The sexual response for women is based on a combination of physiological (physical response by the body), emotional (feelings), tactile (sense of touch), scentful (odour) and psychological (mind and thoughts) stimuli that she is experiencing. A reduced response of desire and arousal may be due to number of physiological and psychological explanations. The menstrual cycle, low self-esteem, depression, anxiety, stress, fatigue, depression, illnesses and physical changes in the body cause libido to fluctuate.
There are many natural and herbal medicines and nutritional supplements available which may help sexual function, support the hormonal system and improve the physiological symptoms associated with low libido of women.
Female sexual dysfunction
Female sexual dysfunction (FSD) is a medical condition which can occur anytime throughout a woman’s life, but is most prevalent in the mid-years. It is defined as:
- Low libido. A persistent or recurrent reduction in sex drive
- Sexual avoidance. An aversion to sexual activity and/or difficulty becoming aroused
- Orgasmic disorder. An inability to achieve orgasm
- Sexual pain (Dyspareunia) is pain experienced during intercourse
Causes of Female sexual dysfunction
Hormonal changes
Hormonal fluctuations of oestrogen, androgens and testosterone which can occur at various stages through a female's life may directly affect libido. Changes to hormone levels can result in sudden symptoms never experienced before.
- Vaginal dryness is associated with lower levels of oestrogen as can happen during the transition into menopause. The lack of lubrication can cause tenderness, pain, soreness and uncomfortable feelings. This can result in negative attitude and a reduced feeling of desire.
- Females entering menopause will often find themselves struggling with some physiological issues such as depression, anxiety, anger and resentment. These disorders, and some of the medications used to treat them, can interfere with the enjoyment or desire for sexual intimacy.
- Breastfeeding and pregnancy hormonal changes can have an effect on libido as does fatigue and body image after pregnancy with added responsibilities of a new baby.
Medical conditions (not sexually related) such chronic kidney disease, multiple sclerosis, diabetes, thyroid disorders, arthritis, cancer and cardiovascular disease can be responsible for symptoms resulting in a low sex drive.
Medications such as antidepressants.
Lifestyle habits such as alcohol and smoking. Whilst alcohol can reduce inhibitions and set the mood, too much alcohol will affect sex drive. Smoking decreases blood circulation and may reduce arousal sensations.
Fatigue can often be one of the main causes of a reduced interest in sex. Exhaustion from parental responsibilities and work schedules can result in couples experiencing reduced desire for relationship pleasures.
Relationship issues. Emotional closeness for women is an important part of sexual intimacy. Good communication, emotional connection, trust and resolving conflicts are needed for healthy physical and emotional relationships.
Remedies and Reassurance
In most cases the reasons for a low libido can be easily explained. Change of life, stress and anxiety, fatigue or illness for example.
Vaginal atrophy and dryness are often a result of age and declining oestrogen levels, but is also associated with fluctuating hormone cycles, lack of essential fatty acids, fungal infections (candidiasis) and sometimes auto-immune diseases such as Sjögren’s syndrome. Establishing a cause for the problem is necessary for the right treatment.
Oestrogen can be increased with dietary intake of plant phytoestrogens. These are plants which have oestrogen activity – they resemble our own oestrogen and thus our body is able to use them. Plant Oestrogens play a beneficial role by supporting lubrication, increasing blood flow to the vaginal area (including the clitoris and urethra) and helping muscle tone in pelvic area. Common phytoestrogens include soy-based foods, legumes (chickpeas and mung beans), alfalfa and linseeds/flaxseeds. Trifolium pratense (Red clover) offers phytoestrogens available in supplement form.
Herbs and Supplements
Essential fatty acids in the form of fish oil, evening primrose oil and flaxseed oils.
Vitex agnus-castus (chasteberry fruit) offers a positive effect on a variety of female reproductive hormones. It has been used for the treatment of premenstrual syndrome and has been demonstrated in at least one study to improve vaginal tone and thinning as well as lubrication among perimenopausal and menopausal women.
Lepidium meyenii (Maca) is a supplement for general health and wellbeing. It can help to support the emotional wellbeing of menopausal women by reducing menopausal symptoms such as moodiness and mood imbalances, help support sexual function and healthy libido in post-menopausal women.
