Q: Why has my libido taken a nosedive since I had kids (ages four, six, and nine now)? I love my husband, but my body just seems unwilling to cooperate.
A: Aside from the exhaustion of raising kids, it's possible your libido is suffering because of a lack of testosterone. Many women don't realize when they are testosterone-deficient, which can be a problem long after giving birth. Symptoms include low energy, low mood, and decreased genital sensation, as well as low libido. I suggest you get your testosterone levels checked by your doctor, and if they're low, discuss replacement options. Although there is debate within the medical community about what constitutes low testosterone, my opinion is that anything less than 20 ng/dl of total testosterone and 0.9 ng/dl of free testosterone is too low. Ask your doctor to let you see your results. That way you can be open to the option to pursue treatment elsewhere if your levels fall below these amounts and you’re not satisfied.
Testosterone replacement is available in the form of lozenges, sprays, capsules, patches, and creams. Depending on the formula, it can take anywhere from a few weeks to a few months for you to see results. Dosages should be kept as low as possible and monitored carefully to lessen the chance of side effects, such as unwanted hair growth and liver problems.
If it's poor lubrication you're struggling with, you might want to try an over-the-counter lubricant. And you should be practicing Kegel exercises daily to strengthen your pelvic muscles, especially since you've gone through three pregnancies and labors; both vaginal and cesarean births can be especially damaging to the pelvic floor.
Kegel exercises will increase blood flow to the genital area and improve muscle tone for enhanced arousal and orgasm ability (not to mention a better experience for your partner because of increased tightness). Start with one set of ten (tighten and hold for a few seconds each time) and gradually work your way up to a few sets a day. Do them fast and then slow to work two different groups of muscle fibers, both of which benefit sexual function. If you need help locating your pelvic muscles, try stopping your urine in midstream or tightening your vagina around your finger — you will feel the pelvic muscles contracting.
It’s also important to focus on the emotional side of things. If you aren’t making time for yourself and your relationship, you won’t be in the mood for sex. Consider the following:
Put your spouse first. The most important skill to master as parents is the ability to multitask and balance your numerous responsibilities. You might think that the best way to do this successfully is to always put your children first. Not so! It’s tempting to put your children ahead of everything, not only because you love them but because you feel guilty if you don’t give them all you have, including your time. However, my personal belief is that a happy, healthy marriage and stable home is the absolute best gift you can give your children. Instead of seeking perfection as a parent (which is an impossibility to begin with) and ignoring your own needs, make your relationship and your own happiness a priority. When you do so, you will ensure that your marriage stays strong and you are the best you that you can be.
Focus on what is really important. You can put your spouse before your kids by making sure to prioritize what is really important and not funneling your energy into certain activities, like planning a huge blowout for your child’s fourth birthday party. He won’t remember much beyond the cake and ice cream, so there is no reason to give yourself premature grays as you try to color-coordinate the invitations to the napkins. Instead, put the focus on what really matters — your family relationships.
— Dr. Laura Berman