What low desire is, and what it is not
Low sexual desire, or low libido, means feeling less interest in sex than you used to. The Cleveland Clinic describes it as wanting sex less often or less strongly, thinking about sex less, and sometimes feeling upset or worried about the change. It notes that low libido can be short-term or last a while, and that it affects up to 1 in 5 men, and even more women, at some point in life.
There is no correct amount of desire to measure yourself against. The Mayo Clinic puts it plainly: "There is no magic number to define low sex drive. It varies." The International Society for Sexual Medicine (ISSM) adds that desire often rises and falls over a lifetime, and that periods of low desire are not unusual.
This article is about one person's desire and what may be lowering it. If the main problem is a gap between you and a partner, Mismatched Desire looks at that dynamic.
Physical causes
Desire depends on the body as well as the mind. The NHS lists several common physical contributors:
- Hormone changes, including those that come with pregnancy, having a baby and menopause
- Some medicines, such as those for high blood pressure and antidepressants
- Hormonal contraception, such as the pill, patch or implant
- Other sexual problems, such as erectile dysfunction or vaginal dryness
- Drinking too much alcohol
- Long-term conditions such as heart disease, diabetes, an underactive thyroid or cancer
The ISSM notes that in men, lower testosterone, often associated with aging, can reduce desire, and the Cleveland Clinic adds chronic pain to the list of health conditions that can affect it. The Mayo Clinic points out a quieter factor that many people overlook: exhaustion. Caring for young children or aging parents, or recovering from illness or surgery, can drain the energy that desire needs.
Pain deserves a special mention. When sex hurts, the body learns to expect discomfort, and interest can fade as a form of protection. Pain is a reason to see a physician or gynecologist, not something to push through. Pain During Sex covers it in more detail.
Emotional and psychological causes
The ISSM describes stress, anxiety and depression as among the leading causes of low libido, and notes that past trauma or negative sexual experiences can create psychological barriers to desire. The Mayo Clinic also lists poor body image, low self-esteem and a history of physical, emotional or sexual abuse.
These causes are often less visible than a medication change. Someone may feel fine at work and with friends, yet notice that the part of them that once wanted sex has gone quiet. Common emotional threads include:
- Chronic stress that leaves no room for pleasure or play
- Low mood, where little feels rewarding, sex included
- Anxiety that keeps the mind busy and the body on guard
- Feeling self-conscious or unattractive in your own body
- Old messages about sex being shameful, dangerous or a duty
- Memories of experiences that were unwanted or frightening
Depression and anxiety are big enough topics to have their own article: How Depression, Anxiety, and Stress Affect Sexual Desire.
Relationship causes
For many people, desire is closely tied to how they feel about their partner and the relationship. The ISSM names communication problems, unresolved conflict and a lack of emotional intimacy as factors that can create distance and lower desire. The Mayo Clinic adds trust issues, poor communication about sexual needs, worry about a partner's ability to have sex, and simply not having enough privacy.
Resentment is a common example. If you feel unheard in daily life, or carry more of the household load than seems fair, sexual interest can be one of the first things to go. That does not mean the low desire is "really" about the relationship, or that anyone is to blame. It means the relationship is one of the places worth looking.
When low desire becomes a concern
Lower desire is not automatically a problem. What tends to matter is whether it bothers you. Planned Parenthood describes hypoactive sexual desire disorder (HSDD) as having little or no interest in sex and being bothered by it, and calls it one of the most common sexual problems people have. The Mayo Clinic notes that you do not have to meet any medical definition to seek help if low desire troubles you.
Only a clinician can assess whether a diagnosis applies. For most people, the more useful questions are personal: When did this start? Did anything change around then? Is it with one partner, or in general? Does it feel like a loss, or more like a relief?
Where to start
Because physical and emotional causes so often overlap, a good first step is a visit with your physician or gynecologist, or a urologist where that fits. The NHS suggests seeing a doctor if you are worried about your sex drive, if you think a medicine or contraception may be affecting it, or if it has not returned after pregnancy. The Mayo Clinic notes that the answer is sometimes as simple as adjusting a medicine or getting a condition like diabetes or high blood pressure under better control.
If you suspect a medication, do not stop or change it on your own. Talk with the prescriber, who can weigh the options with you.
Where therapy can fit
Psychotherapy cannot treat a hormone problem or a medication side effect, but it can help with what surrounds them: stress, low mood, shame, grief over a changed body, the after-effects of past experiences, and the patterns in a relationship that make desire harder to reach. It also gives you a private place to sort out what you want, rather than what you feel you should want.
Dr. Lehmann, a licensed clinical psychologist in Franklin, Michigan, offers therapy for intimacy and sexual concerns as part of individual or couples work. Ask her which format fits your situation when you call. Therapy works alongside medical care, not in place of it.