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The following information about hormones is incomplete, see the article about Androgens and Androgen Deficiency for more in depth information.
The subject of hormones is extremely complex. To use an analogy, they are like a jigsaw puzzle. A jigsaw puzzle is made up of many interlocking pieces that connect together to make up a single picture. Each piece of the puzzle fits into only one position in that puzzle. If you do not have all the pieces and they do not fit together correctly you do not get to see the entire picture. Consider trying to assemble a puzzle when you have only half the pieces. Then consider what it is like if you have pieces from two, three, or four puzzles that are all mixed together. Understanding our hormones is even more challenging when you take into consideration that medical researchers have not found all the pieces to our puzzle. We simply do not have all the answers.
Starting at puberty our bodies produce increased levels of the hormone testosterone and it commands us to seek out a reproductive partner. This is not something we choose or have control over, it just happens. This is true for both men and women. While women may have one-tenth to one-fifth (10-20%) the amount men have flowing through their body it still influences their actions to a significant degree. A woman's body is significantly more sensitive to testosterone so small changes in its level can have a major affect on their overall health and sexual desire. Without proper levels of testosterone you will not experience sexual desire, and may experience other health problems.
The adrenal glands and ovaries produce five different types of steroids from cholesterol; androgens and estrogens are two of them. Androgens are commonly considered the "male" hormones and estrogens the "female" hormones even though both sexes have them circulating throughout their body. Women usually have higher levels of estrogens than androgens. The ovaries and adrenal glands each produce about half the total amount of androgens in a woman's body. There are five different types of androgens, testosterone is one of them. Testosterone acts on the body and brain and causes us to desire sex, and to be more responsive to sexual stimulation. Testosterone also affects several bodily functions and influences our overall health.
After the ovaries and adrenal glands produce the testosterone most of it binds with a protein called sex hormone binding globulin (SHBG). Only 1-2% of the total production of testosterone is considered "free testosterone" and affects sexual function. When evaluating a woman's testosterone levels, total testosterone, SHBG, and free androgen levels must be determined. This allows doctors to know how much testosterone is being produced and how much is available to affect sexual function. These tests should be performed before midday and after menstruation starts or soon thereafter, in the early follicular phase of the menstrual cycle.
It should be noted that estrogen increases the production of SHBG which then results in less free testosterone in the body. Estrogen might be said to be an anti-testosterone. This is why high dose birth control pills may suppress sexual desire and why hormone replacement therapy may further suppress sexual desire. It may also explain why some women experience increased desire later in life rather than during puberty, when their estrogen levels are high. Estrogen levels drop sharply after ovulation, which may account for an increase in desire mid-cycle when a woman is most fertile, and estrogen levels are at their lowest during menstruation, possibly explaining why many women experience increased desire when they are actually least fertile.
A woman may not produce sufficient testosterone or her body may not be sensitive to it so she does not experience sexual desire, or only to a limited degree. The amount of testosterone and a woman's sensitivity to it is not constant throughout her life. While there is frequently a surge of testosterone production during puberty, its level decreases slowly throughout adulthood. A woman is not likely to notice a difference from one day to the next, but looking back over time notice her desire and pleasure are not what they once were. She will slowly come to realize something is missing. This realization may take place while a woman is in her twenties or later in life. Women whose ovaries are surgically removed, surgical menopause, may experience an immediate 50% decrease in their testosterone level meaning they may notice major changes within days of surgery. Hormone levels may not return to the same levels that they were prior to pregnancy too.
It should be noted that desire might exist without the ability to experience sexual arousal and orgasm, as other chemicals play a part in these physical responses. Nitric oxide and cyclic quanosine monophosphate (cGMP) are two of the important ingredients of sexual arousal. Nitric oxide is produced as a result of sexual stimulation and cGMP relaxes the blood vessels in the erectile tissues allowing blood engorgement (labial) and erection (clitoral) to occur. This means a woman can desire sex even if she is not able to experience arousal and orgasm. She may as a result find herself drawn to intimacy, not sexual activity, as sex only increases her level of sexual frustration. Women on antidepressants frequently experience this side effect.
