Lampshade_express

No, it's advanced heart disease

What's the age range of the women who do this work? Are there older women who do this? Do any clients go in there seeking Cougars?

But the truth is that the narcissist actually has very low self-esteem And in many cases eventually (with age) breaks down, then their facade falls apart, their true colors show, and everyone abandons them

Source: my mother is a raging narc

Yep. My SSRI has totally destroyed my sex drive. My sex drive literally does not exist anymore. It absolutely sucks.

I think you're over-generalizing, and just because you've never met an N with low self-esteem doesn't mean they don't exist. Read the literature. The narcissistic traits can develop as a maladaptive coping strategy to low self-esteem.