Introduction:
Sexual desire is a purely bio-physiological born impulse that drives the individual to seek sexual activity, including sexual arousal and orgasm. This drive is also called libido, and it goes through highs and lows due to multiple factors such as physical factors, lifestyle changes, pathological conditions, psychological conditions, and some medications. This article elaborates on all the normal physical changes a woman goes through in life, which significantly contributes to reduced sexual desire.
What Are the Different Physical Changes Which May Contribute to Reduced Sexual Desires?
Reduction in women's sexual desire can be singularly caused by anatomic and physiological changes or associated with other factors such as psychiatric illness, marital discord, systemic conditions, or a combination of these factors. This reduction in sexual desire can lower a woman's sexual initiation, which may lead to less frequent sexual encounters and, in turn, threaten romantic bonds by depriving couples of many benefits of sex, such as pleasure, intimacy, and emotional attachment. Pregnancy, breastfeeding, menopause and post-menopause, menstrual cycle, and aging are the potential physical changes that lead to reduced sexual desire in a woman.
What Pregnancy-Related Changes Contribute to Reduced Sexual Desire in Women?
Pregnancy brings about plenty of physical and psychological changes in a woman. Various studies have suggested a slight decrease in sexual desire in the first trimester, a variable in the second trimester, and a significant reduction of sexual desire found in the third trimester, where it lowered to the level defined as that of sexual dysfunction.
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First Trimester:
In the first three months of pregnancy, the adaptation phase begins. Hormonal and psychological factors contribute to the liability, which makes women seek much more affection and attention from their partners. A woman may require more than usual effort to maintain sexual activities due to nausea, vomiting, aversion to some smells and foods, And other associated discomforting symptoms such as hypersalivation, headache, drowsiness, and hypersomnia affect a woman's sexual activities. The majority of women have a fear of abortion during the first few months, which may contribute to lower sexual desire.
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Second Trimester:
In the second trimester, all the changes of the first trimester may persist or reduce, resulting in some improvement in sexual functions. For example, a woman may experience improved libido in the second trimester because of a decline in physical discomfort and fear compared to the other two trimesters.
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Third Trimester:
Many women report a significant reduction in sexual activity in the third trimester. It is mostly attributed to physical factors such as the growth of the abdomen, her perception of body image, avoidance of sexual intercourse as advised by a doctor, and considering oneself unattractive to the spouse.
What Are the Breastfeeding-Related Changes Contributing to Reduced Sexual Desire in Women?
During the breastfeeding phase, prolactin and oxytocin are responsible for lactation. The consequences of these hormones are while breastfeeding; the woman gains great pleasure from that activity and contact with the baby. As a result, much of her need for attachment is derived from breastfeeding, which is healthy and customary. However, another result is that lactating women will likely have a declined demand for pleasure and intimacy from their partners. Some of the reasons for reduced sexual activity during breastfeeding are:
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Vaginal Dryness
Another significant change in breastfeeding is the lack of vaginal lubrication during sexual excitement. This vaginal dryness may cause discomfort and pain during sexual intercourse, reducing sexual desire in lactating women. This condition is easily resolved using a water-based lubricating gel spread on the vulva and into the vagina.
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Fatigue and Stress
Another reason for reduced sexual desire during this phase is frequent breastfeeding sessions with the baby. In addition, having a disturbed sleep pattern may instigate a state of fatigue and stress.
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Breast Engorgement
Moreover, women's breasts can cause great discomfort during lovemaking if they are engorged with milk or leaking. Emptying the breast before having sexual activity can partially resolve the problem, and in case of leakage, the use of a towel can help during lovemaking.
What Changes in the Menopausal and Postmenopausal Stages Contribute to Reduced Sexual Desire in Women?
Women in the menopausal and postmenopausal phases can experience a decline in sexual desire and orgasm.
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In Menopause:
The physiologic changes of menopause are largely mediated by estrogen, which affects the sexual response of women. Hypoestrogenic levels of menopause may delay clitorial reaction time and alter nerve function, resulting in slow or absent orgasmic response. This effect, along with vaginal dryness, can further bring about a reduction in sexual desire.
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In Postmenopause:
Postmenopausal women experience-
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Persistent dyspareunia (genital pain related to sex).
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Delayed or absent lubrication of the vagina.
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Post-coital bleeding due to thinning of the vaginal skin.
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Delayed or absent orgasm greatly affects motivation for sexual intercourse.
All these factors lead to the experience of painful coitus, which ultimately conditions her response as reduced libido.
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Hormone Treatments:
Hormone treatments can be helpful in the postmenopausal period by alleviating sexual symptoms. They can be used locally or systemically, such as estrogen, androgen preparations, and tibolone. It gives noticeable results in improving vaginal lubrication and the ability to reach orgasm and sexual drive; however, individualized management and sexual counseling are mandatory to achieve long-lasting and meaningful results in improving sexual function.
What Menstrual Cycle-Related Changes Contribute to Reduced Sexual Desire in Women?
The different stages of the menstrual cycle also often have substantial effects on the sexual desire of women.
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Many studies suggest an association between a woman's sexual desire and sex hormones, estrogen, and progesterone. Changes in the ratio of these hormones are part of the monthly menstrual cycle, which can change women's sexual desire.
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During Menstruation and a few days after it, the level of this hormone is comparatively low, resulting in a reduction in sexual desire.
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A few days after the ovulation and in the pre-menstruation phase, there is a boost in progesterone production which may lead to a dip in sexual desire.
What Are the Age-Related Changes Reducing Sexual Desire in Women?
The age-related reduction in sexual desire is more prevalent and severe in females than males.
Apart from the post-menopausal effect during aging, physical illness can also impact sexual functions directly due to interference in the endocrinal, nervous, and vascular processes that mediate sexual response. In addition, it may be due to weakness or pain in the body and psychological factors.
In addition, old age may have already negatively altered women's self-esteem. Urinary incontinence is another more common symptom in older women. It is present up to 25 percent of old-aged women. During intercourse, this urinary incontinence may result in withdrawal from sexual intercourse due to the embarrassment of leakage of urine during coitus.
Conclusion:
It is important to evaluate sexual desire in couples as reduced sexual desire brings challenges in a romantic relationship during pathological conditions and normal physiological changes in women's life. The consequences of low sexual desire may imply uncomfortable and painful intercourse for women and even pose difficulty for men because it limits genital arousal. All this may be the reason for the couple's conflict or breakdown. In such cases, the ideal management for affected women is a complete assessment of the factors affecting sexuality and a combined treatment approach to alleviating these factors. The use of an individualized approach can enable women to continue to have a satisfying sexual life, depending on their personal preferences.
