, we experience a lot of vaginal dryness. You don’t self-lubricate like you used to.” She recommends her patients use a vaginal estrogen cream twice a week. “It will give you a sense of being younger, and that your vagina still works the way that it used to,” she says.
Depending on the root of what may be causing your HSDD, your gynecologist also may refer you to a sex therapist or behavioral therapist. “There are sex therapists that specifically deal with HSDD. Talk therapy may also help treat HSDD,” says Dr. Streicher. “There is such shame. Many patients think, ‘Here is this man/woman that I like and I should want to have sex with them, but every time I have physical contact I feel anxious.’” Along with helping get through the day-to-day HSDD struggles, a therapist can help resolve past trauma. Anxiety medication may be used to help treat HSDD as well. Once your HSDD treatment is underway, you might also want to try these 48 simple ways to improve your sex life.
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