Why do so many women lose enjoyment of sex as early as their 30s or 40s, and what, if anything, can be done about it?
That’s the question I set out to answer as I embarked on an investigation of the science of the FEMALE SEX DRIVE, the results of which I hope you will watch tonight (8pm, Catalyst, ABC 1). The reason I was so passionate to look for answers? Well, it happened to me. And before I go too much further – I have personally found an answer that has worked. And I’m grateful.
Let me introduce myself. My name is Dr Jonica Newby, and I’m a science reporter for the ABC’s longstanding flagship science program, Catalyst. I’m in my mid 40s, fit, happy relationship, and would have considered myself way too young to have any problems with libido. I’ve always really enjoyed sex. Not just for its physical and emotional pleasures, but it has been a core platform of my sense of self, my feelings of being a female on this earth. None of which I realised so profoundly until it started to fade – when my ability to rely on my body to respond sexually evaporated.
Watch the teaser for Female Sex Drive below. Post continues after video.
It started about two years ago. Subtle – I’m not sure I even really noticed it for a while, it’s only in retrospect I can track it back. What changed? Well, I could beat around the bush, so to speak, and hide behind phrases like “loss of libido” or “loss of desire”, but I’ve decided if I am to go public like this on a topic which, let’s face it, is still taboo, I will try to be direct. It means the quality of orgasms diminished – they were still there, just not as good. It means the level of arousal was less so and it was harder to lose oneself in the moment. It means the touch on the skin was less craved, and less noticeable when it happened. It just meant the whole experience of sex was less rewarding. The body was not responding how it should. And it was shocking, to me. Even though I tried to hide it from my partner – successfully, I believe. But alone and inside my head, I was deeply distressed.
I’m lucky. I’m a science reporter, and I knew of a medical option that I hoped would work. I didn’t let it get to the point where my own relationship was compromised. That’s not the case for the many devastated women I spoke to off-the- record while researching this story – not one of whom was prepared to go public, thus confirming my belief this topic is very difficult for women to talk about openly.
Take “Suzie”. She’s in her late 30s – a pretty petite blonde, lovely husband, two small kids. Her sex drive started to die about 5 years ago. It didn’t just fade, it disappeared. Sex became nothing, or worse than nothing, a horrible source of conflict between her and her husband. Her skin no longer craved touch, it actively rejected it. She would pick fights, avoid hugs, anything to avoid having to confront the reality that her body wouldn’t fire up. Her husband would get desperate, going from begging to sulking and back again. Every now and again, she would think to herself; I must try, I must try and she would have sex, but as she said to me, tears in her eyes, “I wouldn’t enjoy it. I felt nothing”. She got to the point where she said to her husband, “I think I need to let you go. Much as it would kill me, I love you and you deserve to be with someone who can give you what you want and I can’t give you that.” And let me be clear – she still absolutely loved her husband. This problem was tearing her and her relationship apart.
Sex is such an important aspect of intimacy for so many people. It can be the reason a relationship starts, and the reason one ends. And for some reason, sexual interest does seem to fade more quickly in women.
The Australian Survey of Health and Relationships, a study of 10,000 men and women, aged 16 – 59, found 55% of women reported lack of interest in sex, compared with 25% of men. Women were more likely than men to report being unable to come to orgasm (29% vs 6%) or not finding sex pleasurable (27% vs 6%).
And yet, we women hardly ever talk about it. Maybe we joke, but when it’s really serious, we shut up and put up. There’s a culture of silence, even shame when it comes to women seeking answers for problems with sexual wellbeing. It’s a legacy, perhaps, of a society that used to shame us for liking sex, and now shames us for being anything less than goddesses in the sack. And the contrast with men’s sexual health is profound. As soon as a man starts to feel his libido – or performance – flag so to speak, he knows he can talk to a doctor about it. There’s Viagra. There are injections. There are a host of interventions to help men get “back on the job”. There’s nowhere near that awareness for women.
Watch the trailer for The To Do List below, where Aubrey Plaza finds her sex drive.
So – let’s try to address that right here, right now.
In my Catalyst special tonight, the first topic I tackle is testosterone. Yes, I know we think of it as a male hormone, but it is equally important in women – although the levels circulating in a woman’s bloodstream are much lower than in men. Testosterone, it seems is a key influencer of female desire.
Professor Susan Davis, one of the world’s leading experts and proponents of testosterone for women, says “With respect to sexuality in women, testosterone has effects on the brain, sexual thoughts, fantasies, motivation. But what is often not recognised is testosterone is a blood vessel dilator. So it in fact dilates blood vessels in the genital area and increases the capacity for women to have an orgasm, simply through blood flow.”
