Low libido – it plagues women across the world, but why? Does sex drive change after kids? Is low libido due to stress? Does sex drive alter with age? And most importantly, is there a way to treat low libido? These are questions the majority of the women that come into my office ask – and the answer is yes, there are many things that can be done.
How to revive your sex drive
In my practice, I find that about 90 percent of my female patients have low libido – half of them are bothered by it, half are OK with it and just deal with it in their own ways. Of the half that are unhappy about low libido, most don't realize that there are real treatments for low libido. Instead, they often look to the Internet for products which rarely work -- or just try and go to sleep before their husband gets into bed.
The most important thing for women to know is that a decrease in sex drive is a normal change that most women experience after the age of 35. The widespread rumor of women's sexual peak being in their early 40s is false.
The evaluation for low libido has several important parts, including:
A thorough history.
A physical exam with an emphasis on the pelvic exam. Often there may be physically based problems when the woman thinks that everything is working perfectly fine.
Blood testing the basic components, which includes evaluating estrogen levels, testosterone levels as well as thyroid levels. Too often I find that doctors do blood tests and tell the patient that everything is normal. Many doctors don't understand that lab values for normal ranges can be erroneous and that most women don't feel well when their blood test results are in the "normal range." As a facility dedicated to women's health, we have our own set of normal lab values and when our patients have blood levels in that range is when they seem to feel better.
There are also special tests that can be done based on the patient's history as well as her physical exam, which can offer clues about other tests that may need to be done.
Depending on the above testing, various options can be discussed with the patient, which may involve small amounts of hormone replacement using bio-identical hormones.
Treatments for low libido
Treatment plans may involve creams or pills, which some patients may find inconvenient or difficult to use or take. The expense can be $20 to $60 every month. Most insurance companies will not cover the expense of meds from a compounding pharmacy or much of the lab work or hormone testing that is necessary. I suggest bio-identical hormones that are covered by insurance plans (ask your doctor what they are using and check with your insurance to see if it is covered) and any lab work and visits are usually covered as well.
For women who may not receive enough benefit after trying the treatments for low libido mentioned above, options exist that focus on the "G spot," and there is also a treatment known as vaginal rejuvenation. Despite being a very common problem, there are very few doctors who specialize in this area -- this even though it is a very simple problem to evaluate and treat. Surgery is usually not necessary and insurance covers most of the costs.
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