There are a lot of analogies for libido - but when it comes to comparing male and female libido, men are often described as a sprint, whereas women are more of a marathon. But, is this based in science? And, if so, what can women do when it feels more like 126 miles instead of just 26?!

Nitty Gritty (sometimes Literally) Logistics of the Vagina

Let's be real - for many women in perimenopause onwards, half the battle is figuring out why sex feels different (and usually, not in a good way!). When you're feeling dryness, pain, or nothing at all, libido isn't exactly going to be forthcoming.

We have written blogs on penetration pain, on the different symptoms of atrophy, and on why dryness occurs, but all these issues will affect libido. {LINKS}

What we sometimes forget is that, if you are in pain or any kind of discomfort (i.e., pressure, lingering UTI or leakage issues etc.), then your brain is sending different signals than the ones you want. This looks like this:

• Neurological Pathways: Pain signals are transmitted through the nervous system, potentially interfering with the neural pathways involved in sexual arousal. This can disrupt the body's ability to focus on sexual stimulation and experience pleasure.
• Hormonal Response: Pain can trigger the release of stress hormones like cortisol, which can counteract the effects of hormones involved in sexual arousal, such as testosterone and estrogen.
• Psychological Factors: Pain can lead to negative thoughts and emotions, such as anxiety and depression, which can further dampen sexual desire and arousal.

But, for some women, there is also the loss of any kind of sensation which is primarily due to declining estrogen. That looks like this:

• Tissue Changes: Estrogen helps maintain the thickness, elasticity, and moisture of the vaginal tissues. As estrogen levels decline, the vaginal walls become thinner, drier, and less sensitive.
• Blood Flow: Estrogen helps regulate blood flow to the genital area, including the clitoris. Reduced blood flow can diminish sensitivity and arousal.
• Nerve Function: Estrogen can influence the function of nerves in the vaginal area, affecting sensation and responsiveness to stimulation.

These changes can result in decreased sensitivity to touch, reduced lubrication, and difficulty achieving orgasm - all of which means next time our partner wants to start up the fun, we are simply less interested (or even actively against being in more pain - naturally!).

Foreplay & Getting In the Mood…

We often hear that foreplay is important... so, let's look at exactly why… 👩‍❤️‍💋‍👨 As we age, have less time, are in long term relationships, or perhaps have had changes we aren’t sure how to express, and this means foreplay can sometimes fall by the wayside.

What does this mean for our brains and bodies?

Well, during foreplay, a complex interplay of hormones and neurotransmitters initiates and fuels sexual arousal. Key players include:

• Dopamine: Often called the "pleasure hormone," dopamine is released in anticipation of sexual activity. It increases focus, motivation, and excitement, preparing the body for arousal.
• Oxytocin: Known as the "love hormone," oxytocin is released during physical touch and intimacy. It promotes feelings of bonding, trust, and pleasure, enhancing the overall experience.
• Norepinephrine: This neurotransmitter increases alertness and focus, further intensifying arousal and excitement.
• Endorphins: These natural pain relievers are released during sexual activity, contributing to feelings of euphoria and relaxation. (Note: these are typically not strong enough to inhibit pain from, say, dryness/tearing from vaginal atrophy!)

These neurotransmitters work together to stimulate blood flow to the genitals, increase sensitivity, and trigger physiological changes that prepare the body for sexual activity.

Between the physiological changes happening to our vaginas and vulvas, and a lack of foreplay, which diminishes our neurological response...things might not be looking too good 😬 .

Orgasm Understanding

From our nifty diagram, you can see the structure of both the vagina and the vulva, as well as the full clitoral bulb. The clitoral bulb is wishbone shaped, extending inside the walls of the vagina. But, what does this mean for libido? Well, often, libido can be driven by whether we are having orgasms - in sort of a circular loop that can please or frustrate us.



To understand orgasms better, let’s take a look at how they work…

Physiological Aspects:

• Increased Blood Flow: During arousal, blood flow to the genitals increases significantly, causing the clitoris, labia, and vagina to become engorged with blood. This vasocongestion contributes to heightened sensitivity.
• Muscle Contractions: The hallmark of orgasm is a series of involuntary muscle contractions, primarily in the pelvic floor muscles surrounding the vagina, as well as the uterus and anal sphincter. These contractions are rhythmic and occur at intervals of about 0.8 seconds.
• Hormonal Release: Orgasm triggers the release of various hormones, including:
  • Oxytocin: Often called the "love hormone," oxytocin promotes feelings of bonding, connection, and well-being.
  • Prolactin: This hormone is associated with sexual gratification and contributes to the post-orgasmic feeling of relaxation.
  • Dopamine: A neurotransmitter associated with pleasure and reward, dopamine surges during orgasm, contributing to the intense feeling of euphoria.

