Libido Loss

What Your Symptom Is Telling You

The last time you were hot in bed was when the air conditioner broke. And the only thing that gets turned on once the lights go out is the alarm clock buzzer.

Maybe your spouse pesters you to do the mattress dance more than you want to. You may even oblige, but you don't really want to and don't really enjoy it. Is something wrong with you?

Sex therapists don't like to play a numbers game when talking about frequency of intercourse and what's considered normal. They're more concerned with determining what's right for a couple to maintain a healthy relationship.

"If you're in a relationship and you make love one or two times a month or less, that might be considered low," says Shirley Zussman, Ed.D, a certified sex and marital therapist in New York City and director of the Association for Male Sexual Dysfunction. "But who's to say what level of desire is more desirable?"

Low libido becomes a problem that should be addressed only when it is perceived as a problem, sex therapists say. "It's usually only in the framework of a relationship that it becomes an issue," Dr. Zussman says. "It's when there is a discrepancy in desire between the person and the partner, or when people feel there's something wrong with them because they have a low level of desire."

Everyone experiences peaks and valleys in sexual desire, an ebb and flow in libido that could be caused by any of a variety of factors, from a bad childhood to a bad day to a bad illness, from too much stress to too little time. Occasionally, a hormonal imbalance or prescription drug will sap sex drive. And, of course, there's a difference between sexual drive and sexual function. You may be able to become aroused and experience orgasm yet have little or no interest in doing so. (That's why seeking professional advice from your doctor or a qualified sex therapist is not a bad idea if your problem persists.)

If your lowered libido persists and you perceive that you have a problem, what can you do about it?

Symptom Relief

Libido is an appetite, Dr. Zussman says. And it often can be difficult to help someone acquire a taste for something—or to acknowledge to themselves that they really do have a craving for something delightful. "You can present tempting foods like a luscious dessert," she says, "but that won't necessarily help someone who doesn't feel like eating or who denies the pleasure of eating sweets."

Here's what sex therapists might suggest to cultivate a sexy sweet tooth and put a lilt in your libido.

Sample from the sexual spice rack. For many couples, sex becomes as exciting as doing the dishes because they do the same thing all the time. Reading a sex manual and trying new positions or new techniques may add a renewed dash of zest to making love, Dr. Zussman says.

Don't forget to touch. People with low libidos often are reluctant to express any sort of affection toward their mates, according to Jo Marie Kessler, registered nurse practitioner, certified sex therapist and educator in private practice in San Diego. They may believe their gestures amount to teasing or will spark a debate over making love, but the loss of touch makes their partners feel unwanted and unloved.

"I always encourage them to maintain or resume expressions of affection—a kiss on the cheek or lips, casual touches on the arm or shoulder, a brush of their hair," she says. "Both partners need to demonstrate that they care, but with the understanding that the display of affection is not a signal for sex."

Read something risqué. You don't have to don sunglasses and a trench coat and creep into an adult bookstore, Kessler says, "but you could read some romance novels, love poems or erotic literature to try to nurture or enhance your own sensuality."

Spend an hour in the shower. Don't treat bath time as just a three-minute clean-up before you dash out the door to work. "Avail yourself of all the sensual experiences in the shower or tub," Kessler says. Feel the pleasure of the water as it dances on your skin. Lather yourself gently and sensually, perhaps with a loofah sponge rather than a washcloth. Use bath salts and lightly scented candles.

Let your fingers do the talking. Take the time and pleasure to know your own body and your partner's without any pressure to have intercourse and orgasm, Kessler says. "Focus on the leisurely exploration of each other's bodies, and share the joy and intimacy of that alone." Touch each other, feel and caress each other's genitals, notice the sensations of your two bodies as they move about. Tell each other what feels good.

Don't hesitate to help yourself. Sexual self-gratification is not dirty or wrong, Kessler says. In fact, a person with low libido can use masturbation to learn what feels good to his or her body, so that sex provides positive feedback instead of negative feedback. Practice first in private, she suggests, where you won't be so self-conscious, then broach the topic of mutual masturbation with your mate.

Mind over Sexual Matters

In conjunction with sensual enhancement techniques, sex therapists also suggest other kinds of strategies to lift low libido. "You can deal with the immediate problem with techniques, but that might not help forever or to save a relationship," Dr. Zussman says.

Here are a few more approaches.

Dig yourself out of the dumps. Depression can produce some very physical symptoms and is one of the most common causes of inhibited sexual drive, Dr. Zussman says. "When you're depressed, you have an interest in practically nothing. Certainly your libido will be decreased, too. It just flies out the window." (See Depression on page 119.)

Look in your medicine chest. A number of prescription and over-the-counter drugs, especially certain types of psychiatric and antidepressant medications and some high blood pressure pills, could dampen libido for both men and women, says Richard C. Reznichek, M.D., a certified sex therapist, assistant clinical professor of urology at UCLA and urologist in Torrance, California. Some drugs also interfere with your ability to be aroused. If you're using medications that you think are responsible for decreasing your sex drive, don't stop taking them, Dr. Reznichek advises. Speak first with your doctor and ask for alternative drugs.

Ask for help. From your spouse, that is. At least at first. He or she may, after all, have been the first to note the low libido. Whether it's exploring each other's sensuality, experimenting with new positions or trying to get in the mood more often, explain to your spouse that you may feel awkward, self-conscious and a bit stressed in attempting to change, but that you want to do it for the sake of the relationship, Dr. Zussman says. "Evoke their cooperation. Tell them that you'll need their help and understanding."

Talk to yourself . . . or perhaps to a friend. Ask yourself why your sex drive jackknifed into a ditch, Dr. Zussman says. Has it always been that way? What was happening in your life or relationship when it veered? Mull it over in your head, then talk to your partner, a friend or a family member who knows you well, Dr. Zussman advises. They may help spark some insight.

Take time to address your stress. He works. She works. He's tired at the end of the day. She comes home late several evenings a week. The kids have homework that needs to be checked. The ambition to excel professionally, the demands of raising children, the need to maintain social connections—all those stressors put the brakes on sex drive, Dr. Zussman says. "That can put you in a state of apathy when it comes to sex," she adds.

None of those everyday, everyweek worries leaves much time, ambition or emotional energy for making love, Dr. Zussman says. She suggests that a couple may need to give sex a higher priority in their relationship. "Try making a date with your partner. Not just to make love, but to talk with each other, hold each other and share your feelings and concerns with each other. That may help to restore your sexual interest."

Help for Those Hormones

It's also entirely possible that your libido is being K.O.'d by a hormone imbalance in the body. Here's what you should consider.

Deal openly with menopause. Some women may notice a declining interest in sex during menopause, Kessler says. It's a common side effect while the body is attempting to adjust. Estrogen replacement therapy can help return your libido to normal, she says. "Once the unpleasant symptoms of menopause have stopped, the drive returns and could even be enhanced." If you are going through menopause, ask your doctor about hormone replacement therapy.

Wait out the pregnant pause. Hormonal changes during pregnancy, especially the last trimester, and lactation often can dampen the drive for sex, according to Kessler. "Hormones are present in different levels at these times," she says. "Loss of libido immediately after childbirth and during lactation is nature's way of spacing children."

Test your testosterone. If you're a man who seemingly has no psychological reason for a lack of desire, you may want to ask a doctor to perform a blood test that will gauge your body's level of testosterone, according to Dr. Reznichek.

Low levels of the male hormone aren't a common cause of sapping your sexuality, but it always must be suspected, Dr. Reznichek says. Depending on the cause, a physician could prescribe either testosterone injections or a medication that counteracts other hormones that are suppressing naturally occurring testosterone, he says.