Introduction

Loss of libido is a decrease or loss of sexual desire and interest in sexual fantasies. It can be distressful for many people experiencing it.

It can be a temporary issue that happens occasionally or can occur for longer and become permanent. It can affect individuals of any age or gender.

Why does this happen in people and what can one do about it? 

Understanding the factors contributing to losing libido is crucial for effectively addressing this issue.

Let's find out below. 

What is Low libido?

Low libido refers to a reduced interest in sexual activities or intimacy.

It's important to understand that there is no universal standard for a low or high sex drive, as these are subjective experiences. 

Some people may experience sexual desire almost every day while some may be desirous of sex only once a week or even a month.

These are all normal depending on the person experiencing it.

A change in libido becomes a concern if someone notices a sudden decrease in their usual level of sexual desire.

For instance, if a person who typically has daily sexual desire starts experiencing it only once a week, this shift is worrisome.

However, someone who has always felt sexual desire once a week would not find this unusual.

Signs of Low Libido in Men and Women

Here are some signs you can look for in men for low libido:

• Loss of interest in sex life: There is no longer any interest in sex life as there used to be earlier.
• Erectile dysfunction: Erectile dysfunction is one common sign of low libido which reduced testosterone levels can cause.
• Low sperm count: Infertility as a result of low sperm count can also be a sign of low libido.
• Loss of sexual fantasies: A decrease in imaginative or mental stimulation related to sex may indicate a decreased overall interest or desire for sexual activity.
• Muscle loss: Low libido can be associated with decreased testosterone levels, contributing to muscle loss. Testosterone is a hormone that plays a role in both sexual function and muscle maintenance. Therefore, decreased testosterone levels may lead to reduced libido and muscle loss. 

Some signs you can look for in women with low libido are:

• Loss of interest in sexual activities and initiating sex: A sudden loss of interest in sexual activities with no fantasies or thoughts about sex is indicative of low libido.
• Difficulty getting pleasure: Female libido is complex, and unlike men, women may sometimes not achieve orgasm through sexual intercourse even under normal conditions. However, experiencing difficulty in deriving pleasure even with genital stimulation can indicate low libido.
• Loss of sexual fantasies: Just like in men, loss of sexual fantasies or reduction in sexual thoughts can be signs of low libido in women.
• Absence of pleasure sensations: The absence of pleasurable feelings when genitals are stimulated is also indicative of low libido in women.

What Are the Causes of Loss of Libido in men?

The causes of low sex drive in men can be understood under two factors. They are :

Physical factors:

Many health conditions and lifestyle factors can greatly influence men's libido.

Sedentary lifestyle: Lack of physical activities and exercises with a poor diet can negatively affect your sex drive and overall health.

Certain medications and drug abuse: Antidepressants, high blood pressure medications such as diuretics, antipsychotic medications, and antiepileptic drugs can lead to a decrease in libido. Substance abuse such as alcoholism, smoking, and drug addictions can also decrease libido in men.

Hormonal imbalance: This happens when the body stops producing testosterone as much as it did earlier. As a result, there is a decrease in libido in men and a reduced ability to get and maintain erections.

Aging: Testosterone levels naturally decline with age, thus leading to a decrease in libido.

Illness: Health issues such as cardiovascular disease, obesity, neurological disorders, and diabetes can negatively affect libido.

Lack of sleep and fatigue: Lack of sleep or sleep disorders like sleep apnea, or chronic fatigue can impact sexual desire.

Psychological factors:

Relationship issues: Dissatisfaction, conflicts, communication gaps, and arguments can all lead to a loss of libido.

Mental health issues: Stress, anxiety, depression, mood disorders etc can have a profound impact on your sex drive. Most people suffering from mental health issues experience decreased libido.

Body image issues and performance anxiety: A negative body image can lead to low self-esteem and thereby low libido. When you are constantly concerned and worried about performance failure in bed, it affects your libido negatively.

Past trauma: A survivor of sexual abuse or a bad sexual experience usually suffers from loss of libido. 

What Are the Causes of Loss of Libido in Women?

Causes of loss of libido in women can be categorised into physical factors and psychological factors.

Physical factors

Just like men, there are many physical health issues responsible for the loss of libido in women. They are:

Hormone issues: Women's hormones fluctuate often due to conditions such as periods, menopause, pregnancy, breastfeeding, etc. All these can lead to decreased sex drive.

Fatigue: Insufficient sleep due to childcare, exhaustion due to work and household responsibilities, etc can lower sex drive in women.

Medications and substance abuse: Antidepressants, high blood pressure medications such as diuretics, antipsychotic medications, hormonal contraceptives etc can diminish libido. Substance abuse such as alcoholism, smoking, and drug addictions can also decrease libido in women.

Health issues: Health issues including diabetes, thyroid disorders, chronic pain, and hormonal imbalances can impact libido.

Psychological factors

Psychological factors responsible for loss of libido in women involve:

Negative body image: Negative body image can wreak havoc on confidence and self-esteem, fueling self-hatred and ultimately leading to a decline in libido.

Toxic relationships: Fights, unresolved conflicts, or absence of emotional intimacy between partners can decrease libido.

Trauma: Past experiences of sexual abuse or trauma may lead to sexual pain disorders, such as dyspareunia (pain during intercourse) or vaginismus (involuntary vaginal muscle spasms), and can make a person avoid sexual activity, causing a loss in libido.