Neurological Aspects:

• Nerve Stimulation: The clitoris, with its rich network of nerve endings, is the primary source of sensory input for most women's orgasms. Stimulation of the clitoris sends signals through the pudendal nerve to the spinal cord and then to the brain.
• Brain Activity: Brain imaging studies have shown that multiple brain regions are activated during orgasm, including:
  • Sensory Cortex: Processes the physical sensations.
  • Motor Cortex: Controls the muscle contractions.
  • Limbic System: Involved in emotions and pleasure.
  • Hypothalamus: Regulates hormonal release.
• Temporary Altered State of Consciousness: Some women describe orgasm as inducing a temporary altered state of consciousness, characterized by intense focus, heightened sensations, and a sense of losing control.

Different Types of Orgasms:

While the physiological and neurological processes are similar, women can experience orgasms in different ways, often categorized by the type of stimulation:

• Clitoral Orgasms: These are the most common type and result from direct or indirect stimulation of the clitoris.
• Vaginal Orgasms: These are often associated with deep penetration and stimulation of the G-spot (a sensitive area on the front wall of the vagina). However, some research suggests that vaginal orgasms may also be primarily driven by clitoral stimulation due to the internal structures of the clitoris.

To help better understand our orgasms, it can be helpful to see how the vagina and the penis compare, as well as how the different parts of the vagina and vulva function:

.

Ok, so now you know all about orgasms, you might be wondering what this has to do with libido? Well, remember how we talked about decreased sensation or pain being a byproduct of hormone changes?

This can mean less orgasms, and it can be really hard to get in the mood if we are never, or hardly ever, having an orgasm! When it does feel good, it’s easy to think “oh, let’s do that again”, but if the experience is well, meh, there’s little motivation to repeat the effort.

Hormone Chemistry

Understanding orgasm and sex can be done on a lot of levels, as we have mentioned in this blog, however, there are some key hormones (as well as those neurotransmitters we’ve already mentioned) that play a significant role in libido.

Hormones:

• Estrogen: This hormone plays a crucial role in sexual desire by increasing blood flow to the genitals, enhancing sensitivity, and improving lubrication. It also influences mood and overall well-being, which can positively impact libido.
• Testosterone: While often associated with male sexuality, testosterone also plays a significant role in female libido. It contributes to sexual desire, arousal, and orgasm.
• Progesterone: While it doesn't directly stimulate libido, it helps balance hormone levels and create a stable hormonal environment, which can indirectly impact sexual desire.

When our hormones are out of balance, we can find ourselves feeling physiologically different (i.e., our vaginas don’t feel great, and we aren’t in the mood), but they can also impact our overall wellbeing, and contribute to other factors that can impact how easy it is for us to feel sexy…

Outside Factors (Physiological and Psychological)

Often forgotten about when it comes to libido, there are a myriad of things that can affect our libido - in lots of different ways (many of which are also affected by hormones!)…

⚖️ Weight: Significant weight changes or being overweight/underweight can disrupt hormone balance, impacting sexual desire and sometimes our feelings about ourselves.

💤 Sleep: Insufficient sleep can lead to fatigue, hormonal imbalances, and increased stress, all of which can lower libido.

😧 Stress: Chronic stress elevates then lowers cortisol levels, which can suppress sex hormones and decrease sexual interest.

👩‍❤️‍👨 Connection (with a partner): A lack of emotional and physical intimacy can create distance and reduce desire for sexual activity.

💗 Romance: The absence of romance and novelty in a relationship can lead to decreased excitement and lower libido.

💪Physical Health: Chronic illnesses, pain, and certain medications can directly or indirectly affect sexual function and desire.

🧠Mental Health: Conditions like depression and anxiety can significantly impact mood, energy levels, and libido.

🔒 Privacy: A lack of privacy or feeling like one cannot relax can inhibit arousal and make it difficult to engage in sexual activity.

So…

Women are not like men - a blue pill isn’t the answer. If it were easy, there would be a pill that worked by now - but there isn’t. During perimenopause and after the menopausal transition, the chemical messengers are very different. If you have been struggling with low to no libido, hopefully you now have a deeper understanding of why desire has altered so much.