Ask The Doctor: Low Libido

I'm in a healthy, happy relationship, but my sex drive has started to lag in recent years. Why is this, and how can I revive my libido?

It’s common for our sex drives to dwindle as we grow older—and the numbers tell the story. The Kinsey Institute notes that while 18- to 29-year-olds have sex an average of 112 times per year, the 40 to 49 set has sex just 69 times a year—that’s a nearly 50 percent decline over a 20-year period. Of course, these numbers are averages; normal sexual behavior can range from virtually no activity to daily sex. However, while no particular number of times per week, month, or year is the golden ticket for every couple, studies show that people who have sex once or twice a week have healthier hearts, enhanced immune-system function, lower stress levels, and higher self-esteem than those who have sex fewer than one to three times per month. We can attribute lagging libido to stress, fatigue, depression, side effects of certain prescription medications, and negative body image. In addition, busy work and family schedules often leave couples little time and energy for the intimacy needed to foster sexual desire. Sex-hormone levels also fluctuate naturally as we age, impacting sex drive.

Sex up your supplement regimen

  • Cordyceps sinesis, a mushroom-like fungus that is used as a tonic in traditional Chinese medicine (TCM), can boost sex drive by relaxing blood vessels to increase blood flow to the genitals. Cordyceps also expands production of the sex hormones estradiol, progesterone, and testosterone. Brew between 3 to 9 grams of cordyceps in hot tea, or take 1,050 mg of dried extract two or three times daily, and you should notice an uptick in sex drive within four to six weeks.
  • Ginseng is another herb long used in TCM because it sparks nitric oxide production, which relaxes muscles and increases blood flow. Studies published in the Journal of Sex and Marital Therapy in 2001 and 2006 focused on ArginMax, a combination of Panax ginseng, L-arginine, gingko, damiana, vitamins, and minerals. In the 2006 study, 72 percent of female participants who took six capsules, each containing 100 mg of Panax ginseng, daily showed significant improvement in sexual desire after four weeks.  
  • Muira puama has long been used for sexual health. Similar to cordyceps, steroid-like compounds found in the bark of this Brazilian tree may increase blood flow and ramp up sex-hormone production. Take six 1,000 mg tablets of Herbal vX, a blend of muira puama and gingko, daily for 10 days or two 1,000 mg tabs daily for 30 days.
  • DHEA (dehydroepiandrosterone), a building block for both female and male sex hormones that is secreted by the adrenal glands, may increase sex-hormone production. Daily doses of 50 mg have been shown to lift libido.

Break a sweat
Recent research shows that moderate-intensity exercise increases sexual arousal in women by causing changes in mood, nervous-system activity, and hormone and neurotransmitter levels. Twenty minutes of any exercise that accelerates heart rate, quickens breathing, and causes you to sweat should help foster sexual desire.

Nourish your nether region
Let’s face it, if intercourse feels abrasive or uncomfortable in any way, your interest in sex will likely diminish, which makes natural lubrication all the more important. Lubricants protect the vaginal tissues from abrasion due to friction, and can help enhance enjoyment. Hydration is key to help your body produce its own lube, so drink six to eight glasses of water daily and eat plenty of healthy, hydrating fats from olive oil, almonds, walnuts, and avocados. If you or your partner finds it more difficult to generate moisture than in the past, try a water-based, water-soluble nontoxic lubricant that’s slightly acidic to match the vagina’s natural pH. To guard against infection—which can occur when skin becomes irritated due to abrasion—keep vaginal flora in balance. Add probiotics—healthy bacteria that support the immune system—to your diet or supplement regimen. Probiotic-rich foods include organic yogurt, kefir, sauerkraut, and kimchi, which is a pickled vegetable mixture.

Just breathe
Taking time for yourself to de-stress can do wonders to spark sexual desire. We take in so much information every day, so make an effort to just “be and not do” for 15 minutes daily. And don’t forget to experience pleasure and delight, which can be as simple as feeling the wind or sun on your body, stretching your muscles, picking flowers, getting a massage or foot bath, or wearing clothes that feel soft or silky next to your skin.

Do it together
Be sure to spend quality intimate time with your partner to rev up libido. Take a yoga class, learn to tango, or bathe and shower together, then carry this attention to sensual delight into the bedroom. The ancient practice of tantric sex teaches couples how to be in the moment and focus on the breath, sense of touch, and muscles while connecting with each other. Mindful, joyful attention to shared pleasure is a vital component of good sex.

Question answered  by Shelley Wroth, MD, an obstetrician and gynecologist at Duke Integrative Medicine in Durham, North Carolina.