Mental health issues: Anxiety, depression, and mental health issues can kill intimacy and remove the desire for sexual activity. Stress and hypertension can disrupt hormonal balances in the body, making a person incapable of sexual arousal.

Diagnosis

To regain your libido, the first step is to visit your doctor to identify the causes behind your low sex drive.

There are some common procedures you can expect your doctor to conduct to diagnose the underlying cause.

Your doctor will take your medical history, relationship status, sex history, and ongoing medications, if any.

If they suspect any physical reason, further tests and examinations such as physical examination and blood tests like hormonal level tests will be conducted to first rule out any physical issues. 

After this, if no issues are found physically, you will be referred to a counsellor, a sex therapist, or a psychologist so that mental health is addressed.

Treatments

Treatment depends on the kind of causes affecting the libido.

Here are some treatment options:

• Hormone therapy to address hormonal imbalances.
• Medications to treat underlying conditions like depression or anxiety.
• Testosterone replacement for men with low testosterone levels.
• Counseling or therapy to address psychological factors such as stress or relationship issues.
• Lifestyle changes include regular exercise, a healthy diet, and stress management techniques.
• Communication and intimacy-building exercises, often through couples or sex therapy.

When to See a Doctor?

There is no ideal level of libido that applies universally to a healthy sex drive. As mentioned before, it's subjective.

Only a person can understand and know about the changes they are experiencing.

If someone feels their low libido is affecting their relationship and they want to improve it, they may make an appointment with a doctor to find the best ways to increase libido.

For those who notice a drop in sexual desires and fantasies about sex, and feel their quality of life and well-being are affected by low sex drive, consulting a doctor can help identify the cause and find an effective way to bring back the desired libido.

Conclusion

Low libido in men and women can stem from a variety of factors, including hormonal changes, psychological issues, medical conditions, medications, lifestyle factors, relationship issues, and body image concerns. 

While fluctuations in sexual desire are normal and can be influenced by various factors, persistent concerns should not be ignored. 

Seeking medical advice, communicating openly with the partner, and exploring treatment options can help restore sexual satisfaction and improve overall well-being. 

Remember, you're not alone, and there are resources and professionals available to support you on your journey toward a fulfilling and satisfying sex life.

FAQs

What is a normal libido?

Libido varies from person to person and is subjective. Some have high sex drive, others low; both are normal. It's concerning only if low libido deviates from the usual level. Fluctuations with age and time are normal. Many factors influence libido. Unless it significantly impacts one’s daily life, don't stress about its normalcy.

Why is my wife's libido so low?

Hormonal imbalances caused by thyroid conditions, pregnancy, breastfeeding, menopause, or taking certain medications such as hormonal contraceptives etc can lead to low libido in women. Other medical conditions such as endometriosis, diabetes, and other chronic diseases can be the causes of low libido in women.

What lifestyle factors can affect libido?

Lifestyle factors such as stress, lack of sleep, poor diet, sedentary lifestyle, excessive alcohol consumption, and drug use can contribute to low libido.

Which doctor to consult for low libido in females?

Females worried about libido can start by discussing it with a gynaecologist, especially if there is suspicion of issues like PCOS or endometriosis. Gynaecologists can also help assess your hormone levels. If physical factors are ruled out, consider seeing an endocrinologist to check for conditions like thyroid disorders or diabetes that may affect libido. 

If no physical issues are found, a sex therapist can help address any underlying psychological factors contributing to low libido.

How can I talk to my partner about low libido?

It's essential to approach the conversation with empathy, honesty, and openness. Choose a time when you both feel relaxed and comfortable and express your concerns without placing blame. 

Encourage your partner to share their perspective and feelings, and work together to find solutions that support your needs and desires.

References

• Cleveland Clinic. Low Libido (Low Sex Drive) https://my.clevelandclinic.org/health/diseases/15216-low-libido-low-sex-drive. (Accessed on 29/03/2024)
  
• HealthGains, Low Libido in Men due to Hormonal Imbalance (2021). HealthGains. https://healthgains.com/hormones-for-men/low-libido/. (Accessed on 29/03/2014)
• Everyday Health, Upham Becky (2023). Can Acupuncture Help Boost Your Sex Drive and Pleasure? (2023) https://www.everydayhealth.com/sexual-health/acupuncture-help-improve-sexual-health/#:~:text=Acupuncture%20is%20one%20of%20the,can%20make%20sex%20less%20pleasurable (Accessed on 30/03/2024)
• Meyers M, Margraf J, Velten J. Psychological Treatment of Low Sexual Desire in Women: Protocol for a Randomized, Waitlist-Controlled Trial of Internet-Based Cognitive Behavioral and Mindfulness-Based Treatments. JMIR Res Protoc. 2020 Sep 29;9(9):e20326
• Metromale Clinic and Fertility Center. Low Libido – Meaning, Symptoms, Causes and Treatment. https://metromaleclinic.com/low-libido-meaning-symptoms-causes-and-treatment/ (Accessed on 04/04/2024)
• Healthline, (2020) Low Sex Drive in Women: Symptoms, Diagnosis, and Treatment (2020) https://www.healthline.com/health/treating-hsdd/symptoms-diagnosis-treatment. (Accessed on 04/04/2024)