That's one of the questions MiddlesexMD medical advisor and sex therapist Sheryl Kingsberg often hears. I asked her to write about how she answers it.
Each of us is unique, with varied interests, beliefs, backgrounds, and experiences. Given how different we all are, it is often very difficult to define what is “normal.” This difficulty in pinning down such a definition holds true for many things, including one’s sex drive–everyone’s is a little different.
As a woman’s life changes, her sex life and interest in sex may change as well. For examples, at midlife, her balance between career and family may shift; perhaps more of her time and energy is pulled in a different direction. This may affect her interest and energy for sexual activity, and her idea of a normal sex drive may change as well. She may not have the same desires she felt when she was younger, or she may often find herself thinking about her to-do list and not about sex. However, it’s important to note that her sex life is still an important part of her personal life and her overall health.
For some women, however, it can feel like sexual desire is nearly gone, sexual thoughts or daydreams are rare, or other sexual problems develop, like difficulty with arousal, lubrication, or pain. These changes may not simply be due to changing priorities, other physical problems, age, or situational stress. In this case, women may be experiencing a sexual dysfunction.
While anyone who owns a television and has seen ads for Viagra or Cialis knows that sexual problems are common in aging men, there is much less discussion about aging women. The reality is, sexual problems affect over 40 percent of adult women and can present themselves at any stage of their lives. There are several specific sexual disorders, including Hypoactive Sexual Desire Disorder (HSDD), Female Sexual Arousal Disorder (FSAD), Female Orgasmic Disorder, Sexual Aversion, Dyspareunia (pain with sexual penetration), and vaginismus (the inability to have wanted sexual penetration due to an anxiety response).
HSDD is the most common sexual problem for women. Nearly one in 10 women reported low desire with sexually related personal distress; the distress associated with it can affect more than just a woman’s sexual life. Research has shown that the impact of HSDD can extend further, causing detrimental effects in other aspects of her life. These can include difficulty with personal and social relationships, a poor self-image, mood instability, and even depression.
As a clinical psychologist, I see firsthand how HSDD and other sexual problems negatively affect women’s lives. A woman’s sexual health is a basic human right and an important part of her overall health and well-being. It is normal for a woman’s desires and sex drive to fluctuate given all that life throws her way. However, a significant lack of desire, and/or absence of sexual thoughts or fantasies that causes distress, is a sign that this is not just a normal fluctuation but rather may be HSDD and should be discussed with a healthcare professional.
What is a “normal” sex life for a woman? It may be different for each woman, but it comes down to whatever she feels is right for her and her relationship. It’s not about how often a woman engages in sexual activity, but rather that her desire remains satisfying to her.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.