Low Libido: What to do about it
This blog is based upon my podcast episode on low libido here
The Hormonal Symphony: A Key Player in Sex
Life throws a lot at us, and it’s no wonder that sexual drive can ebb and flow. Whether it’s stress, hormonal changes, or just the grind of daily life, feeling disconnected from your libido is frustrating. But here’s the good news: you’re not alone, and there are ways to reignite that spark. Let’s dive into the why, the how, and the let’s-do-this of sexual desire.
Hormones are like the conductors of your body’s orchestra, and when they’re out of tune, it’s hard to feel in sync. Testosterone, estrogen, and even oxytocin (the love hormone) play critical roles in sexual desire.
How Vaginal Estrogen Changes Affect Sensation
If you’ve been feeling “off,” it might be worth checking in with your healthcare provider to measure hormone levels. Low testosterone, for example, can sap energy and desire.
Also, low vaginal estrogen can make having penetrative sex painful because the tissue can become dry, feel raw and burn. This can also happen when our vaginal pH is off as well. This can lead us to avoiding having sex all together because we associate it with pain.
Vaginal estrogen is often described as the viagra version for vaginas.
Fair warning, in the US, people sometimes have to really advocate to get this prescribed, which I cant wrap my head around.
Signs You May Have Low Vaginal Estrogen:
Feeling dryness or burning in the vagina and at the opening)
You are postpartum (within 12 months)
Currently breast-feeding
Have been on prolonged oral birth control
You are >35 and are showing signs of perimenopause
Have had a complete hysterectomy
Have undergone cancer treatments that impair your hormonal production
Re-occurrent infections, such as UTIs (urinary tract infections)
You notice your vaginal opening is red, or pale (compare it to the inner side of your upper lip — the other lip around your mouth ;)
You notice less sensation around your clitoris and in your vagina
Often times treatment is adding in vaginal estrogen (it needs to be local to the tissue, not just systematic).
It is important to insert the vaginal estrogen vaginally but also use it for spot treatments to the urethra (internally and externally) — its located just behind the clitoris and internally at 12 o’clock (think of your vagina as a clock and the clitoris is at 12). This is why I often find the cream version more helpful.
The urethra has a different blood supply than the vagina, so it helps to reduce risk of UTIs as it allows the tissues to be more resilient.
However, some people can’t tolerate estrogen. For non-hormonal options, products like hyaluronic acid suppositories can improve vaginal comfort and moisture — a game-changer for many.
You can always start by inserting your favorite lube deeper into the vagina with a lube launcher if you having penetrative sex.
Most lube often gets taken up at the opening, which is why I suggest the launch- I love the name because I cannot figure out a more professional way to say it.
Stress: The Ultimate Libido Killer
Your nervous system is designed to prioritize survival, not pleasure. So, when you’re stressed, your body isn’t focused on getting you in the mood. It’s too busy running from a metaphorical bear. Try not to be too down on yourself about this. We are all a work in progress doing our best.
Self-Care Isn’t Selfish
Carve out time for yourself to lower stress levels. Whether it’s a quick walk, a few minutes of deep breathing, reducing stress helps your body shift from fight-or-flight mode to rest-and-digest — where sexual arousal lives.
Communication: The Foundation of Desire
Feeling disconnected from your partner? You’re not alone. Desire starts outside the bedroom, with meaningful communication and connection. Our personal live and sex lives are no different, but for some reason we often think they are.
Sex Educator, Al Vernacchio, has a TED talk on using pizza as a metaphor for sex. If each party can communicate what they want on the pizza, everyone leaves satisfied.
Talking about what we like sexually has been considered taboo, especially in the heterosexual world.
But here is the deal: everyone’s body has different sensations, likes, dislikes etc. So it is vital to communicate what you like to your partner(s). It is virtually impossible for someone to know what you enjoy without them knowing.
If you don’t know what you like, try exploring your body by yourself. Try different strokes (circular, side to side, up/down, different rhythms, different types of penetration — including vaginally & anally). Just take note of what feels good.
If you struggle with intimacy because of religious guilt or shame, you may want to check out my podcast episode here where we address this. This is something I have struggled with as well but thankfully have worked through. Another great resource for me was Emily Nagoski’s book, Come As You Are.
Pro Tip: Desire Begins With Words
Sex doesn’t have to mean candles and lingerie. It can start with a kind word, a thoughtful text, or even sharing something you appreciate about your partner. Apps like Paired can help foster intimacy with fun, daily prompts that make reconnecting easier.
Exploring New Avenues: Toys, Erotica, and Beyond
Sexual desire isn’t one-size-fits-all. Exploring new ways to connect — with yourself and your partner — can unlock desires you didn’t know you had.
Toys Are Not Taboo
Sex toys can be an exciting addition to your intimate life, whether you’re solo or partnered. Explore options that suit your comfort level. Apps like Dipsyoffer steamy, short-story erotica to spark your imagination.
Think Beyond Penetration
Sex doesn’t always have to center on penetration. Sensual massages, oral sex, or simply exploring touch can create new pathways for connection and arousal. Remember, the journey is just as important as the destination. Society has made it seem that peneration is the end all be all, and this isn’t true. All sex is sex.
Lifestyle Check-In: Is Your Life Supporting Your Desire?
Sometimes, low libido has less to do with hormones or relationships and more to do with lifestyle. Are you overworked, overtired, or feeling disconnected from yourself?
Make Small Changes That Add Up
Start small: commit to better sleep, regular movement, and moments of joy. Even minor tweaks can create a ripple effect, helping you feel more energized and connected.
Professional Help: When to Seek Support
If you’ve tried lifestyle changes and still feel stuck, it’s okay to ask for help. Treatments like Viveve (for vaginal dryness and laxity), the MonaLisa or Cleovana (for enhancing clitoral sensitivity) are available for those looking to boost physical and emotional connection. In this podcast episode we discusse medical options to help with vaginal estrogen changes.
Medical Checkups Matter
Conditions like high blood pressure, autoimmune diseases, or even certain medications can impact libido. A medical evaluation can help uncover any underlying issues and create a tailored plan for improvement.
Permission to Enjoy: It’s Your Journey
Rediscovering your sexual drive is about giving yourself permission to enjoy pleasure — on your terms. Explore, experiment, and communicate. Whether you’re reigniting an old flame or discovering new passions, it’s all part of the adventure.
Remember, it’s a journey, not a destination. And yes, having fun along the way is highly encouraged.
Until next time,
Dr. Mary
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