If you’re a woman, everyone wants to help you with your sex drive.

The medical profession may classify you as having hypoactive sexual desire disorder (HSDD)…aka, low libido. The drug industry wants to sell you its latest pill.

The good news: If low sex drive bothers you, there are better ways than popping a pill to rekindle the flames of desire.


The pharmaceutical industry is excited about flibanserin (Addyi), the first-ever drug approved for low libido in women, but many doctors and mental health professionals aren’t so jazzed about it. It doesn’t move the desire needle much, and there are worrisome side effects. And did we mention that you’re supposed to take it every day…but you can’t take it if you drink alcohol? To learn more, see Bottom Line’s 12 Things You Should Know About the New Female Viagra.

Even the HSDD diagnosis itself is controversial. “There is no evidence that hypoactive sexual desire disorder is a medical condition,” according a report in Journal of Medical Ethics. The author documents the extensive marketing campaign that the pharmaceutical industry sponsored to convince physicians that HSDD is, in fact, real—and thus needs to be treated with a drug.

Still, there’s no question that many women do struggle with a lack of desire, and that it can have real, sometimes painful, effects on their sense of well-being, as well as on their relationships. If you’re dealing with lagging libido—and you can’t or don’t want to try the new “little pink pill”—what can you do about it?

To find out, we spoke with noted sex therapist Kathryn Hall, PhD, a psychologist in Princeton, New Jersey.


There are many, many reasons why women lose desire for sex—relationship problems, stress, fatigue, body image issues, hormonal changes in menopause, medications such as anti-depressants, as well as depression itself, Dr. Hall noted. But you don’t have to have a reason. Many women don’t. Here’s why…

It’s very common for women to lose sexual desire as a relationship progresses over time from lust to love.

“We know from a lot of studies that for many women, desire—their spontaneous lust—seems to wane in midlife,” Dr. Hall says. “It’s a normal pattern to lose that sort of lustful feeling, and it doesn’t mean there’s something wrong with you.” The truth is, there’s no “normal” when it comes to desire and how it plays out. If you don’t want to have sex very often, or at all, and that doesn’t bother you or your partner (if you have one), that’s fine. Your desire, or lack thereof, is only a concern if it’s distressing for you or problematic for your relationship.

If it does bother you, on the other hand, Dr. Hall has some suggestions that she’s seen work for the many couples she’s counseled. Here they are…


For women, what often replaces lust is “responsive desire”—getting in the mood after things have already gotten going because her partner has taken the initiative. That’s perfectly fine for many couples. But some partners may resent always having to initiate sex. And many women miss the excitement of lust and eventually start to feel like sex is an obligatory chore, something they have to do so their significant others don’t get angry. Fortunately, Dr. Hall has seen many patients and couples work with these challenges to improve their sex lives, although she acknowledges that it’s not necessarily an easy road. Here are some of the strategies she believes can help…

• Be realistic about sex, but don’t give up on it. Now that you know that a lot of women struggle with a low sex drive, you can work on bringing desire back into your life. “You’ve made a decision that you need sex in your life and in your relationship and that you’re going to put some energy and effort into it,” Dr. Hall says. “It’s not going to happen naturally.” And that’s OK.

• Have maintenance sex. “A lot of couples who stay sexual throughout their life span have what I call ‘maintenance sex,'” Dr. Hall says. They think, “OK, it has been a while and I don’t really feel like it but, you know what? I’m going to put some effort into it because we need sex in our life and in our relationship.” Hall says these couples understand that bad sex happens and boring sex happens, but they still make lovemaking a priority because most of the time sex is satisfying.

• Set yourself up for success. The first step is to get out of the rut of feeling that sex is a chore. Start by challenging the belief that you never want to have sex with your partner. Think about the occasions when you enjoy it more, such as when you’ve just shared a nice time doing something together, and choose those kinds of situations for initiating sex—rather than if it’s late and you have to get up early and go to work the next morning, or when you’ve been fighting.

• Reengage with your own desire. You may feel like you want to get sex over as quickly as possible. For many women, that means focusing only on satisfying their partners to get the deed done. Hurry up. You don’t need to take care of me. Let’s just focus on you. Have your orgasm and then we’ll be done. If this sounds like your internal dialogue during sex, try slowing down and paying attention to what you need and want sexually. Put on some clothing that makes you feel sexy. Watch some erotica or, if you’ve ever used one, get your vibrator out. Have a glass of wine if that helps. Do these things not because you think it’s going to turn your partner on, but because it’s going to turn you on. And don’t forget to clue your partner into what you like. He or she is probably dying to know!

• Make an effort to initiate sex. This is probably the furthest thing from your mind, but it may be a big deal to your partner. Dr. Hall says: “When couples come in to see me, the man will often say, ‘Look, I’m always the one that initiates this, and I don’t like doing that. I want to be desired.’ Of course he does, right? Men in their midlife want to feel like, ‘Hey, I’m still vital and attractive and desirable,’ and, if his partner never wants to initiate sex with him, it doesn’t feel great.” Being more mindful about initiating sex from time to time can go a long way toward making your partner feel physically cherished—and that can only reap benefits for you.

Have you found ways to rekindle your desire? Share your comments below.

For more tips and insights, see these Bottom Line stories:

The Truth About Women’s Sexual Desire

Can Life Without Sex Be Happy?

How Much Sex Makes Couples the Happiest?

Feeding Your Libido-Boosting Hormones

The Libido-Boosting Mind-Set That Will Make You Love Sex Again