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Sex Drive, Female Libido & Sexual Desire in Women: The Impact of PMS & PMDD
by Dr. Daniel J. Heller
Sex drive and libido are important but often overlooked topics: many women still feel uncomfortable talking about these subjects, particularly with their doctors and medical professionals. But PMS and PMDD can have a real impact on sex drive and libido, and that can strain relationships and diminish life enjoyment, so it’s important to understand the connection between your monthly hormones and your sexual desire.
Too much of the discussion of this topic centers on the promotion of medical tests and nostrums that don’t address the real problem. We’ve all heard advertisements for "male enhancers" that are supposed to help men’s sex drive or even their anatomy. Many similar solutions are marketed to women, too: hormone creams and patches, and pills and herbs that claim they can enhance a woman’s libido.
The truth is, sex drive and libido in most women is less chemical and hormonal than it is in the heart, and in the head. For many women, feeling sexy and having normal (for you) sexual desire depends on things feeling right both in your life and in your relationship. We’d say that the decreased sexual desire that can accompany PMS and PMDD is not just a chemical phenomenon. It can often be summed up by the five Ps of female libido.
The five Ps don’t have to do with estrogen, or testosterone, or horny goat weed—an herb you might have read about as you browse the web reading about sexual desire. But the five Ps are the five main factors that affect how most women feel about amorous encounters.We offer five anti-anxiety hints to overcome anxiety and anxiousness issues (and anyone can benefit from them):
Personal refers to internal feelings: your degree of stress and your feelings of self-esteem and confidence, particularly as these feelings may relate to poor body image.
Stress: Stress activates physical, mental, and emotional pathways that create a state of alarm, far different than the type of feeling that typically leads to sexual intimacy. Although sexual activity can also be a release from stress, the kind of chronic stress that many women experience lowers sex drive. Whether it is that stack of household bills, or work or boss difficulties, relationship troubles, or even just the hassles of long commutes, shuttling kids around, or juggling all the many responsibilities that come with being a woman today, chronic stress tends to act like an anti-aphrodisiac.
Because of this, a better way to help female libido may be to forget about sex altogether, and focus on better managing stress, by managing your expectations for yourself and the demands on your time, and through learning to "go with the flow" to make life and living smoother. We share many useful ways to cope with the demands of life, including many helpful tips on managing stress.
Body Image: By now, many of us have come to recognize that the media bombards us with unrealistic models, literally, of the feminine ideal. In magazines, TV, movies, and online, razor-thin models and actresses with airbrushed features and apparently no blemishes or fat cells— or, at least, perfectly placed fat cells—are presented as the standard to which every woman should aspire and by which every woman must be measured.
This supposed ideal is not only unrealistic, it is destructive and damaging to women, perhaps especially to young girls, teenagers, and young women. Women, like men, come in all sizes and shapes, but many women compare themselves against an absurd ideal. Don’t forget, the images we see of models and actresses include special lighting, graphic manipulation, and airbrushing to erase supposed imperfections, so we rarely see them as they really are.
Then there is the fact that, as a result of a variety of factors including improper diet and lack of exercise, more and more Americans are overweight and obese. Although this phenomenon has been appropriately labeled an epidemic, it influences our idea of what is a "normal" appearance, and that plays into the impact of the unrealistic expectations created in the media, including ubiquitous social media channels.
Finally, American culture is obsessed with women’s appearance and sexuality, and this causes many women and girls to judge themselves (and causes men, too, to judge women and girls) mostly on the basis of physical characteristics. This makes many women feel that they simply don’t measure up, and this a bad thing for libido and sexual desire. It also gives rise to problems in the next area of personal feelings, self-esteem.
Self-Esteem: The self-esteem of women and girls is a huge subject, and we can’t cover all of the important issues and controversies here, though some of them are reviewed in our discussion of anger and anxiety. But all of the factors that contribute to a woman feeling less than, and to not truly believing in herself, also make it hard to feel acceptable and desirable.
Another factor in self-esteem that is too complex and difficult to explore in-depth here is the role of physical and sexual abuse in women’s and girl’s lives and histories. However, we know that this unfortunate reality plays a major role in how women feel about themselves and about men, as well as having an impact on their ability to pursue healthy habits and lifestyles, and their degree of sexual satisfaction.
Second in importance to your own internal feelings are the feelings you have towards your sexual partner, and these feelings play a large role in how open you feel to sexual relations. For instance, do unresolved tensions in your relationship make it hard to relax and feel open to your partner? Oftentimes, issues build up and can create a sense of resentment. Perhaps your partner doesn’t do their fair share around the house, or is often sarcastic and dismissive to you, and this leads to ongoing hurt or angry feelings that, for most women, makes sex the last thing they want to share with their partner. What this means, essentially, is that sexual intimacy is for many women a reflection of the overall intimacy and quality of the relationship.
Another potential issue can be whether you find your partner attractive. Do you still see the physical and emotional qualities that attracted you to them in the first place? People change, and not always in a way that would stimulate your libido and sexual desire. Does your partner have grooming or hygiene habits that are a turn off for you? Realistically, physical attractiveness is usually an important factor in sexuality. These aren’t necessarily simple issues to resolve, of course, but candid discussion about these matters can do wonders for a relationship, and for your sex life.
Pain is the third P, and there is more than one type of pain that can contribute to low sex drive and a decreased libido. Pain during intercourse, of course, is the most obvious way pain could interfere, but this condition (also called dyspareunia) is not usually just a PMS or PMDD problem—women who have this symptom usually have it all month long. But PMS aches and pains, along with other painful symptoms like cramps, migraines, and breast pain can lower libido and make sexual relations seem more like a bother than an enjoyment.
PMS & PMDD make everything else worse. Whatever is going on in your life, PMS and PMDD accentuate the downside, from aches and pains to mood swings and handling stress. The same is true with the factors that interfere with libido and sexual desire. PMS and PMDD increase stress; they worsen body image through bloating, acne, and depression; they diminish self-esteem; they take a toll on relationships; and they cause a lot of physical and emotional pain.
The next time you hear a simple solution for sex drive, whether it’s a drug or pill or hormone, remember that women’s libidos are probably as much emotional, mental, and situational as they are chemical. A holistic solution that sees you as a whole woman and a whole person, including all aspects your life, is a better approach to sex drive and sexual desire.