Low Libido Causes

June 7, 2007 7:07 AM

What is a good starting point for rectifying a low libido? How can one determine if it is physical or mental?

I am a 32 yr-old female. I have MS. I am on birth control and Prozac as well as an interferon. I did not have sex until I was in college, and it began as an alcohol related event. My poor self-image was not helped by that. I frequently get UTIs. I am not sure where to seek help to get this issue resolved before it destroys the best relationship I have ever had. Any suggestions?

posted by anonymous to human relations (16 comments total)

Birth control is a well-known libido-suppressant. Go off the pill is one obvious step.
posted by londongeezer at 7:13 AM on June 7, 2007

Prozac and other anti-depressants are also well-known libido suppressants. Go talk to your doctor and be honest. They have seen this issue before; they will run necessary physical tests. Especially with the MS and all your prescriptions, I would try the doctor first. But really, why not also try talk therapy - Why choose just one course of action? Try looking for both kinds of causes.

Also, lots of people don't have sex until college, and then have sex in alcohol-related events. That much is nothing to feel ashamed or awkward about, especially not this many years later. Might be worth talking through with someone anyway.
posted by LobsterMitten at 7:18 AM on June 7, 2007

Re: the UTIs -- you are taking the basic step of peeing immediately after sex, right? Switching brands of lube / condoms / etc can be a good second step, too.

But I'm with LobsterMitten -- college sex with alcohol is so normal as to thoroughly unexceptional. Talk to a counselor if thinking about it is making you feel bad, but also remember that there are lots and lots of people all around you who had equally unexciting and emotionally ambivalent first times. (Mine certainly wasn't something to feel proud of, and was, like yours, in college.)
posted by Forktine at 7:32 AM on June 7, 2007

All good suggestions.

Also...keep in mind that many people simply have low libidos, and that's perfectly normal for them. Our society sends out this pervasive idea that everyone should be craving sex 24/7...but that's just not true across the board.

But, definitely check out some counseling if you feel there really is a problem.
posted by Thorzdad at 7:58 AM on June 7, 2007

Seconding or thirding birth control and antidepressants as both being powerful libido suppressants. I think some people switch to Wellbutrin for this reason or add it to their med regime, although obviously this may not be for you.

Also, birth control can dry you out - everywhere - and could be exacerbating/causing your UTIs.

Finally, did you go on the Prozac before or after you went on the birth control? Birth control can also make you depressed. I almost went on anti-depressants when I was on bc, just to figure out that it was actually the birth control that was making me crazy. IANAD.
posted by walla at 8:01 AM on June 7, 2007

I was struck that you mentioned that you had MS as part of the "background" of this particular problem. Do you have body image issues related to the disability that are interfering with your ability to see yourself as attractive or sexual? Along with the negative associations you have about your first sexual experience, your sense of having had a "late start," and your open acknowledgment of a poor self-image, it seems very likely that there's a strong emotional/psychological component to this that's compounded by the birth control and SSRI's, both of which are notorious for killing libido.

Even once you do feel horny again, you want your next experience and future relationships to be pleasurable and fulfilling, and it sounds like working through some of these upsetting experiences and self-esteem issues might help you do that.
posted by foxy_hedgehog at 8:06 AM on June 7, 2007

Well any woman who has had a few experiences with a UTI is not especially keen to repeat it.

As Forktine mentioned - pee straight after the deed! Also regularly drinking cranberry juice seems to help as well.

It seems that you have a lot of separate issues to work on - and possibly any one or a combination is making you feel this way. I'm not sure whether going off the Pill is the answer (because then there is the fear of the consequences of not being on it to interrupt the mood as well) - but maybe the one you are on is not right for you.

Also outside of investigating (with your Doctor) the effects of the various medications you are on, what can you do to make you feel more in touch with yourself on a sexual level? Indulging in long baths, getting massages, changing your hairstyle - all these things help with giving you a little mental boost about your self esteem along the way as well.
posted by gomichild at 8:20 AM on June 7, 2007

Interferon also has effects on libido, although that may be more apparent in men.

I'd say you really need to talk with a doctor about this...you're currently on three different medications that can include decreased libido as a side-effect. I'm not sure that with that kind of load you're going to be able to effectively change the way you feel with something like self-acceptance and a bubble bath.
posted by OmieWise at 8:31 AM on June 7, 2007

Can you sometimes "fake it until you make it," at least sometimes? With enough foreplay and enough lube, you might still enjoy sex even though your drive is low.
posted by croutonsupafreak at 8:40 AM on June 7, 2007

I am not a doctor and I am a guy who doesn't have MS. I have, however, taken antidepressants.

