Let’s Talk About…Wait, what?!? Sex? Libido?

libidoLet’s talk about … Wait, what?!?

It’s OK, I’m your gynecologist.  You can talk to me about … (sex!).  The vast majority of my patients have the “logistics” of it down, it’s the libido part (or lack thereof) that plagues most of us.
Well …
I’m going to tell you something that maybe no other gynecologist will tell you, we GROAN inside when we see those two words on a patient’s “issues” list — “low libido.”  Not because we don’t care or don’t want to help you, but because we usually CAN’T fix it for you, and as healthcare providers, we like things that we can fix; we like to fix things!  That being said, just because we can’t fix it doesn’t mean there’s nothing that can be done to fix it (or at least improve it) …  it’s just that, for better or for worse, you have to do the things yourself that will, in most cases, improve that elusive libido.  The thing about the female libido is that it is not as simple as the male libido (understatement of the year, right?).  It is, just like us women, very complex.  Multiple factors contribute, and the majority of them are not directly related to physical arousal/vaginal considerations, but to desire/interest.  The female sex organ is as much her mind as anything else.  It is really difficult to muster up desire when your days are spent working, being supermom, and trying to “fit it all in.”  Face it, for many, sex falls to the bottom of a (very long) to-do list, and who wants to have sex just to cross it off a list?
There are, sometimes, underlying and medically correctable barriers to a healthy sex life; certain conditions cause painful sex, and if the pain is alleviated then desire for sex may improve.  We can help evaluate for and correct these.  Some women leak urine during sex or have a vaginal odor they find bothersome, making them self conscious and reducing sexual desire, which are also considerations that we OBGYN’s may be able to correct.   But if physical sex is fine and the desire just isn’t there, then you probably don’t have quite as easy a “fix.”  Getting enough sleep, being well hydrated, managing stress, and avoiding excessive alcohol can all help improve your desire for sex.  Also, no matter how much you love your little bundles of joy, for many women those kiddos can be a big bucket of ice water on their libidos–it’s psychologically difficult for many women to be in “mommy mode” until the babies are in bed and then flip a “sex kitten switch” for her partner.
Sometimes, spending some grown-ups only time, away from those beacons of all our love and happiness, can help increase libido, for the moment.
But for an overall lack of interest, women really need to love themselves (that’s NOT what I meant, although masturbation does sometimes help, also … ).  I mean, stop the negative internal dialogue that we all have going on about our bodies.  In a recent interview with a well respected sex therapist, she cited, as the number one most commonly identified factor in poor libido, self body shaming.  LOVE yourself–look in the mirror every day and identify something about you that is beautiful, rather than lamenting whatever you perceive are your imperfections and physical shortcomings. When your partner tells you that you are sexy and that you are desired, let yourself hear it, and accept it graciously.  Shut down that snarky voice in your head rolling her eyes at you and and saying, “Yeah, right.”
Exercise, even in the absence of weight loss or achieving that elusive perfectly fit ideal, will not only improve your self body image but will also (eventually, because let’s be real, when we start to exercise after a time period of sedentary living, we feel TIRED!!) actually improve your energy level.  So maybe, at the end of a busy day, you will have just a little more energy left over for some…relationship building.
Sex is a healthy part of any adult woman’s life.  At Virginia Beach Ob Gyn, we want you to have a healthy, happy, and fulfilled life in every aspect.  So, even though we may groan a little when we see the “issue” written down, please bring it up at an appointment, if it’s on your mind, so that we can help you (even if it’s just to help you help yourself) find ways to improve your libido.
Raegan N. Kotsko, M.D. is an obstetrician and gynecologist in Norfolk, VA, practicing at Virginia Beach Obstetrics & Gynecology, PC.   She offers a full range of obstetrical and gynecologic services, including well woman preventative medicine, contraception counseling and management, and evaluation and management, both medical and surgical, of gynecologic problems.  Dr. Kotsko practices at three office locations in Virginia Beach, VA.