Low Libido – Symptoms and Treatment

Libido is a term that describes sex drive or interest in sexual activity. There is no single standard to assess what a healthy libido is. It varies from one person to another and from one life stage to another. For example, libido typically declines with progressing age so older people may not have the same libido they used to have when they were younger. Libido is regulated by different biological and psychological factors. Physiological factors such as neurotransmitters and hormones play a role in regulating libido. Libido is also affected by psychological stress and mental health problems. Both mind and body are important for a healthy libido and sex life.

What Is Low Libido?

When one’s libido decreases and causes significant distress, it can be a cause for concern. Low libido can refer to a decrease in the frequency or intensity of sexual desire. It is a common condition affecting 20% of men but it is much more prevalent in women. It can be temporary but it can also be a long-term sexual health problem. Low libido can impact one’s mental health and lead to relationship issues.

Symptoms of Low Libido

Symptoms of low libido include:

To diagnose low libido, doctors ask patients about their medical history, sexual history, and sexual relationships. They try to identify any biological clues to possible health conditions that could be causing a decline in their libido. They also check the patient’s mental health and any recent exposure to high stress or sexual trauma which could be affecting their sex drive.

Common Causes of Low Libido

Low Sex Drive in Men

In men, decreased libido is associated with low levels of testosterone or medical conditions related to sexual dysfunction. Male hypogonadism is a medical condition characterized by low testosterone levels because the testicles do not produce and secrete sufficient testosterone which reduces sex drive and impairs sexual function. This can also be linked to brain disease where hormone regulation is irregular.

Men with obstructive sleep apnea (OSA) frequently experience (1) a decrease in their libido. Sexual dysfunction in men can entail erectile dysfunction (ED) or premature ejaculation. While drugs like Viagra can help some men with ED, they are not always effective. These sexual problems make patients feel anxious and stressed about sexual activity so they become too self-conscious about the idea of having sex and avoid it instead, therefore leading to low libido. Libido also decreases with age as a result of low testosterone hormone levels.

Low Sex Drive in Women

In women, low libido is a symptom of various sexual dysfunction conditions. Low libido is the main symptom of hypoactive sexual desire disorder (HSDD) which is defined by a loss of interest in sexual activity for at least 6 months. This can be triggered by low androgen levels (2) in the blood stream. Sometimes physical conditions such as vaginismus (abnormal vaginal contraction in fear of penetration) or vaginal dryness are often accompanied by low self-esteem which can lead to reduced interest in sexual activity and lack of sexual desire.

Aging also affects libido in women. As a woman ages, her sex hormones gradually decline. Menopause is characterized by a drastic decrease in sex hormones especially estrogen so it is typically associated with sexual dysfunction. Perimenopausal and menopausal women are more likely to experience a drop in sex drive due to the reduced levels of estrogen. Postmenopausal women report (3) that fatigue, body image issues, and vaginal symptoms also contribute to their low libido. During the postmenopausal period, blood tests show that women experience a drastic drop in estrogen levels. Without estrogen, vaginal lubrication and overall libido decrease.

Some chronic illnesses can also negatively affect libido due to the impact on brain chemistry and sex drive. Such conditions include chronic pain, diabetes (4), hypertension, heart disease, chronic kidney disease, cancer, depression, and anxiety disorders.

Some medications also actively suppress libido. Antidepressants like SSRIs are one of the most common iatrogenic (drug-induced) causes of low libido. In fact, some patients experience long-term low libido even after stopping SSRIs (5) – this is a disorder called post-SSRI sexual dysfunction (PSSD). Side effects of hormonal contraceptive drugs like the combined pill also include low libido. Other drugs including high blood pressure medications and chemotherapeutic agents can curb sex drive as well. When patients identify specific medications as the cause of their low libido, they should consult their healthcare provider for appropriate alternative drugs.

Psychological issues like high stress, relationship problems, and sexual abuse are also associated with low libido. People with a history of sexual abuse becomes extremely distressed at the idea of being sexually active due to the negative memories associated with their trauma.

Treatment Options for Low Libido

Treatment for low libido is tailored to each patient based on the underlying cause of their reduced sex drive. For example, if a specific medication is responsible for their libido problems, they can contact their healthcare professional to request an alternative medication. Restoring libido is possible through different treatment options including psychological counselling, hormone supplements, or lifestyle changes.

Psychological counselling, especially couples therapy, can help patients manage their sex-related anxiety more effectively. Sex therapy is particularly helpful for patients who struggle with arousal. Sex therapists create a safe and relaxed environment for patients to openly discuss their sexual problems. They help them adjust their lifestyle, manage stress, and build more meaningful bonds with their partners.

Men can be eligible to receive testosterone replacement therapy while women may undergo hormone replacement therapy (HRT) to amplify their estrogen levels. These supplements restore the sex hormone levels needed to stimulate sexual desire.

Lifestyle changes towards a healthier body and mind contributes to a better sex life. Reducing consumption of tobacco and alcohol can benefit people experiencing loss of libido. A study (6) found that smoking is a risk factor for decreased libido in middle-aged to elderly men. Exercise and meditation are drug-free tools to manage stress better and restore sex drive.