Physical causes

• Anaemia, which is very common in women because of iron loss during periods.
• Alcoholism.
• Drug abuse.
• Major diseases such as diabetes.
• Post-baby ‘coolness’, a term we have coined for the loss of libido that often happens after childbirth. It is almost certainly linked to hormonal changes that occur at this time. The general trauma of childbirth also plays a part – and after having a baby, many women are too exhausted to think about sex.
• Prescribed drugs, particularly tranquillisers.
• Hyperprolactinaemia – a rare disorder in which the pituitary gland is overactive.
• Other hormone abnormalities: leading Swiss gynaecologist Dr Michael Nemec claims that abnormalities in the production of luteinising hormone (LH) often cause lack of desire. And top British gynaecologist John Studd says that many women who have lost their libido lack androgenic (male) hormones. This view remains controversial.

You may be surprised that we haven’t mentioned the menopause as a physical cause of loss of desire.

Contrary to myth, the menopause doesn’t usually cause loss of libido, and many women feel a lot sexier and have more orgasms in the postmenopausal part of their life.

Psychological causes

These causes are very common. It’s understandable that when a woman is having a bad time emotionally, she may lose interest in sex.

Psychological causes include:

• depression
• stress and overwork
• anxiety
• hang-ups from childhood
• past sexual abuse or rape
• latent lesbianism
• serious relationship problems with your partner
• difficult living conditions, eg sharing a home with parents or parents-in-law.

What should a woman do about lack of libido?

Start by going to your GP, who can discuss the problem with you and do any necessary tests.

An alternative is to go to a woman doctor at a family planning clinic, since these practitioners are used to dealing with this particular problem.

Unfortunately, in the last few years family planning clinics have become swamped with patients, and many of them now won’t take on psychosexual difficulties.

Are there any medicines for female loss of desire?

While it’s clear that the big pharmaceutical companies are searching for a drug that will turn women on, they have had little success.

At present, drugs are not of much relevance to the average woman who wants to pep up her libido a bit.

Far more important is to have the support and understanding of a partner who wants to help you defeat the problem – and who understands how to get you excited in bed.

Testosterone

Hormones are often suggested as a treatment for FSAD, particularly the male sex hormone testosterone.

Doctors have been trying out testosterone on women for more than 40 years, rarely with much benefit. Side-effects include hairiness, spots, a deep voice and enlargement of the clitoris.

However, there is clinical evidence to support the use of testosterone as a treatment for low sexual desire. In 2007 a testosterone skin patch called Intrinsa became available in the UK.

This patch is only licensed on the NHS for women who have had an early surgically-induced menopause. Obviously, this is quite a small number of people.

Suction vibrators

Inventions that are supposed to increase female desire come and go.

In 2001 a device called the EROS was approved by the American Food and Drug Administration (FDA) for treating low sexual desire.

The gadget applies suction to the clitoris and so increases desire.

Desire cream

A much hyped new ‘desire cream’ was also introduced in 2001. It contains an ingredient similar to wintergreen, and its effect is to produce a tingly sensation in the clitoris. It, too, has made little impact on British medical practice. There are various other similar products now available.

Erection drugs

Erection drugs like Viagra have still not been proven to help women who have a low libido.

There is some evidence that they may have a beneficial ‘local’ effect in increasing blood flow to the vagina and clitoris for a few hours. They may also increase lubrication in some women.

But in Britain, these drugs are not licensed for use in women.