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Medication and tests for very low SEX DRIVE.

Resolved Question:

Hi

I am a 34 year old female and I have a very low sex drive basically no sex drive. I am in a 5 year relationship and this is starting to cause some strain, Do you know if i can be prescribed any medication or should I go and have some tests carried out. Please help :(


Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello.
Thank you for your query at DoctorSpring.com.

I understand your concern and will do my best to help you.
Decreased sexual desire or libido is a fairly common complaint among women and the cause can be multifactorial. Organic, psychological, medication, and substance-related issues (eg, depression, diabetes, use of selective serotonin reuptake inhibitor drugs) all may affect sexuality.

I would like additional details to help you better.
1. Have you been pregnant and delivered recently?
2. Do you have any vaginal or pelvic pain / vaginal itching/ dryness/ discharge?
3. Any abnormal genital tract bleeding?
4. Any urinary or anal incontinence?
5. What is your principle sexual concern (eg, low desire, difficulty with orgasm, painful sex)?
6. How long have you been experiencing this issue? When were you last satisfied with your sex life?
7. When did you start to notice a change that was bothersome to you? Do you have any idea what may have occurred at that time that contributed to the problem (eg, infertility, birth of child, depression, new medication, issue with partner)?
8. Do you believe stress, fatigue, or limited privacy are contributing to your sexual problem?
9. Any medical illness or medication you are on?
10. Does your partner have problem such as erectile dysfunction or any medical illness?
11. How would you describe your relationship with your partner (eg, caring, communicative, loving, strained) ?
12. Do you and your partner talk about sexuality? Have you ever met with a counselor or sex therapist to discuss sexual problems?
Please reply to the above in the follow up.

Lifestyle changes, therapy and if required medication, based on your specific diagnosis will take care of your issue.

Feel free to voice your concerns.

Kind regards.


Patient replied :

Hi
Thank you kindly for your reply one step in the right direction
I have a history of been a smoker but none of the others
1. Have you been pregnant and delivered recently? NO 2. Do you have any vaginal or pelvic pain / vaginal itching/ dryness/ discharge? VAGINAL ITCHING 4. Any urinary or anal incontinence? ANAL ITCHING 5. What is your principle sexual concern (eg, low desire, difficulty with orgasm, painful sex)? NO DESIRE 6. How long have you been experiencing this issue? When were you last satisfied with your sex life? 8 Months maybe even longer 7. When did you start to notice a change that was bothersome to you? Do you have any idea what may have occurred at that time that contributed to the problem (eg, infertility, birth of child, depression, new medication, issue with partner)? NONE OF THESE 8. Do you believe stress, fatigue, or limited privacy are contributing to your sexual problem? NO 9. Any medical illness or medication you are on? NO 10. Does your partner have problem such as erectile dysfunction or any medical illness? NO PROBELMS WITH MY PARTNER AT ALL 11. How would you describe your relationship with your partner (eg, caring, communicative, loving, strained) ? CARING, LOVING 12. Do you and your partner talk about sexuality? Have you ever met with a counselor or sex therapist to discuss sexual problems? WE TALK ABOUT IT NO NEVER MET WITH A THERAPIST
I hope you can point me in the right direction as to what is wrong with me I look forward to hearing from you
:)


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello.
Thank you for your response.

Your condition can be classified as Hypoactive Sexual Desire Disorder (HSDD), wherein there are deficient (or absent) sexual fantasies as well as a desire for sexual activity. This has a multi-factorial etiology (cause) and does not mean something is wrong with you. This can be a phase in almost everyone's life. Since you have vaginal itching, an element of vaginitis may also be responsible for the decreased desire. The good thing is, with adequate treatment, you can be rid of this issue.

I have the following suggestions.
1. If in addition to the vaginal itch, you have symptoms like an abnormal discharge or menstrual irregularities, please consult a Gynaecologist for a local examination and appropriate management.
2. Please consult a sex and/or couples therapist, with your partner for a complete evaluation. Involving your partner will help him understand what you are going through and will resolve the strain. This therapy is highly effective and it will educate you about all aspects of sexuality and specific exercises will be assigned to enhance sexuality and combat low libido. Certified sex therapists may be located through the website of the American Association of Sex Educators, Counselors, and Therapists: www.aasect.org . Their services are often covered by insurers.
3. Fatigue and stress contribute significantly to low libido even though it may not be apparent. If these are present, you need to take steps to reduce stress with support groups, yoga or other relaxation techniques or exercise.
4. If you are overweight and unhappy with your body image, it will affect your sexual interest. In this case, you will need to work towards losing weight.
5. You need to bring novelty to your relationship. Establish a regular 'date night' and try to spend an occasional night or two away from responsibilities. This can lead to significant improvements in sexual interest. Reading books about sexuality, visiting a store with items designed to increase sexual pleasure and expanding the typical sexual repertoire effectively increase libido and response.
6. If you aren't already using a vaginal moisturizer and/or lubricant, please use a moisturizer like Replens®, Me Again™, Vagisil® etc, 3 times a week. In addition, you can also use a lubricant at the time of coitus to decrease irritation and itching.
After all these measures, if the issue still persists, pharmacological therapy (medications) can be considered.
I hope this was helpful. Let me know if I can assist you any further.

Regards.


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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