Let’s talk about sex part 2 – libido

When it comes to libido, one of the most important things for women to do is not compare. There is no “magic number” for a healthy sex life, regardless of what popular magazines may say. A woman’s sexual desire can fluctuate over the years and is affected by many circumstances. How many times a friend has sex a day/week/month should not pressure you in any way- or make you feel like your sex life is inadequate.

Generally, when relationships begin to have problems is when a couple has different libidos. If your partner wants to have intercourse three times a week, and you are fine having intercourse once a month, there will more than likely be conflict. This can cause great strain and stress in a relationship. It is important that couples keep the lines of communication open and express their feelings in order to navigate these times. When libido becomes a concern from a healthcare provider standpoint, is when it changes. If you lose the desire for sexual intimacy, begin to have concerns regarding your libido, or are beginning to have problems within your relationship due to your desire, you need to speak with your healthcare provider. There are many factors, as well as stages of life, that can affect libido.

Pregnancy, postpartum, and menopause are three big stages of life where libido fluctuates – often as rapidly as the hormones do. It is important to realize that each of these stages of life is beautiful, and comes with changes in the body. Once you are accepting of your body and your new normal, it is easier to navigate your sexual health and relationships. From sagging breast and stress incontinence to stubborn belly fat and droopy bladders, it is important to remember that you aren’t alone. You are not the only woman, nor will you ever be the only woman with these issues. If you don’t love yourself, it will be hard for you to let anyone else love you. We are all imperfect.

Women should understand there are many physiological problems that can cause a decrease in libido. One of the most common causes of a decrease in libido is the pain. You should not have pain with intercourse. Endometriosis, ovarian cyst, vaginismus, vulvodynia, vaginal atrophy, and uterine fibroids are all reasons women may have discomfort during intercourse. If you have a decrease in libido due to discomfort, see your healthcare provider. A vaginal exam, as well as an ultrasound, can help lead to a diagnosis. There are many treatment options to help with discomfort, and once a diagnosis is made, a plan can be formulated and get you on the right track to pain-free intercourse.

Another big factor that plays a role in our libido is our mental health! Hello, stress, hello worry, hello 5,000 things I need to check off my list before tomorrow. We are a society that is constantly on the go and a lot of times we are too busy taking care of others rather than ourselves. Anxiety and depression affect millions of Americans and take a toll on our sexual health. Not to mention, anxiety and depression medication are notorious for decreasing sexual desire and some can interfere with sensation and orgasm. Anything that causes you to worry is going to decrease your desire. Generally, when the stressor is removed or resolved, the libido will return. One important thing to realize, if you have ever had a prior experience with rape or sexual abuse, it is important to seek help. Therapy is critical to help with psychological well being and sexual intimacy.

These are just a few things that can cause problems in our sex lives. Certain medical conditions, as well as medications (prescription and OTC), recreational drugs, and alcohol, can also cause affect our sexual health. There is no “magic number” of how often you should have sex and it is important to remember that you have your own “baseline”. Anytime you begin to have no sexual desire or anytime you sexual health begins to affect your relationships, you need to schedule an appointment with your healthcare provider. Being open with your provider is very important. They can’t help you if you don’t let them know what’s going on.


Stephanie Howard is a board-certified Physician Assistant practicing obstetrics and gynecology in Knoxville, Tennessee. She has always had a passion for women’s health and immediately started working in the field upon graduation in 2010. Stephanie is an advocate of education and believes women of all ages have the right to be informed about their body and how it works. She has an online comprehensive health education program for teenagers that covers everything from male and female anatomy to birth control and sex education. Stephanie is an adjunct faculty member for the South College Physician Assistant program in Knoxville, Tennessee. Her role is to precept clinical year students and educate them on the physical exam, diagnosis, and treatment of obstetric and gynecologic patients. Stephanie was awarded preceptor of the year for the South College Physician Assistant program. She was also awarded the PA/Physician Team of the year by the Tennessee Academy of Physician Assistants. Stephanie’s Instagram account, TheGyn_PA, covers gynecological topics for all ages and anyone interested in female health. She truly believes Knowledge is power and wants to provide a source of accurate information for females everywhere. Stephanie is married to her high school sweetheart, Taylor, and together they have two boys Hudson (4) and Jax (1).

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