When a woman’s sexual health and wellness is not where she wants it to be at any point in her life, it can be easy to blame it solely on hormones. In reality, the world of libido, arousal, and sexual dysfunction is a complex one that involves a variety of intrinsic and extrinsic factors – some of which are as basic as your partner taking out the trash (yes, really).
On Wednesday’s show, Megyn was joined by Mary Jane Minkin, MD, a board certified OBGYN and clinical professor at Yale School of Medicine, to discuss what influences a woman’s sex drive, how hormones alone are not to blame for a lack thereof, and what women – and their partners – can do about it.
Factors That Influence a Woman’s Libido
Libido, as Dr. Minkin explained, refers to the desire to have sex. “Wanting to want to have sex [is] a very important thing,” she said. Some women who experience a low sex drive are not bothered by it. But many women understandably are. “The major issue that we’re concerned about with libido is women who have decreased libido and are concerned by it – they’re not happy with the situation,” Dr. Minkin shared.
The good news is that there is much that can be done to increase sexual desire. The bad news is that libido concerns are, in Dr. Minkin’s words, “multifaceted” and don’t necessarily present the same way for everyone. Many women assume that libido is linked to hormones. While that is true, it does not tell the whole story. “One of the things my medical students and residents ask me all the time is, ‘How do you figure out what’s what,’” Dr. Minkin said. “The answer is it’s really hard.”
So, if it’s not strictly hormonal, what else could it be? “If you look at any woman’s life, there’s so many things going on besides just hormonal activities,” Dr. Minkin said. For starters, there is the state of her relationship. “If you don’t really like your partner, you’re probably not going to want to have sex with him or with her, it’s just something you’re not going to be interested in,” she noted. “You have to really be happy and liking your partner if you’re talking about sex with somebody else.”
Physical limitations may exist. “There are women who have painful pelvic conditions or significant medical conditions, which are just really debilitating for them,” Dr. Minkin noted. “Who would want to have sex if it’s going to hurt?” This is especially true of women in menopause who may be experiencing vaginal dryness.
You have to also consider environmental stressors. Take, for example, motherhood. “Oftentimes women who’ve just had babies will talk to me about their decreased sexual desire, decreased libido,” Dr. Minkin explained. “Well, they’re exhausted – they’ve been up feeding this kid every night, they’re not getting a decent night’s sleep, and they’re thinking about having to go back to work.” All of these things might “overwhelm her desire to have sex,” she added.
Later in life, many women find themselves becoming caregivers again. “We’re looking at our partners, we’re looking at our kids, but… we have a significant aging population… and many of my patients are taking care of their mother or their father or – when I give a talk I get a laugh on this one, I’ll say – even worse you have to take care of your mother-in-law,” Dr. Minkin joked.
The net-net: “You’ve got all these responsibilities going on and all of those can be dampening your desire to have sex,” Dr. Minkin shared. “There are many, many things at play besides just the hormonal issues intrinsically going on for a woman.”
Arousal vs. Desire
It should be noted that libido and arousal are two separate things. “You may have no problem getting aroused when you actually get down to it, but the desire can be a problem for some women,” Megyn said.
In fact, Dr. Minkin said this is one of the key differences between men and women. She cited Rosemary Basson, MD, and her model of non-linear sexual response that examines how women’s libido is a “circular issue.” As she explained, “a guy’s got… a lot of testosterone and that’s certainly one of the hormones significantly involved in desire, so a guy says, ‘I want to have sex’ and that’s it.”
It’s far more “complex” for women. “Maybe she knows that if she does have an intimate relationship with her partner that will improve the relationship and improving the relationship will further lead to increasing her desire because the relationship is better,” Dr. Minkin said. “There may be many other issues than just the hormonal issues at play… It’s more of a circular issue rather than just a linear model.”
Listen Up, Fellas
With that in mind, Megyn and Dr. Minkin agreed relationships are a two-way street. “If you’re a man wanting to have sex with your wife or your partner, it would behoove you to work on the relationship whether that’s important to you or you just want more sex,” Megyn said. “You need a willing partner, and your partner is going to be more willing if she feels emotionally closer to you.”
One such area this applies to: household chores. “This is why they say men should help with the housework because it relieves the burden on the wife; it makes you feel closer to him; it makes you feel a little bit more pep in your step; it could re-fire your desire,” Megyn explained. “It’s not that it’s hot to see your husband take out the trash, it’s that you want shared burdens on the things that are no fun around the house.”
At the end of the day, no one wants to be doing more than their fair share. “I’ll say to Doug, I’m not cooking the dinner, and cleaning up the dinner, and cleaning up the house, and then you want to cuddle up to me because, at that point, it feels like another chore,” Megyn shared. “It needs to be more balanced.”
Dr. Minkin agreed. “If the guy figures it out, that’ll be great because he’ll end up getting more of what he wants, too,” she concluded. “It’ll make the relationship much stronger for the couple.”
You can check out Megyn’s full interview with Dr. Minkin by tuning in to episode 609 on YouTube, Apple Podcasts, or wherever you like to listen. And don’t forget that you can catch The Megyn Kelly Show live on SiriusXM’s Triumph (channel 111) weekdays from 12pm to 2pm ET.