Low Libido (Low Sex Drive)

What is low libido (low sex drive)?

Low libido (low sex drive) is a decrease in the frequency and/or intensity of sexual desire that you once had. It can be temporary or long-term.

Libido is your overall sexual drive or desire for sexual activity, which includes sex with a partner and masturbation. Libido is complex and is influenced by biological, psychological and social factors. Biologically, sex hormones (testosterone and estrogen) and neurotransmitters (such as dopamine and oxytocin) regulate libido.

Libido naturally varies significantly from person to person. Your sex drive can also change throughout your life. There’s no right or wrong level of libido. Some people have sex or feel like having sex every day, while others may feel like having sex a few times a year or not at all. The “right” or “normal” libido for you depends on your preferences and life circumstances.

However, if a decrease in libido is causing you distress, it’s important to talk to a healthcare provider or mental health professional.

Several conditions and situations can lead to low libido, including:

• Relationship issues.
• Medical conditions.
• Hormonal imbalances.
• Mental health conditions.
• Certain medications.
• Stress.
• Aging.

How common is low libido?

Low libido (low sex drive) is common. It affects up to 1 in 5 men and even more women at some point in their lives. It’s also common to experience a drop in sex drive more than once during your life.

What are the symptoms of low libido?

The main symptom of low libido is a decrease in sexual desire compared to your regular interest in sex.

Other symptoms include:

• Having no interest or a decrease in interest in any type of sex, including masturbation.
• Having a decrease in sexual fantasies or thoughts of sex.
• Feeling unhappy or distressed about having a low desire for sexual activity.

What causes low libido?

Several biological, psychological and social factors can lead to low libido.

Health conditions that can lead to a decrease in sex drive in anyone include, but aren’t limited to:

• Cancer.
• Chronic kidney disease.
• Chronic pain.
• Diabetes.
• Headaches.
• Heart disease.
• Hyperprolactinemia.
• Hypertension (high blood pressure).
• Hypothyroidism.
• Rheumatoid arthritis.

Psychological and social factors that can lead to a decrease in sex drive in anyone include:

• Relationship problems with your partner: Relationship issues, such as problems with communication, trust or intimacy, are among the most common causes of a decrease in sex drive. A couple’s desire for sex also tends to decrease over the course of their relationship.
• Stress and exhaustion: Stress, including stress from work, family or life in general, can reduce your sex drive by taking your mind off of sexual desire. Chronic stress can also interfere with your hormone levels, resulting in lower libido.
• Depression: Low self-esteem, feelings of hopelessness and physical fatigue can lower your libido. Depression also causes an imbalance of the neurotransmitters that help regulate libido.
• Anxiety disorders: Anxiety can cause increased levels of the hormone cortisol (the “stress hormone”). High levels of cortisol can suppress the sex hormones that impact your sex drive.
• History of sexual trauma: Experiencing trauma such as sexual harassment, sexual abuse or rape can impact your sexual desire.

Other causes of low libido include:

• Side effects of certain medications: Antidepressants, antipsychotic medications, chemotherapy drugs and blood pressure medications can decrease your sex drive.
• Alcohol, smoking or recreational drugs: Drinking excess amounts of alcohol and improperly using drugs can both lead to a loss of sex drive. Smoking can suppress your testosterone levels, which can cause a lowered libido.
• Physical activity: Either too much or too little physical activity can cause a decrease in sex drive.

There are also several conditions and situations that affect you based on your reproductive anatomy.

Low libido in women

Medical conditions that can lead to a decrease in sexual desire include:

• Perimenopause and menopause: During perimenopause and menopause, your ovaries decrease their production of estrogen, which can lower libido.
• Sexual dysfunction: Sexual dysfunction is a problem that can happen during any phase of the sexual response cycle. Issues such as painful sex (dyspareunia), vaginal dryness, vaginismus or problems reaching orgasm can create anxiety surrounding sex and lead to a decrease in sexual desire.
• Pregnancy, giving birth and breastfeeding: These processes involve large fluctuations in hormone levels, which can affect sex drive. Uncomfortable physical symptoms and stress related to these life situations can also lower your libido.
• Infections: Temporary conditions, such as vaginal yeast infections or urinary tract infections (UTIs), can result in a decrease in libido.
• Reproductive health conditions: Reproductive health conditions, such as endometriosis, premenstrual syndrome (PMS) and polycystic ovary syndrome (PCOS) can all negatively impact libido.