Trifolium pratense (red clover) is a plant rich in phytoestrogens offering oestrogenic properties shown to have a beneficial effect on vaginal health among postmenopausal women.
Cimicifuga racemosa (black cohosh) is an herb which has been used widely in the treatment of menopausal symptoms. It is a selective oestrogen receptor modulator with both oestrogenic and dopaminergic effect. Some studies suggest improvement in vaginal dryness and sexual functioning in menopausal women.
Panax ginseng is beneficial in improving fatigue, insomnia and depression in menopausal women.
Withania somnifera (Ashwagandha) is an ancient plant used in Ayurvedic and indigenous medicine form more the 3000 yeas. It is known to increase strength, enhance sexual performance and nourish the body. In modern studies it has proven its medicinal benefit in many areas of health, and in this incidence, offers a beneficial action for combating anxiety.
Tribulus terrestris (Tribulus) is considered an herb supporting energy and vitality. It has shown beneficial aphrodisiac effects in a number of studies and may safely and effectively improve sexual desire in women.
Vitamin D. Studies have shown vitamin D supplementation may improve vaginal health of women, particularly during menopause.
DHEA (Dehydroepiandosterone), and its sulfate (DHEAS), are precursors to estradiol and androgen in ovaries, low levels of which have been associated with decreased female sexual function. Studies have found DHEAS offered benefit to peri- and post-menopausal women with sexual dysfunction.
Probiotics supplementation can help colonize the vaginal tract which helps maintain normal urogenital health and prevent or treat infections.
Supporting Energy levels
Getting enough rest, good quality sleep and eating well are the necessary ingredient to combat fatigue. Other ways to help with fatigue include:
- Checking iron levels and supplementing if necessary
- Multivitamin or vitamin B complex
- Magnesium
Topical application of a lubricant is useful for vaginal dryness. Natural based lubricants are available and may help replenish natural moisture, protect mucus membranes and offer a substitute for the body's own lubrication.
Sleep, exercise and counselling
Sleep. A good night of quality sleep is often the best remedy for many health concerns and in the case of low libido there is a correlation between disrupted sleep patterns and hormonal regulation. Sleep apnea poses a significant risk for sexual dysfunction in both men and women.
Exercise. Exercise increases the flow of blood to the pelvic region can bring nourishment life to vaginal tissue. Pelvic floor exercises, yoga or Tai chi style physical activity may help to increase blood circulation and strengthen the pelvic region.
Counselling. Talk to a counsellor or your health care provider about your concerns. Psychological concerns are real and having someone who you can discuss your fears and anxieties with can help give reassurance.
References
- Sarris, Jerome and Wardle, Jon; 2014, Clinical Naturopathy 2e, Elsevier, NSW Australia
- Romm, Aviva; 2010; Botanical Medicine of Women’s Health, Churchill Livingstone Elsevier, USA
- https://www.mayoclinic.org/diseases-conditions/female-sexual-dysfunction/symptoms-causes/syc-20372549
- https://www.sciencedirect.com/topics/medicine-and-dentistry/female-sexual-dysfunction
- Female Sexual Dysfunction: Natural and Complementary Treatments https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519565/
- Red clover extract (MF11RCE) supplementation and postmenopausal vaginal and sexual health https://pubmed.ncbi.nlm.nih.gov/17007858/
- The non-estrogenic alternative for the treatment of climacteric complaints: Black cohosh (Cimicifuga or Actaea racemosa) https://pubmed.ncbi.nlm.nih.gov/23459142/
- https://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/testosterone-therapy/faq-20057935
- Effect of Vitamin D on the Vaginal Health of Menopausal Women: A Systematic Review https://pubmed.ncbi.nlm.nih.gov/32307935/
- Withania somnifera (L.) Dunal - Modern perspectives of an ancient Rasayana from Ayurveda https://pubmed.ncbi.nlm.nih.gov/32783987/
- Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo - controlled study https://pubmed.ncbi.nlm.nih.gov/24773615/
- The role of lactobacilli and probiotics in maintaining vaginal health https://pubmed.ncbi.nlm.nih.gov/24170161/
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