Quick Answer
Low libido, or reduced interest in sex, is common in both women and men and often has more than one cause. Hormone changes, such as menopause or low testosterone, can play a role, but so can stress, relationship factors, depression, poor sleep, pain with sex, chronic health conditions and many medications. A provider can help sort out which factors apply to you.
Who this is for: women and men who have noticed a lasting drop in sexual desire that bothers them, and want to understand possible causes.
When Is Low Libido a Concern?
Sexual desire naturally varies between people and changes over a lifetime. There is no “normal” amount. Low libido becomes a concern when it is a change for you, lasts for months and causes you or your relationship distress.
Common Causes in Women
Hormone changes
Perimenopause and menopause can reduce desire directly and indirectly. Lower estrogen can cause vaginal dryness and discomfort during sex, which can make sex less appealing over time.[1] Pregnancy, breastfeeding and some forms of hormonal birth control can also affect desire.
Pain or discomfort
Pain with sex from dryness, pelvic floor problems or other conditions is a common and treatable reason for lower interest.
Life and relationship factors
Stress, fatigue, caregiving, body image and relationship issues have a strong effect on desire.
Common Causes in Men
Low testosterone
Low testosterone can reduce sexual desire, along with energy and mood. It is diagnosed with symptoms and repeated morning blood tests.[2]
Erectile changes
Difficulty with erections can lead to lower interest or avoidance of sex. Erectile problems can also be an early sign of heart or blood vessel disease, so they are worth discussing.
Other factors
Stress, depression, poor sleep, sleep apnea, alcohol and excess weight can all affect libido in men.
Libido is influenced by hormones, health, medications and life circumstances.
Causes That Affect Everyone
- Medications, including many antidepressants, some blood pressure medications, opioids and some hormone treatments
- Mental health, including depression and anxiety
- Chronic conditions, such as diabetes, thyroid disease, heart disease and chronic pain
- Sleep problems and ongoing fatigue
- Alcohol and substance use
Because so many factors can be involved, a good evaluation looks at physical health, hormones, medications, mood and relationships together. Treatment depends on the cause and may include treating dryness or pain, adjusting medications, addressing sleep or mood, counseling, or hormone treatment when it is appropriate.
How We Approach Low Libido at Lake Forest Regenesis
Allana approaches low libido with privacy and without judgment. She reviews your health history, medications, sleep, stress and relationship context, and discusses any pain or physical changes. Hormone testing is ordered when it fits the picture. Treatment options are matched to the cause, from addressing dryness and discomfort to hormone therapy when it is appropriate, with referrals to counseling or other specialists when that would help.
When to See a Provider
See a provider if low desire lasts for months and bothers you, or if you have pain with sex, new erectile problems, or bleeding after sex. Erectile problems can be an early sign of heart disease, so mention any chest pain or shortness of breath with activity. If low libido comes with low mood or thoughts of harming yourself, reach out for help right away, including by calling or texting 988.
Low desire that’s been bothering you for months? Talk it through privately with Allana and look at the possible causes together.
Frequently Asked Questions
Is low libido always caused by hormones?
No. Hormones can play a role, but stress, relationships, mood, sleep, health conditions and medications are often just as important.
Can antidepressants lower libido?
Yes. Some antidepressants commonly affect sexual desire and function. Do not stop them on your own; talk with your prescriber about options.
Can menopause lower libido?
It can. Lower estrogen may reduce desire and cause dryness or discomfort, which can make sex less appealing. Several treatments can help.
Should I get my testosterone checked for low libido?
For men, testosterone testing is reasonable when low libido comes with other symptoms such as fatigue or erectile changes. For women, testing is used more selectively and should be discussed with a provider.
References
- The North American Menopause Society. The 2020 genitourinary syndrome of menopause position statement. Menopause. 2020. Read the statement
- American Urological Association. Evaluation and management of testosterone deficiency: AUA guideline (2018, amended 2024). Read the guideline
This article is for general education and is not a substitute for individual medical advice. See our medical disclaimer.
