• Kim Hood, MD

5 Ways to Improve Libido

Decreased libido in women is one of the most complicated and complex women’s health issues that requires a thorough conversation of social, psychological, and physical factors to attempt to treat it. To give you an idea, a woman’s libido can be hindered by depression, anxiety, kids, finances, bad job, overwhelm, her perception of intimacy based on what she learned from her parents or society, insomnia, health issues, hormonal alterations, pelvic pain, poor body image. This is just a short list of ALL the things that can contribute. It can be one of these. It can be several of these. As many as 42% of women report decreased libido in their lifetime. I do want to make one thing very clear. If you do not like your partner, there’s not a pill for that!

Five things that may help:

1. Optimize your overall health:

Women with health issues do not feel like having sex. I know that may sound basic, but I cannot tell you how many women with multiple medical issues and on multiple meds, don’t feel well, and yet think they should be able to be “in the mood” at the drop of a hat! Regardless of what medical issues you have, some simple dietary changes may actually improve your health and how you feel. Don’t roll your eyes at me. I’m serious!

Now, let me just say, when I say dietary changes, I am not telling you to lose weight. Diet and weight loss are not synonymous! Our diet makes a HUGE impact on how our body functions. You’d be surprised at the major improvements that occur in my patients who do very small things, like remove processed foods, dairy, grains like corn and wheat, and/or sugars, like high fructose corn syrup! If weight loss occurs, great! However, that is not the goal of dietary change.

As one of my functional medicine professors said, “We are not designed to be stressed, toxic, inflamed, infected, malnourished, and unrested AND YET, still easily thrive, grow, reproduce, be thin, feel well, eat anything we want, enjoy perfect BMI’s, and have great sex. This combination would not be natural.”

2. Optimize your hormones:

It is controversial as to whether hormonal fluctuations effect libido. I think for some women they do. For example, women with hypothyroidism don’t feel like doing anything. Sluggish thyroid, sluggish everything else!

I do suggest you work with someone with a functional medicine background on this. Remember, traditional medicine physicians are looking for disease. Functional medicine practitioners are looking for lack of optimization that will eventually lead to disease.

Saliva testing is better than blood testing. There was a time I absolutely did not believe this, but when I really started to look at the research and use it with my patients, I became a believer. Again, I won't get into the details about saliva testing here, but seriously looking to see if your estrogen, progesterone, testosterone, and adrenals are balanced can really improve your energy and therefore, your libido!

3. Optimize your sleep:

When we are tired, we don’t want to do aerobic activity! So, why on earth would we think we should have a libido. Sleep is so important for detoxing and restoring our bodies. There are certain vitamins and minerals I have my patients take in the evening just to make sure their body has the appropriate raw materials in order to detox and restore. Sleep also improves production of cortisol, growth hormone and testosterone.

You need at least 7 hours of sleep. I do not recommend using meds like ambien, valium, klonopin. These meds have been be shown to increase your risk for early onset dementia. “But Dr. Hood, melatonin doesn’t work for me!” It may not. However, there are so many other options out there that help sleep and some can even help restore neurotransmitters that can improve your mood; therefore, your libido!

4. Try medications:

Ok, so I know I live in a world where people want a quick fix. They’d rather be sick, tired, stressed, and eat their junk food. Or, they are optimized and nothing is helping. There are two medications for Hypoactive Sexual Desire Disorder (HSDD) available for women at this time, addyi and vyleesi.

The definition of HSDD is as follows: It is the loss of desire for sex in a premenopausal woman that once had a desire for sex. The loss has been for 6 months or more, causes distress in her relationship, and is not attributed to relationship issues, health issues, meds, or a psychiatric diagnosis. That is a mouthful!

If the patient doesn’t follow this definition, then these medications are not indicated for her. However, I have a serious problem with this hard and fast rule. I just said earlier that women’s libido issues are complicated and complex. One or multiple things can contribute to it’s decline! Furthermore, I am not supposed to give it to my postmenopausal ladies?!?!? Truth is, it hasn’t been studied in them. However, it is currently being studied and preliminary results are good. I have no problem prescribing it "off label" for my postmenopausal ladies.

I will write about Addyi and Vyleesi separately. The history behind both is interesting and both require detailed information that would just make this post much longer than it already is!

5. Plan for it:

Ok, now you’ve tried some of the things I have mentioned. Still no help. What’s next? Many ladies tell me that they don’t think about having sex, but if they go ahead and engage, they are able to enjoy it.

For this to be effective, please remember that you need to socialize with your significant other. Many times, couples live in the same house but never really connect. Date nights are super important. A get away with just the two of you without the kids is important. You need to remember why you guys wanted to be together in the first place and life can be super distracting!

Plan for alone time. Plan for sex. I have patients that schedule social interaction with their significant other just like they schedule everything else. It’s ok to do and it works!

Remember, libido in women is complicated. The five recommendations I have listed are just a few things I have seen help. However, there is so much more that may need to be addressed. Don’t ignore it or think it will get better. Speak to someone with experience in helping women with libido issues. Sex is too important for a good relationship, for good mental health, and for a long healthy life.

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