Alongside headaches, insomnia and anxiety, “loss of libido” was just another symptom I invited clients to tick, or not, on the standard health questionnaire I use as a practising nutritional therapist and hypnotherapist in london. It’s important that I get as full a picture as possible of someone’s health before I decide how to help them, so I always get them to provide this information before they walk through my clinic door.
But I’d no idea of the impact that those three words – loss of libido – would have. Almost without exception, every woman in the 40- to 55-year age bracket who comes to see me now ticks, underlines or circles them. These women might have booked an appointment to discuss weight loss, hypothyroid, irritable bowel syndrome or menopausal symptoms, but underneath all of this is invariably a low libido.
There are no reliable figures on female sex drive in the UK. The Office for National Statistics crunches numbers on other related matters, but has stopped short of asking us how much sex we have or want.
An independent survey from 2014 suggested a decline in those of us who describe ourselves as having a high sex drive from 44 per cent in 2008 to 34 per cent six years later.
In the United States, experts have quoted statistics suggesting a whopping 43 per cent of all women there suffer reduced libido. This seems unfeasibly high and there is some suggestion that these inflated stats could be being driven by a desire to classify low libido in women as a “condition” that needs to be “treated”, so creating a market for female Viagra.
But while low libido has been given a medical name – hypoactive sexual desire disorder – it is clear among my clients that many women are confused by it and certainly don’t know what to do about it. As John Studd, former consultant gynaecologist at Chelsea and Westminster Hospital and professor at Imperial College, says: “Libido is a strange mixture of head, heart and hormones.”
Kathy Abernethy, senior nurse specialist and chair elect of the British Menopause Society, agrees. “Low libido is a very complex problem. It can be related to the physical issues of ageing or to relationship or body image changes.”
Below are some of the most important factors that can reduce libido and what to do about them.
Body image insecurity is something I see in my clinic every day and especially among those who report low libido. For women in their 30s, it may be a case of post-childbirth “mum tum”.
For older women, menopause can accelerate the effects of gravity (everything going south) and also cause weight gain, especially around the midsection.
Relate sex therapist and relationship counsellor Clare Prendergast says, “We’re in our mid-40s, we’ve put on weight. We find ourselves looking at our bodies and feeling ‘yuck!’” In the main, body anxiety is internally, not externally driven. It’s how you feel about yourself that matters.
So, what you can do? Switch off the negative self-talk and replace it with something positive. Find five things you like about your body and repeat them to yourself every day.
Exercise. This increases blood flow, lifts mood, can build self-esteem and reconnects you with physical sensation.
Prendergast says: “Some women have never been connected to their body. They’ve had high-powered jobs and lived in their heads.”
Try a sex ban. Prendergast gets clients to undertake a sex ban for two to three months, during which time couples have to spend time with each other two or three times a week naked, touching but in a non-sexual way. “The aim is to get to know your own and your partner’s bodies again.
As a woman nears menopause, she experiences drops in three key hormones: testosterone, oestrogen and progesterone. The latter two are most often given together as HRT to reduce common menopause symptoms such as hot flushes and night sweats. However, what is less known is that testosterone, which is often thought of as a “male” hormone, may also be important to women in maintaining sex drive.
Testosterone treatment for women is controversial, and while it has some high-profile fans, the jury is still out on whether it is effective in lifting libido. Prof Studd is certain it helps. “Testosterone works brilliantly for women,” he says. An American study from 2003 backs this up, concluding that “testosterone therapy improves well-being, mood and sexual function in premenopausal women”.
So, what you can do? Get your hormones checked, and not just the sex hormones. Dr Sohere Roked is a specialist in bio-identical (synthetic) HRT. At her Omniya clinic in London, before she prescribes anything she checks a whole range of hormones. “I do tests for the sex hormones (oestrogen and progesterone), plus thyroid, adrenal (cortisol) and insulin,” she says. Low thyroid can cause depression, which may affect sex drive. Elevated cortisol is a stress hormone and can also interrupt sex hormone production and action, and insulin is inflammatory. High levels (a fasting level of over 25) of insulin can disrupt other hormones, including the sex ones, again lowering sex drive.
If appropriate, also consider HRT. “Quite often, if women start oestrogen and progesterone therapy that alone will improve libido,” says Dr Roked. Oestrogen is safest taken “transdermally”, that is as a gel or patch, while progesterone can be taken as a tablet. And don’t be tempted to self-diagnose or buy online. “It is important that you don’t have uncontrolled oestrogen in the body,” says Dr Roked.
