Libido (Sex Drive)
Physical, Mental, and Sexual Fitness
Sex without love is merely mating with genitals, but sex with loving intimacy is mating with the soul. As human beings, our sex drives are controlled by more than just hormonal cycling and the phases of the moon. The human sexual response is a very complex, multi-factorial phenomenon that we still don't fully understand.
One of the most frequent complaints in my OB-GYN practice is that of a decreased sex drive. "Libido" is the medical word for sexual desire. Because the sexual response is so complex, decreased libido is usually a concern that cannot be fully addressed in a simple yearly exam. I've found it useful to ask just how long does it take for my patient to fall asleep at night.
"Oh, about 2 seconds," is often the response.
I can say that my job of increasing sexual drive is very difficult indeed if a woman is exhausted by the time it's bedtime. The change in her life is not one of sex drive, but one of exhaustion. The typical patient like this has one or more young children (usually including an infant), works all day, either professionally or homemaking, and has a controlling interest in assuring that the meals come off on schedule. Childbearing begins a very joyful part of one's life, but it also begins a very laborious time as well. I would say an adults-only vacation may remind this couple what sexual frequency used to be like before children.
The wrong contraceptive can also affect sex drive. Worry over its effectiveness or mechanical preparations that halt the mounting excitement can add negative psychodynamics to intercourse that is remembered all too well the next time. With over 40 different birth control pills on the market, each one touting a unique formula boasting the best of all worlds, it is common for a woman to live in continuing PMS on the wrong pill. I've seen couples on the brink of divorce because the wife was on the wrong pill and the man was clueless about rolling with these hormonal punches.
Perimenopause, a medical slang term for the "approach" to menopause, can cause decreases in female hormones that affect libido. Testosterone is not really "the male" hormone, because women have it too; it's just that men have so much of it. When testosterone falls in perimenopausal women, the libido crashes. There are estrogen hormones available which also include testosterone in the formulation for this problem.
Sexual dysfunction is a cause for decreased libido. Sexual ignorance of a partner's needs can lead to anger and then hesitation the next time. Pain with intercourse is sure to nix the mood, and this should be worked up by the woman's gynecologist or the man's urologist. If a woman cannot react or if a man suffers from premature ejaculation, the sex act will end up being an exercise in frustration. There are sexual dysfunction clinicians available for instruction and treatment using clinical techniques. There are a plethora of self-help books about intimacy that can help educate the inexperienced couple. Lately, antidepressants like Zoloft have been used unofficially by some doctors to treat premature ejaculation. Since sex is as psychological a function as it is physical, the Zoloft "trick" is demonstrating that sexual dysfunction is a warning signal that should prompt counseling.
A Healthy Libido
Good, healthy libido all comes back to feeling good--feeling good about yourself, feeling good about your partner, and feeling good about your life with your partner. Good mental health is crucial as well--which is a sneaky way to introduce one of the best ways to seek sexual health: physical exercise. A healthy mind in a healthy body is the same as saying healthy bodies can have healthy sex, with all of the psychological and physical rewards that come with it.
The woman who's exhausted at night would benefit from the energy she would get from a consistent exercise routine. The man who's overwrought over bills and job security is going to have a healthier perspective when his body feels energetic, too. New benefits of exercise are constantly being added to the already long list. Since sex is a physical as well as mental exertion, it walks along exercise as a truly remarkable human endeavor. Otherwise, we'd just mate and that would be that, and we'd get up and run only when we absolutely had to.