Well+Good recently asked via Instagram Stories what about sex confuses you, and in sifting through the many responses, a recurring theme unveiled itself: Many of you answered that you're not in the mood/horny/interested in sex much at all, or at least as much as you'd like to be or feel you should be. And you don't understand why.
- Felice Gersh, MD, board-certified OB/GYN and founder of the Integrative Medical Group of Irvine
- Meika Hollender, co-founder of Sustain Natural and author of Get On Top
- Nagma V. Clark, PhD, certified sex therapist and licensed professional clinical counselor
- Norbert Gleicher, MD, FACOG, FACS, fertility specialist
- Olivia Orley, LMSW, relationship psychotherapist
Below, mental-health professionals and docs explain many of the reasons you're just not in the mood.
1. Stress is occupying your headspace
First things first, libido is different from person to person and can shift with age, stress, and other factors of life. "There is no one 'normal' sex drive for women (or men)," says relationship psychotherapist Olivia Orley, LMSW. "Having a low sex drive is not an inherently negative thing. It is only problematic when you are unhappy about the ways in which it is affecting your life."
"Having a low sex drive is not an inherently negative thing. It is only problematic when you are unhappy about the ways in which it is affecting your life." —Olivia Orley, LMSW
If you can't detach from certain external stress triggers—work, health, relationships—getting in the mood can be tough. Ditto if you don't feel safe or like you can communicate with your partner.
2. The sex is samey, and you're not seeing fireworks
"Another thing that can play a role, specifically for women experiencing a drop in their sex drive, is a sameness in their sex lives," Orley says. Meaning, variation in bed can stoke a fire of sexual interest. This doesn't necessarily mean variety of partners, per se. (Many "have a better sexual experience with the same partners who know their body than having a lot of bad sex with a lot of different people," Orley says.) Rather, it's about exploring your fantasies with your partner and changing things up. A 2016 study even found that people in long-term relationships were more satisfied with their sex lives when they incorporated variety. To shake up your routine, Orley suggests talking about porn (and maybe watching it together), experimenting with some sex toys, sexting, or anything else.
Another factor to consider is whether you can orgasm through partnered, penetrative sex. If not, your partner "might end up feeling like [your] pleasure is not an important part of the sexual experience," Orley says.
"I encourage women to try and recreate their masturbation routine during partnered sex," says sex therapist Nagma V. Clark, PhD. If this feels like "too much" to add into a penetrative-sex sesh, she recommends supplementing it at either the beginning or the end of partnered sex. "I ask partners to participate: caress, kiss, fondle, in a way that enhances their partner's pleasure," Dr. Clark adds. Positions that cater to penetration and simultaneous clitoral stimulation—such as woman on top or reverse cowgirl—can increase the likelihood of orgasm through penetrative sex, she says.
But what if you masturbate regularly but still aren't all that interested in partnered sex? There's a wide range of reasons why this might be the case, including a lacking sense of emotional safety in the relationship, not being able to articulate your desires, and feeling a pressure to orgasm from your partner, says Dr. Clark. "This could cause conflict and disconnect in a relationship," Clark says. In these cases, she recommends the couple seeks therapy to work through their relational issues and rebuild their sexual connection.
3. The Rx factor
A lowered sex drive can also be caused by certain medications—SSRIs are notorious for this. "SSRIs (which are used to treat depressive and anxiety disorders) can negatively impact both male and female sex drives, often causing not just a psychological resistance but also making it difficult to achieve orgasm," Orley says, adding that essentially any medication has the potential to influence your libido—though the most commonly talked-about are SSRIs and birth control.
"[Hormonal contraceptives] alter normal female hormones, and this has been found to affect sexual drive."
"It is very common for women to experience a reduced sex drive when using hormonal contraceptives," says Felice Gersh, MD, OB/GYN and the author of PCOS SOS. "They alter normal female hormones, and this has been found to affect sexual drive." Here's how that works: "They lower free (available) testosterone by increasing sex-hormone binding globulin. They eliminate the spike in estradiol, which normally precedes ovulation and which up-regulates testosterone receptors in cycling women, thereby peaking sex drive," she explains. (LOL how ironic that something many women take so that they can have sex without worrying about getting pregnant can also cause a decreased desire in sex?) Basically, estradiol spikes in the middle of your cycle. This is the "primary estrogen of reproductive-aged women," and that surge of estrogen enhances the function of the receptors for testosterone—which increases your sex drive.
Hormones play a huge role, even if hormonal birth control isn't on the table. "Sex drive is a fundamental animal drive, and humans are no exception to this basic physiological urge and need. The problem these days is that our natural state of health has been dramatically altered by our diets, lifestyles, and the ubiquitous endocrine disruptors we are bathed in," Dr. Gersh says.
Testosterone is a key hormone for female sex drive. Fertility specialist Norbert Gleicher, MD, co-discovered that dehydroepiandrosterone (DHEA), a natural hormone our body uses to make testosterone, can help with fertility in women. But he also discovered something else: That after women finished their treatment, they didn't want to stop taking DHEA, because it had improved their sex lives.
"There was a group of women who, after we put them on DHEA, they loved their love lives. They didn't want to stop taking DHEA because they had a better sex drive and libido," Dr. Gleicher says. "That led us to a study where we tried to quantitate that. That study confirmed our anecdotal impression." Among premenopausal women, they found DHEA supplementation helped increase desire, lubrication, arousal, and orgasm satisfaction. Other studies have also suggested that DHEA plays a role in increasing sexual satisfaction. Dr. Gleicher contends that in many cases, a low level of testosterone can explain a lower libido in women. But don't just simply stock up on DHEA supplements from Amazon, though. "We do not recommend women self-medicate. Since it is a hormone, they should do it under some doctor guidance," Dr. Gleicher says.
5. We just don't care
TBH, not being in the mood for sex could also be explained by shifted priorities. "I think we're living in a time of constant self-improvement and exploration, where women put an incredible amount of pressure on themselves to have it all and do it all, because now more than ever we can," says Meika Hollender, co-founder and CEO of Sustain Natural, a line of environmentally friendly sexual-health products. "As we're slowly gaining more equality in the workplace, and in politics, and our voices are heard more than ever before, I think women are putting themselves first. I think it's not about not being in the mood necessarily, it's just about shifting focuses and priorities, and for some women that may mean sex is just not a focus as much as it was in the past.” And you know what? That's totally cool.
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