But by age 40, we have half the testosterone we had in our 20s. In some women it doesn’t cause much in the way of symptoms. In others, Professor Davis believes it can make a huge difference. And that loss of sexual enjoyment can manifest well before menopause – in our 30s or 40 – right when we’ve got kids, busy jobs, stress. These rightly have their own impact on a woman’s libido, but if women are suffering an underlying physiological diminution of their mojo, they may think it’s just the usual suspects – married life – and not seek help.
In appropriately selected cases, Professor Davis has shown that around 60% of women respond to testosterone treatment. And if you are in the group that responds she says the response is often really good. Take “Suzie”, who I described earlier. For years she suffered with her marriage heading for the rocks until finally she got a new GP who referred her to an endocrinologist for testosterone treatment – which by the way comes in an easy to use cream. Within weeks, she got sexual sensation back. Her eyes light up when she remembers that moment – for her and her marriage, it really was like being reborn.
It would be remiss not to mention that testosterone for women has been very controversial. Discussion has centred on whether there are unknown long term health risks, when there are no long term studies to say categorically one way or another. And some specialists I interviewed don’t believe the science is in that it even works. These are some of the reasons many GPs have been reluctant to consider mentioning testosterone (though that is changing) with more GPs now open to its use. But it is available through your GP. And to date, there is no evidence to say that testosterone does increase long term health risks for say cancer, and several specialists have followed up their patients over decades, and seen nothing to cause concern. In the end, it becomes a quality of life decision for individuals – how much does a better sex life weigh up against the uncertainty of long term health risks. A topic for discussion with your doctor.
So what else might slow a woman’s sex drive?
One surprising element that came up in my research was the potential libido suppressing action of “the pill”. For a proportion of women, their sexual responsiveness is killed by it. Yet nowadays, with young women tending to go on the pill in their teens often well before becoming sexually active, if they are in this minority, they may not be aware if they are being sexually suppressed. At the very least, mothers should be aware of the possibility when their daughters start that crucial contraceptive journey.
But more surprisingly, we women in our 30s and 40s can also develop problems with the pill, even if the pill has been fine for us up until then. As we’ve heard, with age, our testosterone declines. Professor Davis believes this means for some women, the additional impost of the pill gradually becomes too much for their sex drive.
If you are feeling that sex is less than it should be, and relationship factors haven’t changed, then raising this possibility with your GP is a very good idea. For some women, an effective safe alternative contraceptive such as a modern IUD does wonders for the mojo.
Watch the trailer for Female Sex Drive below.
These are some of physiological remedies for a dwindling sex drive. But of course, that’s only half the picture. I also investigated the psychological and relationship remedies available.
Talking at length with Australia’s best known sex therapist Dr Rosie King, one issue in particular stood out. It’s what she calls “the pursuer distancer cycle”, where the man starts to chase the woman for sex. And it’s common after a couple have had kids. Pregnancy, hormones, looking after young ones will temporarily suppress any womans sex drive. But as time goes on, couples can fall into a toxic pattern, where the man starts to chase or even hound the woman for sex, which actually suppresses her libido further, she tries to distance herself, he feels unloved or uncared for, he presses the issue further, she feels even more turned off, and so on it goes in a vicious cycle.
It’s common, but a very difficult cycle to break. And help from a professional like Rosie might be needed. Personally, since researching this special, I’ve been surprised talking to my girlfriends at how many of them are experiencing this, and finding it really hard to talk about it with their husbands.
So what was my personal solution? Well, you have probably guessed by now. It was testosterone. Given my symptoms, I decided to consult with Professor Susan Davis, and then decided it should be filmed for the story. If no one else was prepared to go public on this topic I would! She put me on a testosterone cream, and I now have to have regular blood tests to make sure I don’t overdose and start turning male.
Did it work? Answer – yes. Amazingly. It brought back the sensitivity and responsiveness I had lost. And that is a really big deal for me. So I have decided I am staying with it for now.
Many women will not want to consider testosterone, particularly as we can’t be certain it won’t increase risk of heart disease later in life. Many women will not want to change contraception, or go to a sex therapist. Many women will be very happy with their gradually declining libido, and not want it back. But I believe we all deserve to have the knowledge to make those choices ourselves. We deserve to be aware of all the options that are out there. We deserve to feel we can talk to our doctors, and they will listen to us, and not just say, “oh why don’t you and your hubby go away on a dirty weekend,” in a patronising way – as I heard in one case.
It’s time we women could talk more openly about our sexual wellbeing. Viagra took away the stigma for men. Let’s hope this Catalyst investigation will help do that for women.
Watch “The Female Sex Drive” on Catalyst, ABC TV, Tues, Nov 3, 8pm.