Lulu, a 49 year old patient was experiencing peri-menopausal symptoms like hot flashes, night sweats, somber mood, and loss of libido. She decided to speak to me because her marriage was falling apart because of low libido and decreased sexual sensation. The fact that she was experiencing a low mood with low libido struck me in particular. You might be thinking, what has one got to do with the other? They are interconnected by changes in hormone levels and personal experiences.
I ask all patients if they are sexually active and if they are enjoying a great sex life with each other, then more power to them. Delving deeper, I inquire about their experience with orgasms by asking these questions:
- Do you experience orgasms?
- If so, do you experience orgasms easily?
- Are your orgasms experienced exclusively with solo sex or do you experience them with a partner?
Women are usually very happy to discuss intimate issues with someone who understands them as a health issue. Low libido is a measure of how well people feel about their physical, emotional, hormonal and relational health.
There are many contributing factors to low libido including advancing age, vaginal health issues like dryness, atrophy and/or laxity. Lifestyle, stressors, body image, loss, financial problems, depression, medication and relationship issues may also contribute.
These are complex issues because they involve a woman’s hormones, head and heart. It is important to get to the bottom of these issues. Speaking to your health care provider about low libido accompanied by a low mood or depression is important.
Estrogen is the hormone regulator of the vagina. When the estrogen levels drop in the vagina during perimenopause, it may cause dryness and this may lead to painful sex. Click here to learn about treatment options for vaginal dryness. Left untreated, vaginal dryness may progress to a condition that affects 50% of postmenopausal women, which is vaginal atrophy.
Vaginal laxity, otherwise known as decreased vaginal tightness, may lead to a decrease in sexual sensitivity after childbirth. More than stretch marks or weight gain, vaginal laxity is the number one concern, women have about their physical changes after delivery.
So you can see, head, heart and hormone levels are inter-related. In Lulu’s case, her low mood prevented her from exercising. As it turned out, her vaginal dryness and laxity led to low libido. She was drinking 3-4 alcoholic drinks daily, not only a depressant but a libido leveler too.
Eliminating alcohol, exercise and dealing with her vaginal dryness (she used RepaGyn®) was great place to start. After about one month of her new lifestyle, she started feeling better. Her hot flashes reduced and she was sleeping better.
The next step was to begin a dialogue with her husband about their issues and perhaps seek counselling. I also encouraged her to see her family physician who could manage her low mood and vaginal laxity issues. Sexual health, heart and hormonal problems may wreak havoc on a woman’s life and relationship, but there are many options for treatment. Lulu is off to a great start in getting back to the bedroom.