Reduced Sexual Desire (low libido) and Biochemistry of Love

reduced sexual desire and low libido

Reduced sexual desire is a common clinical problem.

REDUCED (decreased) SEXUAL DESIRE is also called reduced (or low) LIBIDO and is an experience that, at different moments in life, affecting many women.

Female sexuality is influenced by several physical, psychological and social conditions and sexual dysfunctions affect between 24% and 43% of women. Certainly, not an uncommon issue often expressed through a low sexual desire (libido).

The arousal, erotic fantasies, attraction to the opposite sex reside in specific areas of the brain that is localized mainly in the limbic area considered the center of sexual desire, and these areas are activated normally at the time of pubertal development. The LIBIDO suffers some minor physiological changes during the menstrual cycle increasing the ovulation period and persists without significant changes throughout life, even into old age. In fact, contrary to what is generally thought, aging does not negatively affect this aspect of sexuality.

Which factors leading to a LOW LIBIDO (sexual hypoactivity) and then to a reduction of sexual intercourse?

Among the most frequent factors we include those related to psychological problems of interaction with the

factors may affect sexual desire

Factors may affect libido.

partner, stress, sexual trauma, family dramas, social and economic conditions, some of which affect only temporarily desire, others may also have long-term effects and for their solution require what is today called consueling with an experienced professional.

Other important causes of sexual hypoactivity are those related to physical and mental illness: among these we mention the depression and anxiety syndromes, chronic diseases such as diabetes and high blood pressure, thyroid and pituitary endocrine diseases, cancer, acute liver disease and degenerative diseases, alcoholism and drug use. On the occurrence of these conditions, the individual response is highly variable and not always predictable. Overcome the disease, have a good relationship with your partner and the environment, have a sufficient dose of optimism and maintain a good appreciation of yourself can certainly help avoid the loss of libido.

drugs and reduced sexual desire

Some drugs that can reduce libido.

Medical and surgical treatments may also have significant negative effects on sexual desire. Some medications such as antipsychotics, barbiturates, benzodiazepines, lithium, tricyclic antidepressants, serotonin reuptake inhibitors, lipid-lowering (cholesterol lowering medications, statins), some antihypertensives (clonidine, beta blockers), diuretics (spironolattone), certain hormonal preparations (danazol, GnRH agonist, oral contraceptives), anti-ulcer medications (H2 receptor inhibitors) or administered to increase gastric motility (metoclopramide, domperidone), antifungals (ketoconazole) have been implicated in a decrease in libido which is usually reversible by stopping the treatment.

Even Mammary or Genital surgery, while taking care of – often definitively – diseases, can cause (results may vary from subject to subject, often in combination with other issues) a reduced libido (reduced sexual, or sexual hypoactivity.

SITUATIONAL DISORDERS can be quite common and is tied to a particular event such as a couple or a family situation, a pharmacological or chronic treatment (more rare) when  dependent from certain diseases. In  gynecological practice, unlike in the past, the woman speaks more willingly of sexological problems and the gynecologist has taken on a growing role in the differential diagnosis and treatment of these disorders.

We have mentioned the limbic area where reside sexual desire, erotic fantasies and everything is referred to as libido. In this area signals are coming fromthe nearby areas, from the cerebral cortex and also from hormones circulating in the blood that leading to a different modulation of neuroendocrine mechanisms based on differential expression of small substances called neurotransmitters. We can therefore say that there is a biochemistry of love based on the proper interaction of these mechanisms and on different modulatory capacity of hormonal substances. In fact, particularly in women is evident that some substances have an important role in this context: we speak of estrogen and androgen. Although the topic is still controversial, it seems that the positive estrogen effect on the libido is not dependent on direct stimulation of the centers of sexual desire, but is the result of a feeling of wellness perceived in other brain areas.

Androgens conversely would have a direct positive effect and would be the ones to determine what it is the increase in sexual and erotic fantasies in the ovulation period. Between 20 and 50 years, the woman undergoes a slow and progressive reduction of androgen levels (50%). In absence of other interfering factors does not cause significant changes in sexual appetite: androgenic levels after menopause remain stable or a slight increase.

It is mainly in women who are subjected to surgical, medical (chemotherapy) or radiotherapy castration that the decline of these substances is dramatically faster and can therefore result in a significant loss of desire. In these patients has proved useful a small dosage of androgens when clinical conditions permit it. The administration of estrogen and/or androgen under the direct control and indication of a physician may have important effects on libido and can therefore be considered as part of problem solving strategies.

In order to conclude this brief discussion I want to highlight some key issues:

– A temporary reduced sexual desire is frequently situational, in most cases resolve spontaneously and it is no cause for alarm;

– Psychological factors are important just as the relationship with your partner;

– In the presence of a prolonged reduced libido discuss this with your trusted physician and with your gynecologist, do not ignore the problem.

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Filiberto Di Prospero
Medical Doctor, Consultant in Gynecology and Obstetrics, Endocrinology and Metabolism. Director of Gynecologic Endocrinology Unit at Civitanova Marche General Hospital (Italy). Private clinics in Civitanova Marche, Rome and Milan.

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