— Wanting to be horny

You say your lack of sexual desire started during your pregnancy, and that although it has continued, that it has nothing to do with stress, marital problems, or your baby, That may be so, however, the complex hormonal changes that occur during pregnancy, through childbirth and after, have profound effects on a new mother. The abrupt reduction in the hormones that supported the pregnancy stimulates the release of other hormones, which help the uterus return to its normal size and support the production and secretion of breast milk. These hormonal changes affect a woman's sexual desire, arousal, and response. For example, some women have little or no sexual desire or sexual energy, while others resume sexual activity quickly. Decreased sexual desire can result from fatigue and stress associated with the changes in one’s life, including taking care of the new baby, a partner, one’s self, and/or other family members. If your body is still recuperating from the delivery, you may feel fatigue and discomfort for several weeks as your episiotomy (tear or surgical incision of the perineum) or Caesarean Section incision heals.

Studies show that fatigue experienced by new mothers profoundly affects their sexual desire and sexual energy. Research published in April, 2005 from the University of Sydney and Macquarie University in Australia found that breastfeeding mothers are more likely to be fatigued, lack sexual desire, and feel depressed. Requirements for caloric intake and energy expenditure are vastly increased to produce breast milk, so breastfeeding mothers often feel exhausted. In addition, the milk hormone, Prolactin, inhibits ovarian stimulation, so estrogen levels remain low, leading to vaginal dryness and discomfort or pain with intercourse/penetration (unless she uses a lubricant). The bond of the mother with her baby frequently shifts a mother's interest away from procreation (read, “sexual interest”) as she nurtures her infant. This biological foundation hormonally ensures that the baby gets the necessary care and that the mother's stamina is not depleted by another pregnancy.

Certain hormones play a role in sexual feelings, sexual activity, and intensity of orgasm. Both men and women produce testosterone, though men produce twenty times the amount women do. In women, testosterone is produced by the adrenal glands and ovaries in approximately equal amounts. The role testosterone plays in women's sexuality is not well understood, and sexuality depends on the complex interplay of biologic and psychosocial factors.

A recent study published in JAMA in 2005 shows that androgenic hormones (testosterone and DHEAS — dehydroepiandrosterone) are major contributors to sexual functioning in women, but have no direct relationship between dose and sexual interest and/or response. A profile of sexual function in healthy premenopausal women evaluated such factors as desire, arousal, orgasm, and pleasure. DHEAS was weakly correlated with arousal and responsiveness, however, the majority of women with low sexual function did not have low DHEAS levels. This supports the perspective that many factors besides hormones affect women’s sexuality.

In one specific instance, lowered testosterone levels are correlated with lessened sexual desire in women who have an abrupt decrease in testosterone following surgical removal of the ovaries or adrenal glands. This has been studied and well documented, showing the benefit of testosterone replacement for these women, as well as postmenopausal women.

The way you feel and have felt for a while is, in all likelihood, temporary. It’s not clear from your letter if you think this is a problem for you, for your partner, or for both of you. A woman’s desire ebbs and flows throughout her lifetime, as does a man’s. So it may be your impatience or the pressure you are placing on yourself that’s problematic, rather than your lack of desire.

“The New View” of female sexual dysfunction (including women’s sexual desire) was founded by a group of women’s health and women’s sexuality professionals, with Leonore Tiefer, Ph.D., at the forefront. The New View supports a woman’s desire as unique and “normal,” rather than problematic, hence “the new view.” Reading about this new view on the Female Sexual Dysfunction website may give you a new perspective.

Aside from removing the pressure you are placing on yourself, thinking about what is happening in a different way (“reframing” it) and focusing on you and your baby now make sense. Give this some time. Take care of yourself by eating well, exercising moderately, and resting adequately. Or, get someone else, even for a few hours at a time or a few hours each week, to take care of you, or to take care of the baby while you take care of yourself.

Finally, you and your partner may need to find ways of spending time together to remember and create tender, loving, caring feelings that will take you closer to feeling desire.

Alice

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