Low Libido Isn't “Just Part of Getting Older”: When It May Be HSDD
By Michelle Clay, FNP
There Is No “Normal” Amount of Sex You Should Want
One of the first things I tell women is that there isn't a magic number of times per week that you're supposed to want sex.
Some women naturally have a higher sex drive. Others have a lower one.
And if you have very little interest in sex but you're perfectly happy with that, there's not necessarily a problem that needs to be fixed.
What gets my attention is when a woman tells me:
“I used to have a sex drive. Now it's gone—and I want it back.”
That's different.
What Is HSDD?
Hypoactive Sexual Desire Disorder, or HSDD, involves persistently low sexual desire that causes personal distress.
The distress piece matters.
It's not simply having sex less often.
It's not having a lower sex drive than your partner.
And it's not someone else deciding you should want sex more often.
It's about your desire and whether its decrease bothers you.
Why Does Libido Change?
There isn't one single cause.
Hormonal changes can certainly contribute, particularly during perimenopause and menopause.
Testosterone can be part of the picture, but so can estrogen—especially if vaginal dryness or painful intercourse has made sex uncomfortable or even painful.
Certain medications, including some antidepressants, can affect sexual desire and sexual response.
Poor sleep, chronic stress, depression, anxiety, relationship issues and other health conditions may also contribute.
And oftentimes its a combination of several of these things are happening at the same time.
That's why low libido doesn't automatically equal low testosterone.
Can HSDD Be Treated?
Yes—but treatment depends on what's causing or contributing to the problem.
For some women, addressing hormone changes may help.
For others, medications need to be evaluated, vaginal discomfort needs to be treated, or other physical or emotional factors need attention.
Testosterone therapy can be considered for appropriately selected women, particularly after menopause, but it isn't the answer for everyone.
The first step is simply recognizing that if you've experienced a significant loss of sexual desire and it bothers you, it's worth talking about.
You don't have to dismiss it because you're getting older.
Wondering If Your Low Libido Could Be HSDD?
I've created a short FREE HSDD Assessment that can help you take a closer look at your symptoms and whether your loss of sexual desire is causing significant distress.
It’s only four questions and just takes a couple of minutes.
👉 Take the FREE HSDD Assessment
About the Author
Michelle Clay, APRN, FNP-C
Michelle Clay is a Family Nurse Practitioner and founder of Balanced Health, a Kentucky-based telehealth practice specializing in women's hormone health, thyroid optimization, insulin resistance, and weight-loss resistance.