Vyleesi? Addyi? How women can get help for low sexual desire

Understanding how you're faring in all these categories will help you identify the root cause(s) of your low sex drive—and what you can do to start to bring the heat back up.

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We’ll break down everything you need to know about low libido, natural ways to increase it, plus medical treatments, relationship fixes, and more. At Midi, our clinicians have heard—and treated it all—so they can help you regain your spark and interest in sex. Libido is simply a word to describe sexual desire, or how much you want to engage in sexual activity. You can have a high libido, meaning you have a high sex drive. You can also have a low libido, which means a low sex drive. When you’re ready to make a changes to restore your sex drive, you can start with some of these natural solutions for a higher libido: Everyone “knows” that oysters are known to be an aphrodisiac, but you definitely don’t have to eat them to get in the mood. Eating in a healthy, balanced way—shout out to the Mediterranean Diet—reduces inflammation, decreases the risk of metabolic syndrome, and helps maintain a healthy weight, all of which keep blood vessels healthy—which impacts genital arousal. (Blood flow to vaginal tissues is key for vaginal lubrication.) Limiting your sodium intake, in particular, enhances the ability of vessels to dilate. And a special shout-out to tofu and edamame: Soy intake has been also shown to help boost vaginal blood flow and lubrication, which is especially helpful if you’re experiencing vaginal dryness and irritation. Other foods that have been shown to help with sexual health thanks to their effects on the vascular system or vaginal lubrications: watermelon, apples, and cacao. Vaginal dryness, irritation, and pain during intercourse affect 50% of women after menopause. If vaginal dryness and irritation is a big part of your libido nosedive, it’s time to buddy up with vaginal moisturizers and lubricants. Vaginal moisturizers, which you can apply a few times per week, work by improving moisture in vaginal cells so that you’re naturally more hydrated. Midi clinicians recommend the vaginal moisturizing products by the brands Good Clean Love and Revaree by Bonafide. Vaginal lubricants, on the other hand, are products that you use during sexual activity. These products make penetration more comfortable and a whole lot more enjoyable.

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During perimenopause and menopause, declining levels of estrogen can take your typical level of desire and tank it. Not to mention that a decrease in estrogen can also cause vaginal dryness and thinning that make sex uncomfortable and painful. Of course, it’s important to remember that levels of desire are so individual, varies from person-to-person, and can shift throughout life. And then there’s how your low libido can affect your relationship—especially if there’s a mismatch in sex drive with your partner that's putting a real dent in both of your lives. If low libido lingers for a long time, you may be diagnosed with hypoactive sexual desire disorder, or HSDD. If you’re using condoms, you’ll want to ensure that the lubricant you’re using is also condom compatible. (That includes silicone- and water-based lubes, but often not oil-based ones.) No matter what OTC product you’re using, make sure that it’s fragrance-free (and, if a lubricant, also free of colors and flavorings) to protect the health of your vagina. Getting your body moving at the gym (or anywhere, frankly) can help amp up the energy elsewhere. One study found that women who engaged in frequent physical activity had an up to 80% reduction in the chances of having low libido. Exercise helps you in a variety of ways: It has a positive impact on hormones and your nervous system that promote mental and physiological arousal, plus it’s a bonafide mood and body image booster, notes research. (When you’re feeling yourself, you may also be more likely to say ‘yes’ to sex.) You know the feeling of having a high-stress day where you’re left frayed and frazzled? The last thing on your mind might be having sex with your partner. Research shows that higher amounts of daily stress is linked to lower sexual activity—and lower relationship satisfaction, too. Improving stress management by lessening stressful situations, scheduling time for self-care (in whatever way that looks like for you), getting enough sleep, exercising, and eating well can all help improve your mental health and mood. Sleep affects your overall well being in so many ways, including your sexual desire.

