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A woman of any age can become less interested in sex or have a decreased sex drive. This condition is called sexual dysfunction.

What is going on in the body?

In 1999, a national survey of people between the ages of 18 and 59 showed that sexual dysfunction was common among 43% of women and 31% of men. Women and men with poor physical and mental health are more likely to have a decreased sex drive. Someone who has had problems in sexual relationships is also more likely to have this condition.

Moreover, sexual dysfunction is closely linked with overall well-being because the female sexual response is more complicated than the male response. It is influenced to a greater degree by psychological and cultural factors. A woman's sex drive is guided by a complex system of signals between the brain, the ovaries, and other reproductive sexual organs. A healthy brain, more than a healthy body, dictates a woman's desire for sex. Any disruption in this complex interaction may cause a woman to be less interested in sex.

What are the signs and symptoms of the condition?

There are many different types of sexual dysfunction, including:

• a lack of interest in sex, known as decreased libido or LSI (lack of sexual interest)
• the inability to attain or maintain adequate vaginal lubrication and swelling response. This is called female sexual arousal disorder.
• painful intercourse, known as dyspareunia
• painful, involuntary contractions of the vaginal muscles, known as vaginismus
• a delay or absence of orgasm

A woman with a decreased libido may:

• enjoy sex less than she used to
• avoid having sex
• have fewer erotic dreams
• have fewer sexual fantasie

What are the causes and risks of the condition?

Sexual dysfunction in women rarely has a single cause. The factors that may cause this condition include both physical and psychological causes.

Physical causes include:

• diabetes
• vaginal yeast infections
• urinary tract infections
• heart disease
• neurological disorders, such as stroke
• pelvic surgery or trauma
• side effects of drugs, such as antidepressants, blood pressure medications, narcotics, and illicit drugs
• chronic liver disease
• chronic kidney disease
• menopause
• alcoholism
• heavy smoking of tobacco or marijuana
• drug abuse
• breastfeeding
• recovery after childbirth

• stress from work, family, or relationships
• chronic anxiety
• concern regarding sexual dysfunction
• marital discord
• religious or cultural beliefs
• unresolved sexual orientation
• depression
• previous traumatic sexual experience, including rape
• history of incest or sexual abuse

What can be done to prevent the condition?

Since sexual dysfunction in women is often linked to depression or underlying diseases, it may help to see a healthcare professional before it becomes a serious problem. Many of the underlying causes of sexual dysfunction are not preventable, but early treatment may minimize the woman's problems.

How is the condition diagnosed?

A healthcare professional will ask the woman about her medical and social history. Depending on the medical history, the following may be performed:

• physical exam
• pelvic exam
• screening tests for depression
• complete blood count (CBC)
• urinalysis
• a blood test to measure follicle-stimulating hormone (FSH)
• a blood test to measure luteinizing hormone (LH)
• serum estradiol test
• serum testosterone levels
• cultures of the vaginal discharge

Most cases of decreased libido are not related to physical problems, except for menopause. Usually there are other problems, like stress, depression, marital discord, spousal abuse, alcohol dependence, or drug problems.

What are the long-term effects of the condition?

The long-term effects of sexual dysfunction may be poor interpersonal relationships, marital discord, separation, and divorce. Poor self-esteem and a sense of failure may lead to chronic depression and anxiety.

What are the risks to others?

Sexual dysfunction poses no risk to others. It may, however, cause a partner mental stress or lower self-esteem if he does not understand the underlying cause of his partner's sexual dysfunction.

What are the treatments for the condition?

Treatment depends on the cause. It may include:

• antidepressants
• treatment for diabetes
• hormone replacement therapy
• androgen therapy
• sildenafil (i.e., Viagra), a medicine to relax muscles and increase blood flow, particularly to the genital organs
• herbal remedies
• psychotherapy
• marriage counseling

What are the side effects of the treatments?

Side effects depend on the therapy used. They may include:

• excessive hair, acne, greasy skin, weight gain, and elevated cholesterol in women using androgen therapy
• vaginal bleeding, breast tenderness, weight gain, abdominal bloating, and headaches in women using hormone replacement therapy
• diarrhea, sleep disorders, headaches, irritability, and sexual dysfunction in women using antidepressants

What happens after treatment for the condition?

A woman's sex drive is a complex matter. It cannot be cured by taking a pill or talking about the problem. There are subtle stressors in a woman's life that may make her less interested in sex. These stressors are warning signs that she may be feeling emotional and psychological turmoil. This turmoil should be addressed in order to prevent future physical problems.

How is the condition monitored?

Teaching a woman to look for decreased sexual function, stress, and health problems is an important part of treating sexual dysfunction. A woman should report any new or worsening symptoms to her healthcare professional.