Decreased Libido

Sex drive differs from woman to another.

Decreased libido is:
dysfunction in sex desire.
Its symptoms can be fear of sex and avoiding.

Causes:
a. Some medical conditions such as:
– diabetes.
– High blood pressure
– Cancer
– Pelvic organ prolapse
– Pelvic floor dysfunction like urine incontinence
– diseases that affect blood circulation and nerves endings.
– Problems with thyroids

b. Some types of medications like anti-hypertensive medication
c. Sexual problems such as:
– Vaginal spasm(vaginismus)
– Pain during sex due to previous surgeries or infection

d. Fatigue.
e. Surgeries to breasts or reproductive organs
f. Physiological causes such as:
– Previous bad sex experience.
– Previous sexual abuse.
– Low self esteem
– Anxiety or depression
– Stress

g. Hormonal changes due to:
– Menopause, causes a decrease in Estrogen levels resulting in vaginal dryness.
– Pregnancy, delivery and breastfeeding

h. Emotional/relationship factors such as:
– Conflicts with the partner
– Poor communication
– Lack in trust

Diagnosis:
– The doctor will ask about medical and sexual history.
– Blood tests for hormones levels, thyroids or diabetes.
– Pelvic exam checking for any physical changes that might cause the lack of desire.

Treatment:
It is by treating the cause.
– Hormones treatment: with estrogen, comes in pills, patches, sprays or cream.
– Changing some medications currently taken that have sexual side effects. Example: some anti-hypertensive medication

– Some prescribed medication that boosts libido, such as:

a. Addyi: (Flibanserin) Approved since 2015 by FDA, but not available in KSA.
A pill taken every night at bedtime.
Talk to your doctor first as it should not be taken with many other medicines like medicines for hepatitis C, HIV, or infections.

Possible side effects:
Tiredness, allergic reaction to the skin, dizziness, headache, or upset stomach

b. Aphrofem (ginkgo biloba): Available in KSA.

Possible side effects:
Gastrointestinal disturbances
Headache
Allergic skin reactions

– Treating vaginal dryness
– Vaginal dilators in different sizes under specialist observation in case of vaginismus
– Pelvic floor physical therapy to release the tightness
– Sex counseling

– Some changes in life style such as:
a. Reducing stress level
b. Communication with the partner