Birth control and low libido

Certain types of hormonal birth control (contraception) can also lead to a decrease in sex drive, including:

• Combined hormonal contraception, including the combined pill, vaginal ring or birth control patch.
• Progestogen-only birth control pill.
• Contraceptive implant.
• Depo-Provera® injection.

Low libido in men

Medical conditions that can lead to a decrease in sexual desire in men include:

• Low testosterone (male hypogonadism): This is a condition in which your testicles don’t produce enough testosterone (a sex hormone). Male hypogonadism can happen at any age, but testosterone levels also naturally decrease as men age.
• Sexual dysfunction: Conditions such as erectile dysfunction, premature ejaculation or delayed ejaculation can create anxiety surrounding sex and lead to a decrease in sexual desire.

How is low libido diagnosed?

Since a decrease in sex drive has several possible causes, a healthcare provider will ask questions about your:

• Symptoms.
• Medical history.
• Medication history.
• Sexual history.
• Relationships.
• Stress level.
• Thoughts about sex.

If they suspect that a physical condition may be the cause of a lowered libido, they may perform or order the following tests to help determine the cause:

• Physical exam.
• Pelvic exam.
• Blood tests, such as hormone level tests.
• Imaging tests.

How is low libido treated?

The treatment for low libido (low sex drive) depends on the cause. Several treatment options are available.

Depending on the cause, it may be most beneficial to see one or more of the following medical specialists:

• Primary care physician (PCP).
• Sex therapist.
• Psychologist.
• Gynecologist.
• Urologist.
• Endocrinologist.

Types of treatment for low libido include:

• Education and communication: Education about sex, sexual behaviors and sexual responses may help you overcome anxieties about sexual function. Open dialogue with your partner about your needs and concerns also helps overcome many barriers to a healthy sex life.
• Stress management: Stress management involves using techniques to improve how you respond to life stressors. These techniques can prevent or ease stress-induced symptoms, such as low libido. Stress management may involve journaling, exercise, meditation and other forms of self-care.
• Medication change: When a medication is the cause of low libido, your healthcare provider may recommend changing the medication.
• Hormone therapy for menopause: Hormone therapy (HT) boosts your hormone levels and relieves some of the symptoms of menopause, including low libido. The two main types of HT are estrogen therapy and estrogen-progesterone/progestin hormone therapy (EPT).
• Hormone therapy for low testosterone: Providers treat low testosterone (male hypogonadism) with testosterone replacement therapy. Testosterone replacement therapy has several different forms, including pills, creams, injections and patches.
• Individual psychotherapy: Psychotherapy (talk therapy) is a term for a variety of treatment techniques that aim to help a person identify and change unhealthy emotions, thoughts and behaviors. Therapy with a mental health professional can help you address medical conditions, mental health conditions or situations that may be contributing to a decrease in libido.
• Couples therapy: In couples therapy, you and your partner work with a mental health professional to improve the overall quality of your relationship, work on resolving underlying problems and learn how to increase intimacy and physical affection. This can help with issues related to libido.
• Sex therapy: Sex therapists are qualified psychologists, doctors or healthcare professionals who have specialized training in helping people with problems relating to sex, including a loss of sexual desire.

What can I do if I have low libido?

If a decrease in libido is causing you distress, talk to a healthcare provider or mental health professional.

Some things you can do to try to get back to your normal libido include:

• Learning more about sex and sexual response from trusted education sources. This can help you learn about all the factors that affect libido.
• Being open and honest about your sexual desires with your partner. Open communication is essential to healthy relationships.
• Implementing healthy lifestyle changes, such as exercising regularly and cutting back on alcohol.
• Managing any existing health conditions, such as diabetes or heart disease, as well as you can. Talk to your provider if you need to change your treatment plan.

When should I see my healthcare provider about low libido?

If you’re experiencing personal distress or issues in your relationship due to a decrease in libido, talk to a healthcare provider or mental health professional.

They can recommend some lifestyle changes and relationship strategies that may help. If an underlying medical condition is the culprit, they can provide medication.

If you’re worried about the effect of a medication on your sex drive, talk to your provider about changing the medication or trying alternative options.