For many women, the phrase “I don’t feel like it” appears silently and unexpectedly over the years. Sometimes it coincides with menopause. Also with periods of stress, exhaustion, or major life changes. And although it is often assumed to be an inevitable consequence of aging, the reality is much more complex.
Dr. Claudia Carson Osses, gynecologist and coordinator of Gynecology at Clínica RedSalud Vitacura, explains that in women, a decrease in sexual desire does not always represent a health problem. In fact, fluctuations in sexual interest are part of life and can occur at different stages. The difference lies in how that change impacts each woman.
“We talk about a problem when this decrease causes significant personal distress, lasts for at least six months, and cannot be explained by other causes, such as illness, the use of certain medications, a mental health disorder, or difficulties in the couple’s relationship,” says the specialist.
That is, there is no “normal” frequency of sexual desire.
Warning signs are if that decrease causes worry, frustration, sadness, or a sense of loss, and ends up affecting well-being or the couple’s relationship.
For years, loss of sexual desire has been almost automatically associated with menopause. And while hormonal changes play an important role, reducing the problem solely to estrogens is an oversimplification.
It is a fact that the hormonal decrease typical of this stage can cause changes in the vulva, vagina, and pelvic floor. Symptoms such as hot flashes, sleep disturbances, and persistent fatigue also appear, which end up impacting sexual life.
However, the doctor assures that loss of sexual desire in women is multifactorial. The following can affect it:
“Current evidence shows that, although hypoestrogenism is key, it is the psychosocial and mental health symptoms that seem to have a greater specific weight on sexual desire,” the specialist points out.
Many women stop consulting doctors because they believe there is nothing to be done. That they simply aged, and it is part of that stage in their lives.
“It is common for sexual desire to gradually decrease over the years, but that does not mean that interest in sexuality disappears, nor that this decrease is necessarily a problem or something inevitable for all women,” says Dr. Carson.
The specialist emphasizes that these changes should not be normalized. “It is important to convey to women that it is usual for sexual desire to change over the years and that a certain decrease can be part of aging. However, that does not mean it should be assumed as inevitable or that it does not deserve evaluation when it causes distress.”
Read more The CIA in Cuba: Create secret operations group and increase pressure on the regime
In many cases, behind the problem there are causes that can be identified and treated: from emotional or couple difficulties to side effects of medications or changes inherent to the urogenital system.
And there is no single solution. The approach, explains the gynecologist, must be comprehensive and personalized, and must consider the physical health, emotional health, and life context of each woman.
The first measures specialists usually take focus on lifestyle changes, stress management, sexual education, and, when appropriate, sexual therapy or couples therapy.
In some cases, pharmacological treatments may also be indicated under medical supervision. One of them is transdermal testosterone, which, according to the specialist, has been shown to be safe and effective when used with medical indication.
The case is different for the so-called “testosterone chips” or “pellets.” “Their use is not safe because they provide erratic doses of the drug, their absorption is unpredictable, and they can cause serious health risks. They are completely discouraged by medical societies,” she warns.
There is also vaginal DHEA, which can benefit sexual function in some patients, always under medical evaluation.
The doctor’s recommendation is not to wait for the problem to last for years. If the decrease in sexual desire persists, causes distress, affects self-esteem, or begins to deteriorate the couple’s relationship, it is time to seek help.
Dr. Carson explains that the health professional will depend on the predominant cause.
A gynecologist experienced in sexual health or menopause is usually the first step when hormonal symptoms exist, while a psychologist, sex therapist, or couples therapist can be key when emotional or relationship factors predominate.
If disorders such as depression or anxiety exist, the support of a psychiatrist can also be part of the treatment.
