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Low Libido In Women: What's Killing Your Sex Drive?

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Post-baby life was not what Katherine Campbell imagined. Yes, her newborn son was healthy, happy, and beautiful; yes, seeing her husband dote on him made her heart melt. But something felt… off. Actually, she felt off. At 27, Campbell’s sex drive had vanished.

“It was like a switch went off in my head,” she describes. “I wanted sex one day, and after that there was nothing. I didn’t want sex. I didn’t think about sex.” (How Often Is Everyone Else Really Having Sex?)

At first, she told herself this disappearing act was normal. Then after a few months she turned to the Internet for answers. “Women online were saying things like, ‘Be patient, you just had a new baby, you’re stressed… Your body needs time, give it six months.’ Well, six months came and went, and nothing changed,” remembers Campbell. “Then a year came and went, and nothing changed.” While she and her husband still had sporadic sex, for the first time in Campbell’s life, it felt like she was just going through the motions. “And it wasn’t just the sex,” she says. “I didn’t want to flirt, joke around, make sexual innuendos—that whole part of my life was gone.” Is this still normal? she wondered.

A Growing, Silent Epidemic

In a way, Campbell’s experience was normal. “Low libido is extremely prevalent in women,” asserts Jan Leslie Shifren, M.D., a reproductive endocrinologist at Mass General Hospital in Boston, MA. “If you just ask women, ‘Hey, are you not that interested in having sex?’ easily 40 percent will say yes.”

But lack of sex drive alone isn’t a problem. While some women simply don’t want sex that often, low libido is often a temporary side effect of an external stressor, like a new baby or financial troubles. (Or this Surprising Thing That Can Kill Your Sex Drive.) In order to be diagnosed with female sexual dysfunction, or what’s now sometimes called sexual interest/arousal disorder (SIAD), women need to have low libido for at least six months and feel distressed about it, like Campbell. Shifren says 12 percent of women meet this definition.

And we’re not talking about postmenopausal women. Like Campbell, these are women in their 20s, 30s, and 40s, who are otherwise healthy, happy, and in control of every area of their lives—except, suddenly, the bedroom.

A Far-Reaching Problem

Unfortunately, sexual dysfunction doesn’t stay contained to the bedroom for long. Seventy percent of women with low desire experience personal and interpersonal difficulties as a result, finds research in the Journal of Sexual Desire. They report negative effects on their body image, self-confidence, and connection to their partner.

As Campbell put it, “It leaves a void that seeps into other areas.” She never completely stopped having sex with her husband—the couple even conceived their second son—but on her end, at least, “it was something I did out of obligation.” As a result, the couple started fighting more, and she worried about the effect it was having on their kids. (Are Women Meant to Marry?)

Even more distressing was the impact it had on her life passion: music. “I eat, sleep, and breathe music. It was always a huge part of my life and for a while, my full-time job,” explains Campbell, who was the lead singer for a country-rock band before becoming a mom. “But when I tried getting back into music after having my sons, I found myself just not interested.”

The Great Treatment Debate

So what’s the solution? As of now, there’s no easy fix—largely because the causes of female sexual dysfunction are hard to pinpoint and are often multi-factorial, involving things that are difficult to test for, like neurotransmitter imbalances and stress. (Check out these 5 Common Libido-Crushers to Avoid.) So while men with erectile dysfunction or premature ejaculation, two common forms of male sexual dysfunction, can pop a pill or rub on a cream, women’s treatment options involve things like therapy, mindfulness training, and communication, all of which take time, energy, and patience. (Like these 6 Libido Boosters That Work.)

And many women aren’t happy with any of these options. Campbell, for example, rattles off remedies she tried like a shopping list: exercise, losing weight, eating more organic and less processed food, even an antidepressant prescribed by her doctor—all to no avail.

She and many other women believe true hope lies in a pill called flibanserin, often referred to as the “female Viagra.” The drug acts on serotonin receptors to boost desire; in one study in the Journal of Sexual Medicine, women had 2.5 more satisfying sexual events a month while taking it (those on a placebo had 1.5 more sexually satisfying events in the same time frame). They also felt significantly less distress about their sex drives, a huge draw for people like Campbell.

But the FDA blocked its first request for approval, citing concerns about the severity of the side effects, which include drowsiness, headaches, and nausea, in the face of what they consider modest benefits. (Read more about why the FDA Requested More Studies on Female Viagra.)

The manufacturers of flibanserin—and many of the women who participated in the clinical trials of the drug—say those benefits are anything but modest, and the side effects are mild and easily managed by, for example, taking the drug before bed. After gathering more evidence and holding workshops with the FDA to explain more about female sexual dysfunction, they resubmitted a New Drug Application for flibanserin to the FDA this Tuesday, February 17.

While proponents of the drug are hopeful, there’s no guarantee that they’ll get the approval—or if they do, how long it will take to bring flibanserin to market. What’s more, some experts wonder how much the drug, even if it does get approval, will really help women.

“I think a small subset of women with sexual dysfunction would benefit,” notes sex educator Emily Nagoski, Ph.D. author of Come As You Are ($13; amazon.com). But she believes that many women who flibanserin will be marketed to may not have true sexual dysfunction at all.

There are two forms of female desire, explains Nagoski: spontaneous, that flutter you get when you see a new hottie at your gym, and responsive, which occurs when you don’t get turned on out of the blue, but you do get into the mood when a partner instigates sexual activity. Both kinds are “normal,” but women often get the message that spontaneous desire is the end-all-be-all in the bedroom—and that’s what flibanserin promises to deliver. (Am I Normal? Your Top 6 Sex Questions Answered.)

Even for women who truly have neither type of desire, Nagoski adds, “It’s important for them to know that it’s possible to experience improvements without drugs.” Mindfulness training, trust building, trying new things in the bedroom—these are all things that have been proven to increase libido, says Nagoski.

Bringing Low Libido Out of the Bedroom

In Campbell’s mind, though, it comes down to choice. Since she wasn’t part of the flibanserin clinical trials, “I don’t even know if it would work for me. But I’d love for it to be approved so I can try it, and see if it works.” 

But even if flibanserin gets rejected once again—or even if it gets approved and Campbell (who was introduced to me by the drug manufacturer) finds that it isn’t the cure-all she was hoping for—there’s been one positive outcome: The debate over FDA approval has created a more open conversation about female sexual dysfunction.

“I just hope that other women aren’t embarrassed to talk about this,” says Campbell. “Because keeping our mouths shut isn’t getting us the treatment options we need. That’s why I decided to try talking about it. And you know what? That alone has been really empowering for me.”

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