There’s no rule that you must want to have sex. You might identify as asexual or graysexual. But if you’d like to want to have more sex or enjoy it more, it's important to think about why, and what’s in the way.

Men can experience low desire as well, but it’s more often a challenge for women. You might associate desire with good health. You might want to please a partner. You might miss the days when sex was easy and be frustrated by pain or vaginal dryness.

You’re hardly alone: A third or more of women say they have sexual problems, including lack of interest (though it’s important to note that the statistics vary and aren’t recent.) As women get older, they often happily live without sex.

On the other hand, many women live with problems for years that could have been addressed, at least in part. They might like the idea of having sex, but run into obstacles. We'll run through the remedies in a moment. We'll also cover the benefits of steering away from sex.

 

Source: Image by Mohamed Chermiti from Pixabay

Pain and dryness

If sex hurts, a first step is to identify the cause of the pain. It could be simple dryness. Over-the-counter products can help, and gynecologists recommend using a lubricant specifically for penetration. After menopause, when levels of estrogen plunge, you may benefit from introducing hormones, either through a ring, insertable pills, or cream.

A less commonly used option is prasterone (Intrarosa), a nightly vaginal insert that delivers the hormone dehydroepiandrosterone (DHEA) directly to the vagina to help ease painful sex. Ospemifene (Osphena) is a daily pill.

Low desire

Let's say you've been more sexual in the past and your current state feels like a problem.

Women who smoke or drink tend to have more sexual problems of all kinds. So now may be the time to quit cigarettes and alcohol. Easier said than done, but you may be very happy you did!

Minimize physical challenges like arthritis or back pain. Massage, stretching, physical therapy and simply changing positions can make a difference.

Sometimes low desire is a symptom of depression, lack of sleep, an unhappy relationship, or even small changes in the way you communicate or spend time with your partner.

Mindfulness-based therapies and cognitive behavioral therapy designed specifically for low desire may help. You may identify underlying issues. For example, if you have ever experienced sexual assault, you are at risk for sexual problems and may benefit from therapy.

Talk to your doctor and evaluate your medications. It’s not just anti-depressants; opioid painkillers, blood pressure and heart medicine, and other drugs can affect your sex drive.

The Food and Drug Administration (FDA) has approved two treatments for women before menopause: Flibanserin (Addyi), a pill that you take once a day at bedtime; and Bremelanotide (Vyleesi), an injection you give yourself just under the skin of the belly or thigh before you expect to have sex. The medications seem to work equally well but may cause nausea.

Although the FDA has not approved either medication for post-menopausal women, pooled data from three clinical trials revealed benefits with Addyi: More than 40 percent of that group reported it helped them, compared to 29 percent who reported benefits from a placebo.

For an overall plan developed by a woman to solve her own challenges, consider The Orgasmic Diet. Author Marrena Lindberg noticed that her libido surged during pregnancy, dipped while breastfeeding, and roared back after weaning. She changed her diet in order to boost her fertility. She took large doses of fish oil and aimed for meals with 40 percent carbs, 30 percent protein, and 30 percent fat. The program detailed in her book has not been backed up by a scientific trial.

Other tips include examining and potentially getting off oral birth control, getting enough sleep, exercising, and practicing deep breathing.

Anti-depressants are famously rough on the libido. Nutrition can make a difference. This may be in part an effect of omega-3 supplements, as there is some evidence they can help depression, but the amount, quality of the pills, and ratio of different acids all are important and specific to each person. Women carrying extra pounds may be most likely to get mood-boosting benefits.

In my next post, I'll cover the case for celibacy.