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HSDD is defined as “a persistent or recurrent absence of sexual fantasies and desire for sexual activity, causing personal distress or interpersonal difficulties.” That last part—personal distress/interpersonal difficulties—is really important. When your low libido is making you feel unhappy or causing issues in your relationship, then it’s something to take steps to treat. (You’re in the right place, keep reading!) The symptoms of low libido can include: Reduced or lack of desire for fantasies and sexual stimulation Inability to maintain desire during sexual activity Loss of desire to initiate or participate in sexual activity Avoidance of situations that can lead to sexual activity Making things more complex are all of the factors that influence your sexual desire, including: Physical causes: Hormonal changes like menopause, which can affect vaginal tissues in particular, leading to discomfort; stage of life, such as postpartum; medications; and underlying medical conditions like thyroid disease. Psychological causes: Stress, anxiety, depression, past trauma, and more. Lifestyle factors: Poor diet, lack of exercise, sleep problems, and more. Think about it: If you’re conked at the end of the day, do you really want to expend the energy to have sex? But here’s the kicker: Getting good sleep is related to higher libido the next day. In fact, getting just one extra hour of sleep was associated with a 14% increase in the odds of engaging in sexual activity with a partner, according to research in The Journal of Sexual Medicine. Women who got more sleep also reported better genital arousal. When searching for solutions for low libido, you may have come across libido gummies, which are supplements (in gummy form) that contain ingredients that, companies claim, improve sexual desire and function. Products differ across the board but they may include a combination of the following: These herbs are added to libido gummies for one of several reasons: They may help reduce stress and anxiety, are considered an aphrodisiac, improve blood flow, or are linked to enhanced sexual desire. There is, however, a lack of evidence showing that libido gummies will effectively improve your sex life (or desire for one), and individual data on many of these ingredients is also lacking, conflicting, or shows limited evidence. The choice is yours if you’d like to try them to see if they benefit you.

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Many things can make sex less exciting for women throughout life, and especially during menopause, including problems in the areas of desire, arousal, orgasm, and pleasure, says Midi’s chief clinical officer Mindy Goldman, M.D. Unfortunately there are still many societal taboos around discussing sex, says Goldman, making women less likely to bring it up with their doctor. “Women should know that sexual concerns are normal and can be addressed,” says Dr. Goldman. “That’s why it’s especially important to find a provider who is knowledgeable and comfortable and open in discussing these concerns.” So, how can you get your libido back? These types of gummies aren’t considered harmful, so even if it’s just the placebo effect that has you feeling more perked up, take it. Still, before choosing any supplement, it’s important to purchase those that are third-party certified, which ensures that they are labeled correctly and do not contain contaminants. Doing so helps you stay safe when taking them—a must even when they’re available over-the-counter. Supplements are unlikely to be the answer to your libido problems. Your health, life stage, lifestyle, and relationship are all pieces to figuring out exactly why your desire is down—and how to get it back up. Most women benefit from a treatment plan that's more holistic, including a combination of lifestyle changes, medications, and maybe even some supplements, to get your libido back on track. There are many science-backed options available to you to get your sex life back on track. Midlife women in the menopausal transition often benefit from hormone replacement therapy (HRT), especially if you’re besieged with symptoms that may be interfering with intimacy. (Some experts now use the terms hormone therapy (HT) or menopausal hormone therapy, or MHT). The name is a tad misleading because you’re not replacing any hormones in your body so much as you’re giving them a little boost. “Adding back just a tiny percentage of the hormones your body made during your peak reproductive years “is all that is needed to gain so many benefits,” says Midi’s Chief Medical Officer Kathleen Jordan, MD.

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If low libido has become part of your reality, you’re not alone. A staggering 38% of women in the U.S. report struggling with low sexual desire, according to a comprehensive study in the journal Obstetrics & Gynecology. What's more, as you age, so does the likelihood of diminished libido—by the time women reach 65, three out of four report little to no desire. But here’s some good news: You can turn things around. Available in a pill, patch, vaginal ring, topical cream or gel, the medication provides small doses of estrogen (plus progesterone if you have a uterus) to your body. Estrogen deficiency in menopause is linked to a low libido, as well as vaginal dryness and thinning that make sex uncomfortable and painful. Research suggests that HRT can improve sexual desire and symptoms like vaginal dryness. “We know that declining estrogen levels that occur with menopause can affect individual women differently,” says Dr.