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When Your Female Sex Drive Is Circling The Drain

I don’t mean to catch you mid-croissant on this topic, but it may have recently dawned on you that your sex drive is not what it was when you were younger. In fact, when you think about it, maybe you never had much of a sex drive at all, no matter which of your decades you happen to be in now. Straight or gay, maybe you were always polite in your Stanislavsky method acting skills during sex, but you’d honestly prefer to be masturbating alone, tending your garden, watching Game of Thrones, or a little of all three.

Men are much less complicated. Give a man a decent erection and whether or not he’s “in the mood,” when he realizes the toy between his legs is in good working order he will get in the mood fairly promptly. Although drugs like Viagra and Cialis work strictly on the mechanics of male sexuality, proudly gazing downward on their result does enhance a guy’s libido.

Men who think their libido is lower at whatever age they are now compared to when they were in their teens are pretty clueless about what happens with getting older. When you’re 18 and have enough of an imagination, you have so much testosterone you can get excited looking at a concrete block. When you’re older, you hope your low testosterone level ramped up with a prescription will solve everything, but while many men feel better with higher testosterone, the libido part can be disappointing.

I hate to generalize here, but men do like quick fixes.

Women are far more complex
There’s been a great deal of research into the female libido. Vaginal moisture by itself, the counterpart of a male erection, will not enhance sex drive, although vaginal dryness can kill it quickly enough. I’ve written a couple articles about this in the past. One, entitled DIY Sex Drive Enhancement, discusses the effect of sex hormones, the usefulness of masturbation, and the drugs that Big Pharma had just released for the newly named hypoactive sexual desire disorder (HSDD)—i.e., low sex drive.

Assigning a condition an official name green-lights Big Pharma to develop big drugs, like Zoloft for social anxiety disorder. The DIY Sex Drive Health Tip reviewed the then-new drugs for this “condition” that subsequently became mega-turkeys and allegedly lost the companies (well-deserved) millions of dollars.

The drug called Addyi had so many side effects and warnings that doctors were afraid of prescribing it and patients afraid of taking it. Two others, Lybrido and Lybridos, which were combinations of low doses of Viagra, testosterone, and the antianxiety med BuSpar (buspirone), failed in clinical trials and never got FDA approval.

For the pharmaceutically adventuresome among you, the DIY in the title refers to the fact that each could be manufactured by a compounding pharmacist. Your partner, if male, would pop his Viagra at the same time you’d swallow your homemade Lybrido, and good luck to both of you.

Pathetic success and awful side effects
Since, in their hearts, Big Pharma believes that everything can be solved by chemicals, watch now for Vyleesi, FDA-approved for the pre-menopausal woman with low sex drive. With Vyleesi you inject yourself in the abdomen or thigh about 45 minutes before sex. The FDA says that 25% of women using Vylessi reported improvement compared to 17% reporting improvement using a placebo injection. Numbers like these are pathetic.

I’ve shared with you in the past that fact that volunteers for these studies are paid, and often generously. Participants frequently want to please researchers so they’ll be invited to participate in more studies. To make the researchers happy, volunteers tell them what they think they want to hear, namely that they feel somehow “better.”

Remember, too, that volunteers can often recognize they’re on the actual drug because they start experiencing side effects. Conversely, no side effects means they’re in the placebo group. Once they note the side effects, they’ll often tell researchers what they want to hear (“I enjoyed sex more than ever”), and this good news is reported to the drug manufacturer, which gleefully reports it to the FDA, and soon your TV is advertising yet another crummy, overpriced, useless drug.

It’s worth mentioning that the side effects of Vyleesi are the ever-attractive nausea, vomiting, flushing, and headache. Another side effect of Vyleesi is the opaque description “focal skin hyperpigmentation,” and I envision this meaning if the stuff actually works for you you might find yourself covered with dark spots.

The most interesting piece about female sex drive came via this 2013 article in the New York Times, published about the same time Allyi was being released. After interviewing thousands of women about their sexual habits, needs, and turn-ons, the most common villains were found to be boredom and antidepressants.

Boredom, also described as familiarity, makes a new partner the potential cure, but since physicians aren’t going to be prescribing adultery anytime soon, a first step might be to go off antidepressants (or at least reduce the dose).

An astonishing 25% of women are taking antidepressants, so rather than giving yourself injections that might trigger vomiting and skin spots, ask about alternatives to your Prozac. Next, schedule time with Mari Stecker, who uses a combination of acupuncture and herbs to treat libido issues. Schedule a visit with any of us and get a kit that will measure your hormones throughout a month.

Lastly, if you believe there’s a mind-body connection going on, schedule with one of our therapists: Jennifer Davis, Christine Savas, or Janet Chandler.

Be well,
David Edelberg, MD

Leave a Comment


  1. My wife has been on estrogen for menopause symptoms. HER SEX DRIVE WAS LOW AND SHE WAS UNABLE TO HAVE AN ORGASM. Her Dr. added a very low dose testosterone and her libido and orgasms were through the roof! I am 67 and she is 57 and we are having the best sex ever! It has definitely put the spark back into our marriage. We feel like teenagers again.

  2. Jacqueline says:

    Uh …my libido says, this does not apply to us! Thank you jaysus

  3. Stephanie says:

    Hi Dr. Edelberg,
    Emily Nagoski, in book “Come As You Are: The surprising new science that will transform your sex life,” frequently states “sex is not a drive.” Rather, there are factors that hit the accelerator or the brakes.
    It’s a great read.

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