Libido Disorders in Woman: Causes

Pathogenesis (development of disease)

The dopaminergic system (dopamine) is thought to have stimulatory effects on sex drive. Inhibitory (inhibitory) effects are attributed to serotonin metabolism. Somatic factors are distinguished from psychological and social factors that play a role in libido disorders. There is often a combination of various factors such as hormonal disorders and psychological influences. During the menstrual cycle, androgen formation is most pronounced in the theca cells around ovulation and is associated with increased libido. After ovulation, testosterone levels drop to a minimum, which seems to correlate with lower libido. Sexual arousal increases testosterone levels in women.Under the influence of contraceptives (estrogens + progestin), the concentration of SHGB (sex hormone-binding globulin) increases, and freely available testosterone decreases, which may be associated with decreased libido.

Etiology (Causes)

Biographic causes

  • Age of life – older age
  • Disorders in the parent-child relationship (taboos in parenting).
  • Sexual abuse
  • Hormonal factors – menopause (menopause) in women.

Behavioral causes

  • Consumption of stimulants
    • Alcohol
  • Psycho-social situation
    • Partnership problems
    • Psychological conflicts
    • Contact disorders
    • Fear of pain during sexual intercourse
    • Mental trauma such as abuse
    • Stress
  • Sexual inclinations deviating from the norm
  • Decreasing interest in sexuality

Disease-related causes

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Acromegaly (giant growth)
  • Diabetes mellitus (diabetes)
  • Hyperprolactinemia (increased prolactin serum levels).
  • Hyperthyroidism (hyperthyroidism)
  • Hypogonadism – gonadal hypofunction (here: ovaries; ovaries) with resulting androgen deficiency (lack of male sex hormone).
  • Hypothyroidism (underactive thyroid gland).
  • Addison’s disease (primary adrenocortical insufficiency).
  • Graves’ disease – form of hyperthyroidism caused by autoimmune disease.
  • Cushing’s disease – group of diseases that lead to hypercortisolism (hypercortisolism; excess of cortisol).
  • Perimenopause – transitional period between premenopause and postmenopause; varying lengths of years before menopause – about five years – and after menopause (1-2 years).

Cardiovascular system (I00-I99).

  • Arterial occlusive disease (AVD) or peripheral arterial occlusive disease (pAVD) (English : peripheral artery occlusive disease, PAOD): progressive narrowing or occlusion of the arteries supplying the arms / (more often) legs, usually due to atherosclerosis (arteriosclerosis, arteriosclerosis)arteriosclerosis).
  • Hypertension (high blood pressure)

Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87)

  • Liver dysfunction, unspecified

Psyche – nervous system (F00-F99; G00-G99).

  • Anorexia nervosa (anorexia nervosa)
  • Alcohol consumption, chronic
  • Contact disorders
  • Multiple sclerosis (MS)
  • Neurological diseases, unspecified
  • Psychiatric disorders such as anxiety disorder or depression
  • Psychological conflicts
  • Sexual inclinations deviating from the norm

Factors influencing health status and leading to health care utilization.

  • Stress

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99)

  • Renal dysfunction, unspecified
  • Ovarian insufficiency – gonadal underfunction (ovaries/ovaries) with resulting androgen deficiency (deficiency of male sex hormone, for example, circa 3-5 years postmenopausal (after the last menstrual period).
  • Vaginal atrophy due to estrogen deficiency (menopause); clinical picture: vaginal dryness, frequent inflammation, burning, itching, redness and light bleeding of the vagina.

Laboratory diagnoses – laboratory parameters considered independent risk factors.

Medication

  • Amphetamines (orgasmic disorder)
  • Anticholinergics (arousal disorder).
  • Antidepressants
    • Selective serotonin update inhibitors (libido, arousal, and orgasmic dysfunction).
    • Tricyclic antidepressants (libido, arousal, and orgasmic dysfunction).
    • MAO inhibitors (orgasmic disorder).
    • Trazodone (libido disorder)
    • Venlafaxine (libido disorder)
  • Antipsychotics (neuroleptics) (libido and orgasmic disorder).
  • Babiturate (libido, arousal, and orgasmic disorder).
  • Benzodiazepines (libido and arousal disorder).
  • Chemotherapeutic agents (libido and arousal disorder).
  • Histamine receptor blockers
  • Hormones
    • Anti-androgen-acting drugs – e.g. cyproterone (libido, arousal, and orgasmic disturbance).
    • Antiestrogens – tamoxifen (libido and arousal disorder).
    • Aromatase inhibitors (libido and arousal disorder).
    • GnRH agonists (GnRH analogues) – e.g. goserelin (libido and arousal disorder.
    • Hormonal contraceptives (estrogens + progestin) → concentration of SHGB (sex hormone-binding globulin) increases and freely available testosterone decreases, which may be associated with decreasing libido.
    • Testosterone derivatives – e.g. Danazol.
  • Indometacin (analgesic) (libido disorder).
  • Cardiovascular/antihypertensive drugs that may be associated with libido disturbance: Beta-blockers, clonidine (+ arousal disorder), digoxin (+ orgasm disorder), lipid-lowering drugs, methyldopa, spironolactone.
  • Ketoconazole (antifungal) (libido disorder).
  • Lithium (libido, arousal, and orgasm disorder).
  • Phenytoin (anticonvulsant) (libido disorder).
  • Sedatives (orgasm disturbance).

Operations

  • Ovarectomy (removal of both ovaries) – surgically induced menopause.

Other causes

  • Declining interest in sexuality
  • Status after partus/birth of a child (in the first months after, women often do not feel any desire for sex)