A drop in sex drive is one of the most common health concerns people have, and one of the least talked about. Libido naturally rises and falls over time, but a lasting change that bothers you is worth looking into. In many cases, there is an identifiable cause, and it can be treated.
Hormonal causes
Hormones play a central role in desire for both men and women.
- Low testosterone: Testosterone gradually declines with age in men, and low levels can reduce desire along with energy, mood and muscle mass. Women also make testosterone, and lower levels may play a role for some.
- Menopause and perimenopause: Falling estrogen can cause vaginal dryness and discomfort, which can make sex less appealing, along with sleep and mood changes.
- Pregnancy, postpartum and breastfeeding: Hormone shifts, exhaustion and body changes commonly lower desire for a period of time.
- Thyroid problems: An underactive thyroid can lower energy and libido.
Medical conditions
Chronic health conditions often affect sex drive, either directly or through fatigue and pain. Common examples include diabetes, heart disease, high blood pressure, obesity, chronic pain and sleep apnea. In men, erectile difficulties can also lead to lower desire over time because of the stress they create.
Medications
Many common prescriptions can lower libido as a side effect, including:
- Certain antidepressants, especially SSRIs and SNRIs
- Some blood pressure medications
- Hormonal birth control in some women
- Opioid pain medications
- Some medications for hair loss or prostate enlargement
Never stop a prescription on your own. If you suspect a medication is affecting your libido, talk with your prescriber. There are often alternatives.
Mental and emotional health
Depression, anxiety and ongoing stress are among the most common causes of low desire. Body image concerns and past negative experiences can also play a part.
Relationship factors
Conflict, poor communication, unresolved resentment or simple routine can dampen desire. Counseling, alone or together, can help.
Lifestyle factors
Everyday habits matter more than many people realize:
- Not getting enough sleep
- Heavy alcohol use
- Smoking or recreational drug use
- Too little physical activity, or extreme overtraining
- Burnout from work or caregiving
When to see a provider
Consider an evaluation if low libido has lasted several months, is causing you or your partner distress, or comes with other symptoms such as fatigue, mood changes, erectile difficulties or pain during sex. A provider can review your health history, medications and symptoms and, when appropriate, order lab work to check hormone levels.
Treatment options
Treatment depends on the cause. It may include adjusting medications, addressing sleep or stress, treating an underlying condition, testosterone therapy for men with confirmed low levels, or prescription options. For example, PT-141 (bremelanotide) works on desire pathways in the brain, and medications such as sildenafil (Viagra) and tadalafil (Cialis) help with erectile function.
Support at Rune Vitality
Our sexual wellness and men’s health services offer private, judgment-free care for men and women, in person in San Marcos or by telehealth anywhere in California. It starts with a free 15-minute consultation.
Request your free consultation or text us at (760) 539-9332.
This article is for general education and is not a substitute for personal medical advice. Talk with a qualified healthcare provider about your symptoms.