If you are experiencing a low sex drive or sexual response, here are eight steps to consider:
1. Get a complete physical examination; treat any underlying medical conditions. Though it may be difficult to talk to your doctor about a low sex drive, he or she can be a valuable resource or can refer you to other professionals.
2. Ask your doctor if any medications or dietary supplements you are taking may be interfering with sexual function. These may include drugs for hypertension, diabetes, cancer, depression, and anxiety.
3. If you smoke, quit. Smoking contributes to erectile dysfunction in men and also may negatively affect sexual functioning in women.
4. If you decide on testosterone therapy after menopause, the North American Menopause Society recommends using the lowest dose possible for the shortest time, taking it together with estrogen, and using patches, creams, or gels rather than pills. Custom-compounded prescription products vary greatly in quality and dose, however, and should be used with caution. Women with breast or uterine cancer or heart or liver disease should not take testosterone. Healthy women on testosterone should have their liver enzyme levels monitored.
5. Do not take sexual enhancement supplements. Sold in drug and health-food stores and on the Internet and containing various herbs, vitamins, and other nutritional ingredients touted to help with low sex drive, none of these supplements are proven effective or safe. They can also interact with other drugs and be dangerous for people with certain health conditions.
6. If vaginal dryness is a concern, over-the-counter lubricants (such as Replens, Astroglide, Vagisil, and K-Y Jelly) provide relief with no known side effects. During menopause, prescription estrogen creams, tablets, and rings for vaginal use (such as Estrace, Estring, and Vagifem) also may help, but their long-term safety is untested.
7. Kegel exercises help with vaginal tone and may make for more pleasurable sex. They involve repeatedly tightening and releasing the pelvic floor muscles, which are the muscles that also support the bladder and close the urinary sphincter.
8. If the problem is largely psychological or in your relationship, individual or couples therapy may help. Sex therapy also may be recommended. To find a therapist who specializes in sexual problems, contact the Society for Sex Therapy and Research or the American Association of Sexuality Educators, Counselors, and Therapists.