Low Libido

The causes of female sexual dysfunction are poorly defined. Several factors may impede the sexual response cycle, which requires physical and psychological stimulation

  • Alcohol
  • Anxiety
  • Depression
  • Emotional problems; distraction
  • Illness
  • Negative body perception
  • Stress

Two opposing medical perspectives on the causes (and treatment) for female sexual dysfunction exist. One concept, known as the vascular theory, is that diminished blood flow to the pelvic region, due to a medical condition, aging, stress, or hypoactive sexual desire, causes reduced sensitivity (particularly of the clitoris) and dryness, and impairs arousal. 

Decreased blood flow is associated with medical conditions such as diabetes and atherosclerosis. This concept has fueled clinical research and has led to the introduction of topical creams that, when applied to the clitoris, cause vascular dilation, increased blood flow, and vascular congestion associated with the excitement stage. Sensitivity is increased and may lead to arousal. 

A second concept, the hormone theory, focuses on decreased levels of sex hormones, such as estrogen and testosterone, caused by aging. For some women, hormone replacement therapy leads to greater sexual desire. Other medical causes for FSD include the following: 

  • Bicycle riding (long narrow seats associated with perineal pressure and reduced blood flow)
  • Drugs and medications; birth control pills
  • Smoking
  • Spinal cord injury (can cause nerve damage, paralysis)
  • Surgery (of or near reproductive-urinary system or abdomen, may damage nerves)
  • Urinary incontinence (can cause embarrassment, avoidance)
  • Vaginal atrophy

The FDA recently approved a new treatment, Addyi (flibanserin), for Hypoactive Sexual Desire Disorder. To learn more about this treatment talk to your WISH provider, or click here to hear how Addyi can help you

*This information does not replace a provider consultation. You should schedule an appointment with your provider if you experience any of these symptoms. 


The Women's Institute is a division of Urology Associates, P.C. We are committed to the innovation and the integration of advanced technology and advanced therapeutics in our treatment offerings.

We are the first practice to open a center solely dedicated to female urology in Nashville, and we strive to provide the best care possible to our patients.

The WISH clinic was founded on the principles of compassionate, high quality care and continues to serve that mission.