Viagra may help women who experience sexual desire but not arousal and orgasm, even though they once did. Viagra contains sildenafil, which blocks the chemical that suppresses blood engorgement. Blood engorgement is necessary for arousal and orgasm. If a woman experiences desire and has sufficient levels of nitric oxide and cGMP in her body, Viagra may help her experience arousal and orgasm. Viagra has recently been found to help some men who are taking antidepressants, and may be of help to women too. While Viagra is a useful tool in the treatment of sexual dissatisfaction, it is not a miracle drug or one size fits all solution to sexual problems.
Note: Clit pumping also increases blood flow to the genitals and may help with arousal and orgasm, as does regular masturbation.
While men and women may desire sex, what they desire is often two very different things. Men can more easily achieve orgasm during intercourse, because the vagina is directly stimulating their penis. Women frequently find greater enjoyment in manual and oral stimulation of their vulva, as their clitoris is more likely to be directly stimulated. Men enjoy “sex” women “foreplay.” One wants “sex” the other does not. This frequently results in conflict between men and women concerning what they desire and enjoy sexually. They both want to experience sexual pleasure, but how they each want to go about it is where the conflict arises. The key things to remember are they ultimately want the same thing, and they do not have to achieve it at the same moment in time for it to be fulfilling.
While we may assume that sexual desire results in women wanting to participate in vaginal intercourse this is often not the case. She is more likely to desire that which sexually arouses her, gives her pleasure, and results in orgasm, without the worry of pregnancy. Women frequently report vaginal intercourse is not as intense or as enjoyable as clitoral stimulation, during intercourse their level of arousal and lubrication decreases, and they do not experience orgasm during intercourse on a regular basis, if at all. Vaginal stimulation alone may actually increase a woman's feeling of sexual frustration. Even if a woman experiences a desire for intercourse, a vaginal ache, she may find intercourse does not fulfill her sexual needs. She may enjoy it physically, but finds it leaves her wanting more; she wonders what is missing or wrong with her. A young woman may explore intercourse hoping it provides fulfillment but finds it does not, resulting in conflicting feelings. She may find men sexually attractive but discover sex with female partners is more enjoyable, because it is not focused on or involve vaginal intercourse.
Society says women should desire intercourse, and if they do not, there must be something wrong with them. A woman may feel pressured to have intercourse, which results in emotional conflict and loss of desire. If a woman is not happy, stressed, her body instinctively knows it would unwise for her to become pregnant, and suppresses her sexual desire. If sex is not enjoyable for women, and is in fact an emotional burden, their body will say no to sex. It is a vicious cycle.
We make a big deal of intercourse and present the idea that if a couple is having intercourse all their sexual desires will be fulfilled. This can be demonstrated by the way in which Viagra is advertised. Based on these ads, one is led to believe, if a man can have an erection all a couples' sexual problems are resolved. It ignores the possibility that a woman may want nothing to do with an erect penis, even though she seeks sexual pleasure, orgasm, and fulfillment. One must always remember intercourse is only one small and optional part of our sexual experiences.
Absence of desire is not the same as loss of desire. Absence of desire means you never experienced desire, at least to the degree you would like. An example being a woman that did not experience the onset of sexual desire during puberty. A loss of desire means you once experienced satisfactory desire but do not presently. Loss of desire usually occurs slowly over time, but can occur as a result of sudden and major changes in your life and body like pregnancy, breast-feeding, parenting, disease, and surgery. In medical terms, absence of desire is considered "primary" and loss of desire "secondary." Do not take these words literally. Loss of desire is secondary as it is usually caused by something else changing. The primary cause must be learned prior to a solution being found. Your testosterone level may have decreased because of reduced hormone production by the ovaries. The solution may be to supplement your testosterone level. Absence of desire means the primary components or building blocks of desire are not present. Something other than testosterone, a key building block, may need to be added to your body. Absence of desire could indicate problems with your endocrine glands, like the pituitary or adrenal and thyroid glands, or low body fat; body fat has a significant influence over a woman's reproductive and sexual health. Your ovaries may not produce sufficient testosterone, or you are not sensitive to the amount produced, requiring a higher dosage of testosterone than women with decreased desire. Understanding the nature of a woman's impaired sexual desire is key to understanding it's cause and treatment, which may not be an easy process.
Female sexual desire is also addressed in the article titled Managing the Risks Associated with Partnered Sex, in the sections headed The Fox Guards the Hen House, It Just Happened, and Are Accidents Less than Accidental. There is also: What Is Normal, I Mean Typical
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