Low Libido? Here's What Our Sex Expert Recommends

Low libido, no libido, low sex drive, no sex drive… Does this sound like you? Keep reading.

If you would rather do anything—organize your sock drawer, alphabetize your spices, clean up your Inbox, binge-watch reruns on Netflix—than have sex with your partner, chances are you’re experiencing low libido or no libido. Decreased libido, is a common complaint among pre and post menopausal women (and their partners), and more often than not, it’s caused by our hormone fluctuations. 

While low sex drive is extremely common and normal, it doesn’t mean that your sex life is over. It just means you need a little expert advice! 

I asked Dr. Anita Sadaty, a board certified OB/GYN and integrative functional medicine doctor, for her insight and best advice for dealing with low libido (and other physical changes women experience in their 50s). Consider this your guide to all things sex for women over 50!

First off, why do women experience low libido as they age? It is unusual? 

“It’s fairly common to experience a drop in libido with age for a variety of reasons. Although a drop and fluctuation in estrogen, progesterone, and testosterone levels are at play and a significant contributor, I think an even bigger cause is related to stress hormone imbalance and chronic stress in general. Women also tend to experience vaginal tissue dryness and decreased elasticity due to low estrogen levels, which can lead to pain during intercourse. This creates a situation where sex is no longer desirable or pleasurable.”

What are the most common symptoms of low libido? 

Some symptoms include:

• Putting off having sex or intimate relations with your partner

• Feeling like you would rather go to bed than have sex

• Chronic headaches or aches and pains

• Finding that other previously sexually attractive individuals (like movie stars or well-known personalities) no longer create arousal or sexual thoughts

• Not caring about having sex anymore

What are common contributing factors to low libido? What causes it? 

“Aside from hormone fluctuations and the pain I mentioned earlier, there are a number of factors that can contribute to low libido. For example, issues in a relationship—like a breakdown in communication or lack of trust or intimacy in other arenas of the relationship—can certainly decrease sex drive. Other medical conditions (think chronic pain issues, chronic illness, diabetes, high blood pressure, or mood disorders like depression and anxiety) can also play a role. Sometimes medications like antidepressants, anti-hypertensives, heart medications, antihistamines, or anxiety drugs can lead to low libido—but it can also result from lack of self-esteem or concerns about body image.”

What physiological changes can you expect when you age? What happens to your vagina? 

“There are a few changes to look out for… Lower estrogen levels lead to reduced collagen and elastin in the skin and vaginal tissues, which leads to thinning of the vaginal tissue, dryness, lack of accomodation, reduced sensation and arousal, difficulty with orgasm. Low estrogen can also impact bladder health—more urinary leakage and urinary frequency can be common. Estrogen can even impact mental clarity, sleep, and focus. 

And estrogen isn’t the only hormone that decreases as we age; our testosterone levels can dip, too. Lower testosterone levels lead to reduced sensation, more difficulty with orgasm, reduced sexual thoughts, reduced musculature, impact on mood (depression, anxiety, focus) and sleep disturbance.”

Okay, so what can we do to help cope with these changes? Are there exercises we should do? Products we should try?

For urinary incontinence, kegel exercises are helpful, but you must make sure you are doing them correctly. Nowadays there are a variety of devices and biofeedback at-home apps that can help you learn to do kegels properly, like a Kegel smart device, KGoal, or Elvie device. 

Strengthening the pelvic floor is helpful if there is laxity, a lack of sensation vaginally or urinary incontinence issues related to weak bladder muscles. However, if what you are feeling is pain and tightness, then a kegel may not be the best idea. 

In terms of solutions for vaginal dryness, I recommend trying non-hormonal moisturizers—ideally chemical-free options that contain ingredients like hyaluronic acid, vitamin E, and aloe. A few products I recommend are the Hydration Pearls by Bezwecken, Organic Glide, and products from Good Clean Love. You can also see a doctor and ask about estradiol creams or tablets, or DHEA intrarosa suppositories—these usually require a prescription. Lastly, you could try vaginal laser or radiofrequency therapies, like Femilift or Votiva. 

How do you recommend approaching the conversation about low libido with your partner? Any tips? 

“That is a more difficult and nuanced conversation, but it helps to try to be clear about why you may be experiencing this issue. It’s best to have clear thoughts about what is going on and create a game plan with your healthcare provider about how you will be approaching the reasons for the lack of libido. If it is mainly a relationship problem, then obviously that is a different conversation than if it’s a hormonal or anatomic problem. Either way, not laying blame on anyone (including yourself) is very important. 

Remember that if the issues are related to your partner (for example, they may have erectile dysfunction that they are not addressing or they may not be in tune to your emotional or sexual needs) it is best to discuss this with a sex therapist to develop a plan of how to discuss the concerns and how best to approach it in a way that will foster safety and trust.”

And finally, are there any sex toys you recommend? Or products to help with orgasm? 

“There are a ton of toys for improving arousal. Honestly, take your pick of what floats your boat. There are a million. Lelo is a great brand that has toys like the Loki and the Siri. You can use products like the Love Honey bliss orgasm balm to improve your orgasms, or even talk to your doctors about supplements or topical serums that can help with increasing circulation.”

*Note: When choosing a sex toy, look for ones that are made with materials like silicone, stainless steel, or borosilicate glass, as opposed to phthalates or vinyl.

I hope you enjoyed this interview with Dr. Sadaty and that you’re coming away from it feeling empowered, informed, and ready to revitalize your libido! 

For more advice on sex, libido, menopause, and more, make sure you’re subscribed to the Pure Joy Squad on Patreon!

Until next time, 

Renata