Alternatively, some doctors in the UK prescribe testosterone to be used independently as a possible libido booster. Dr Roked produces her own lower-dosed cream for women and advises women to apply it to the wrist, inner upper arm or outside of thigh – areas where there are few hair follicles – to avoid excess hair growth.
Are you depressed?
As oestrogen levels drop at menopause, so do those of the neurotransmitter serotonin. Low levels of serotonin can be associated with reduced sex drive.
What can you do in this case? You could try doing a depression self-assessment test (for example, see nhs.uk/Tools/Pages/depression.aspx) and discuss possible treatment (cognitive behavioural therapy or medication) with your doctor.
If the weather permits, take a daily walk to boost your vitamin D from sunlight. Vitamin D is an antidepressant. “I am a big believer in getting outside,” says Prendergast. Alternatively, take a daily vitamin D3 tablet.
Eat a mood-elevating diet. Go to mind.org.uk and look up the Mind Meal, which is high in brain-healthy vitamins, minerals and fats.
Dr Roked says, “Lifestyle plays a huge part in libido – what you eat, how you sleep, how you move your body. If you can get these sorted out, libido often improves.”
This doesn’t mean you need to start training for a marathon. But eating well, exercising and reducing any intake of alcohol and cutting down or quitting smoking can all benefit your health and improve libido.
Also think about your sleep patterns. Tiredness really is a passion killer, and depression and anxiety can often disrupt sleeping patterns. We need seven to eight hours of sleep a night, so talk to your GP if you are not getting that as it could be a sign of poor mental health or adrenal dysfunction, or acute stress.
Sadly, there is no one magic food for libido boosting. When clients come to me complaining of loss of libido, I advise a healthy, balanced diet, which usually means reducing sugar, caffeine and alcohol, but not fat. We need healthy omega-3 fats for our brains to function properly.
So what you can do to improve your libido through diet? Eat foods to promote healthy blood circulation. Garlic, onions, chilli and ginger are sources of a natural compound called allicin, which dilates blood vessels.
Eat foods that improve brain function. Omega-3 fatty acids from oily fish, such as salmon, trout and sardines improve brain signalling, so helping increase sexual response.
A high intake of caffeine and sugar both raise the level of the stress hormone cortisol, but you can reverse this process by reducing tea, coffee and sugar and instead drinking water and eating wholegrain and lean protein, vegetable and complex carbohydrates.
You could also try eating foods that help you sleep. Sleep hormone melatonin is made from the amino acid tryptophan, but as this is a small molecule it needs the release of insulin, which is stimulated by sugar, to get across the blood/brain barrier. So, include a healthy, slow-release carb food (which will break down into sugar in the body) with dinner such as brown rice, bread or pasta, to promote healthy sleep. If you drink alcohol, reduce the amount as it impacts negatively on the quality of your sleep.
The lowdown on libido
- Testosterone is the first sex hormone to drop naturally in women, before oestrogen or progesterone. A 40-year-old woman has only 50% of her levels at 20.
- In their fertile years, women’s bodies can produce four times more testosterone than oestrogen.
- Sex can improve with age. A study by the University of San Diego questioned 800 women about their sex lives. The youngest and oldest (in their 80s) reported being happiest sexually. 15% of women say they have never climaxed.
- For a healthy sex drive, grill your fish, don’t fry it. While the omega-3 found in fish can help to raise levels of libido-boosting dopamine, if you fry it in vegetable oil, the omega-6 in the oil blocks the absorption of omega-3.
- Frequency of sex declines as you get older. According to a survey of 5,000 people in the US, the largest proportion of women aged between 40 and 49 (46 per cent) say they have sex between once a month and once a week. This drops to 23 per cent in the 50 to 59 age bracket. This compares with over a third of those aged between 16 and 24 managing two or three times a week.
- Zinc has been shown to be low in those with libido problems. Food sources of the mineral include nuts, seeds, lentils and shellfish, or try a daily tablet.
- L-Arginine is an amino acid that may improve libido. Found in peanuts.
- Riboflavin from green leafy vegetables helps to lubricate mucus membranes.
- B vitamins help to regulate sex hormone production. Sources include eggs, fish, milk and green leafy vegetables.
- Vitamin C may help to strengthen blood vessel walls to allow for blood flow.
Text By Lowri Turner/The Telegraph Group Limited, London 2017, Photos By Istock/Shutterstock