Diet plate


Dear Andrea:

I'm in my thirties. Most of my life, my sex drive has been pretty low — not during the "honeymoon" phase, but within a year, it tends to taper off to almost nothing. This significantly, negatively impacts my relationships (my last one ended due to not enough sex; my current one has same problem).

I suspect this is pretty common. What are the typical causes of low libido in women? I don't really believe in aphrodisiacs, but are there any proven treatments?


No There There

Dear There:

Female sexual dysfunctions are, somewhat sadly, a growth industry. With the latest research indicating that something like 40 percent of women experience something dysfunctionish (most often low desire but also anorgasmia, aversion, or pain), you can see how people who develop and sell new treatments might have their eye on you. All good, to a point. We don't want to see the same preying on the desperate but not that bright that supports the cosmetics industry. Did you know there's already a real product called Hope in a Jar? Let's not have another.

Male sexual dysfunction is usually easy to recognize and fairly easy to treat. Most men who think there's something wrong down there want sex — oh, do they want it — but are hampered by lack of or loss of erection, or by coming too fast or, sometimes, too slowly (it's always something). We women tend to keep our dysfunctions tucked neatly away out of sight, like our genitals and our vibrators, so problems are harder to quantify and harder to treat. This is especially true of the desire disorders, which occur in men but are practically epidemic in women. Causes may be hormonal, situational, or historical, and it's tricky even to figure out if you have one, let alone to treat it. How hypo does a hypoactive sex drive have to be before it is considered a problem? And who is it a problem for? Is there a right and proper level of desire out there, and ought women who don't meet it feel inadequate or just different? Must women's desire match men's in order to be considered normal? Should a woman "fix" herself to suit a partner, even if she would be pretty much satisfied with whatever amount of sex her natural inclinations tell her is enough? See what I mean?

There is, I'm afraid, nothing yet available in the way of an aphrodisiac for women (or for men either, should they need one; the history of aphrodisiacs has mostly involved men slipping random substances into women's drinks and crossing their fingers). There are a few things in the pipeline, very close to release, or already available off label, although most are just testosterone with assorted delivery systems. Testosterone patches will be worth trying when approved, but they're simply not going to work for everyone (most of the trials have enrolled naturally or surgically menopausal women only) and aren't safe for everyone. Testosterone has been shown to be effective, though — it seems to be responsible in large part for the "go out and get me some" drive that most men tend to have in greater abundance than most women do, even highly sexual women, so it's the obvious place to look for a treatment for "just don't feel like it" complaints. Wanting to want it is probably the most common complaint going, but you still have to ask yourself why you want to want it before it's really worth trying to want to want it, if you know what I mean. You do know what I mean, don't you?

I do wonder if you are really even part of Hypoactive Nation or if you might have something altogether different going on.

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