I would suggest starting with the antidepressants. Look into switching, see if that makes a difference. It's really surprising how much they can affect your libido.
posted by aramaic at 8:42 AM on June 7, 2007

If you feel that not having had sex until college (and furthermore, not sober), is somehow a failure on your part, then I think you're being way too hard on yourself.

Or, what LobsterMitten said.
posted by desuetude at 9:15 AM on June 7, 2007

Low libido isn't a mental or physical issue, it's a mental and physical issue - not just for you, but for most people (as are most medical concerns). You have listed several things that can contribute to low libido: medications, physical illness/symptoms, and self-image issues. You say your relationship is the best you've ever had - I hope this means that it is a really awesome relationship, not just better than ones in the past that were bad, because relationship issues also have a really big effect on libido. Another issue: you're a woman - and low libido does tend to be more common in women.

I think that since there are multiple issues contributing to this, it might be good to talk about this with multiple health care providers to get some insight. If this is something that has just happened acutely, there may be physiological issues, or it could be a side effect of a medication. It would be good to see someone to rule out those concerns. You might want to consider seeing a sex or relationship therapist as well, as this issue affects both partners, and your partner needs to know how to cope with this and help you through it, too. AASECT is an organization of sexuality therapists and counselors that might be helpful to you.

Please don't be afraid to ask a healthcare provider about this - it is common, and they should be willing to help you (a gyn provider might be a good person to start with as they get these questions a lot - though not all providers are as well-versed in it as they should be). I wish you the best and hope everything goes well for you.
posted by tuff at 9:31 AM on June 7, 2007

How long have you been feeling this way? And how long have you been on Prozac? The sexual effects of SSRIs seem to just get worse over time, and can build to a complete lack of libido, so even if you didn't have quite so much difficulty with it at first it could easily be that, and it would probably be the first thing I'd want to try. But IANAD, and yours should (damn better) know more than I do about it.

Wellbutrin tends to have the opposite effect, and oh wow...but you probably shouldn't rely on that.

Birth control pills can also cause the same problem (although maybe it's a bit faster to hit when they do it?)

And then there's the MS itself. Depending on what nerve pathways or brain areas are being affected, that could also have an effect. (And even when you have a libido, it's damned distracting trying to have sex when your upper inner thigh and half of your pubic area's gone wack).

But you will have to talk to your doctor(s) about this. Start with your GP and see what she tells you.
posted by dilettante at 9:45 AM on June 7, 2007

Just based on my personal experience (I'm male, BTW), I'd look to the antidepressants first, because they really did a number on me (Prozac in particular) when I was using them a few years ago, and I've talked to a lot of other people, both men and women, who've had similar experiences.

I'd talk to your doctor and tell them what's happening -- when I brought it up with my GP, she just said "oh, okay, no problem, we'll switch you to something else" and that was that. It seems to be a really common issue, and your doctor should be understanding and familiar.
posted by Kadin2048 at 9:52 AM on June 7, 2007

wow. that sounds like a lot of stuff.

1. just because everyone else had crappy first times doesn't mean that your first time didn't effect you. It's different for everyone, and what didn't effect someone else might be traumatic for you.

2. you don't say how long your relationship is. if it's a super mega long term relationship: sex changes. People dont' talk about it nearly enough, but navigating sex in a long term relationship can be difficult, and if you can't figure it out by yourself, there's no shame in finding someone that can help you figure it out. Sex is mostly more difficult for women, since we get one huge bone-a-rific message from the media, but the reality is something entirely different. Men typically want something other than what women want at different stages in life. It's something to work on together. If he's not willing to work with you on this, that's a real problem.

Good luck. It's a sort of (warning hippie statement ahead) LIFELONG journey.
posted by bash at 4:04 PM on June 7, 2007

I used to have/think I had frequent UTIs, but I think now that I just had one UTI that kept getting fought off enough to stop showing symptoms, and then coming back into full force. It took me a while to realise that you can have asymptomatic UTIs, so you might want to go back and get re-tested for the infection after you've completed treatment just to make sure that it's actually gone.
posted by heatherann at 4:39 PM on June 7, 2007