Why has My Sex Drive Stalled? 5 Causes and Remedies for Women

August 14, 2024 | By: Anne Scott M.D.

Sexual desire is normal. So if your sex drive is unexpectedly stuck in park, it can troubling, even embarrassing. It also can suggest your body is going through an underlying health issue.

But it’s not uncommon! Of the more than 64 million women in the U.S between the ages of 30 and 59, up to one in every three has or will experience a decline in libido. Yet just 42% of these women seek treatment.

That can be a long-lasting mistake, because a range of health issues, including common urinary conditions, can interfere with your ability to enjoy sexual intimacy.

These conditions include:

  • Pelvic organ prolapse
  • Urinary incontinence or overactive bladder (OAB)
  • Menopausal-related vaginal dryness (genitourinary syndrome of menopause, or GSM)
  • Painful bladder syndrome (interstitial cystitis)
  • Pelvic pain

These conditions are why our urologists regularly treat sexual health issues in women. So let’s talk about it. This blog explains the relationship between these conditions and your sex drive.

How Your Urinary System Can Stall Your Sex Drive

Just as a satisfying sex life supports your overall physical, mental, and emotional wellbeing, your urinary health plays an important role in your sexual wellness. If something goes wrong along your urinary tract, it can interfere with sexual pleasure and even cause discomfort. An estimated 40% of all women experience pain during sex at one point or another in their lives.

Here’s how, explained across five common conditions:

  • Pelvic organ prolapse – If the pelvic muscles become too weak, the organs and other tissue they hold in place can slip into vaginal canal and even bulge out. Nearly half of all women between the ages of 50 and 79 live with pelvic organ prolapse, which can cause pressure, numbness, and discomfort. 
    Treatments we provide include pelvic-muscle strengthening training (Kegel exercises), estrogen replacement therapy, and pessaries (small devices inserted into the vagina to support organs and tissue). Surgical procedures involve lifting the organs into place and securing them with stitches or mesh.
  • Urinary incontinence – Up to 40% of women have trouble holding it in, and many fear they’ll leak urine during sex. Incontinence can occur in two forms: stress incontinence, when urine leaks during activities that put pressure on your abdomen, such as coughing; and urge incontinence or overactive bladder, the sudden and hard-to-control need to pee. 
    Treatments we offer include medications that can strengthen the urethra or relax the bladder muscles (Botox), nerve stimulation (biofeedback), estrogen therapy, or – for stress incontinence – surgery. 
  • Menopausal vaginal dryness (GSM) – Menopause reduces levels of the female hormone estrogen, which keeps the vagina lubricated and flexible for enjoyable sex. In time, the vagina can begin to waste away, or atrophy, heightening the pain. 
    Treatments we offer include topical vaginal estrogen therapy and an outpatient laser procedure called MonaLisa Touch, which could provide rapid relief in just a few treatments. 
  • Interstitial cystitis (IC) – This confounding condition occurs when the bladder lining breaks down and urine leak out, which irritates the pelvis area and can make intercourse painful.
    Treatments we offer include physical therapy (Kegels) and bladder training through biofeedback, medications including Botox, and bladder “stretching,” in which the bladder is filled with fluid while you’re under anesthesia (hydrodistension). 
  • Other forms of pelvic pain – Urinary tract infections, kidney infections, and kidney stones that irritate and inflame the urinary tract can ruin the appeal of sex. 
    Treatments we offer include antibiotics for infections and removing stones through one of several outpatient procedures. 

Do You Experience Hypoactive Sexual Desire Disorder? 

If you are no longer interested in sex with no apparent physical reason, you might have hypoactive sexual desire disorder (HSDD), which is characterized by a woman’s distress over her low libido. 

Although not a urinary-specific issue, our urologists are trained to talk about and treat HSDD because it is among the most prevalent sexual-health issues, affecting an estimated one in 10 women.

Regardless of the cause of your reduced libido, if you’re among the women who want your drive back, your doctor can provide thoughtful feedback and care options to suit you. 

Curious to learn more? Watch our webinar on women’s sexual wellness, including common causes and the latest treatment opportunities.

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