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Hypoactive Sexual Desire Disorder (Low Libido)
Changes in sexual desire are common at many stages of life, and they are a medical concern only when they cause you distress. James has specialist experience in the hormonal and medical contributors to low libido, and offers a thorough, respectful assessment with practical treatment options.
How can Dr James Brown help?
James looks at the whole picture, including hormones, medications, pain, mood, sleep and relationships, to understand what may be affecting your desire. He then works with you on a plan, which may involve hormonal treatment, changes to current medications, and referral to a psychologist or sex therapist.
HSDD is a persistent or recurrent lack of sexual interest or desire that causes personal distress, and is not better explained by another condition, a medication, or a relationship problem. There is no “normal” level of desire. A lower libido is not a problem unless it bothers you.
Desire is influenced by many things at once. Common contributors include:
- Hormonal changes. Perimenopause, menopause, premature ovarian insufficiency, thyroid problems and raised prolactin can all affect desire.
- Vaginal dryness and painful sex. When sex is uncomfortable, desire often falls.
- Medications. Antidepressants (especially SSRIs) and some hormonal contraceptives can reduce libido.
- Mood, stress and sleep. Depression, anxiety, fatigue and a heavy load of responsibilities all play a part.
- Relationship and life factors. Including communication, past experiences, body image and major life changes.
Assessment begins with a detailed conversation, a review of your medications, and an examination where appropriate. Blood tests may be used to check for treatable causes such as thyroid or prolactin problems, iron deficiency, or low oestrogen. A single testosterone level cannot be used to diagnose HSDD, so it is not used on its own to make decisions.
Treatment depends on the cause, and often combines several approaches:
- Treating contributing factors, such as pain, vaginal dryness, thyroid problems, or low mood.
- Hormone therapy. Menopausal hormone therapy and vaginal oestrogen can help women with menopausal symptoms and vaginal dryness.
- Testosterone. For postmenopausal women with HSDD, testosterone may be considered once other factors have been addressed, with regular monitoring.
- Medication review. Where possible, changing a medication that is affecting desire, in discussion with your prescribing doctor.
- Psychological and sex therapy. Including mindfulness-based approaches, which have good evidence for improving desire.
Many women improve with the right combination of treatments.
Have more questions?
Bookings: 1300 722 206