If a woman mentions to her doctor that she has a decreased desire for sex, she may receive an evasive statement or answer. It is a complex subject with many causes, not always well understood by many physicians. Sexual desire, or libido as it is sometimes called, is influenced by our own health, environmental circumstances and the behavior of our partner and others. Dr. L. Barbach recently wrote a review article that pointed out the many contributors to this problem, Barbach L. Loss of sexual desire.
Physical causes are often responsible.
Fatigue, whether due to stress, to physical work or even sleep deficit from childcare or hot flashes, is a common cause of decreased libido. Physical muscle or joint pain, pain with intercourse and urinary incontinence may also interfere with desire for sexual relations. In this case, fear of pain or embarassment works as a supressive force. Decreased estrogen at the time of menopause may cause the vaginal skin to become thin, dry and painful with the friction of intercourse. The opening to the vagina may loose elasticity and be painful with penetration.