Low libido in one or both partners is one of the most common relationship issues — affecting roughly 30% of women and 15% of men in any given year. Common causes include hormonal changes (testosterone decline, perimenopause), medications (especially SSRIs and hormonal contraception), depression or anxiety, chronic stress, sleep deprivation, and unresolved relationship issues. Most low libido is treatable when the right cause is identified.
Low Libido Is Not the Same as No Sexual Interest
Low libido — sometimes called hypoactive sexual desire disorder (HSDD) when persistent and distressing — affects roughly 30% of women and 15% of men in any given year (Kinsey Institute 2024 review). It's the most common sexual issue couples face.
It's important to distinguish low libido from related but different states:
- Asexuality: A sexual orientation where someone doesn't experience sexual attraction. Different from a libido drop.
- Mismatched libido: One partner has higher desire than the other; both may have "normal" levels but mismatched. See our mismatched libidos guide.
- Responsive desire: Desire that follows arousal rather than precedes it. Often misinterpreted as low libido.
- Situational low desire: Low desire only with a specific partner — usually relational, not biological.
- Generalized low libido: Low desire across all contexts — usually has a biological component.
The treatment depends on which pattern is happening.
The Hormonal Causes
Testosterone
Testosterone drives spontaneous sexual desire in both men and women (men have 8-10x more, but women's smaller amount is also functional). Testosterone declines roughly 1% per year after age 30 in men, and drops sharply in perimenopausal and menopausal women.
Symptoms of low testosterone: reduced sexual desire, low energy, depression, reduced muscle mass, sleep issues. Testable through a simple blood test. Treatable through testosterone replacement therapy (with proper monitoring), lifestyle changes, or addressing underlying causes.
Estrogen and progesterone (women)
Both fluctuate dramatically through the menstrual cycle, postpartum period, and perimenopause. Low estrogen causes vaginal dryness, painful sex, and reduced desire. Low progesterone affects sleep and mood, indirectly affecting libido.
Thyroid
Both hyper- and hypothyroidism affect libido. Easy to test, easy to treat.
Cortisol
Chronic stress elevates cortisol, which suppresses testosterone production and reduces sexual desire. The body interprets chronic stress as "not a good time to reproduce."
The Medication Causes
Many common medications affect libido:
- SSRIs and SNRIs (antidepressants): Reduce libido in ~50% of users and delay or block orgasm in ~70%. Specific SSRIs differ; switching can help.
- Hormonal birth control: Reduces libido in ~30% of women. Different formulations affect different women differently.
- Beta blockers and other blood pressure medications: Often reduce libido and erectile function.
- Opioids: Reduce testosterone significantly with prolonged use.
- Statins: Some reduce libido modestly.
- Antihistamines: Can reduce vaginal lubrication.
Always discuss with the prescribing physician before changing or stopping. Often there are alternatives.
Mental Health Causes
- Depression: Reduces libido in ~70% of cases — both directly and through antidepressant side effects.
- Anxiety: Performance anxiety can suppress arousal; chronic anxiety raises cortisol.
- Trauma history: Can create body-level responses that interfere with sexual response.
- Body image issues: Reduce sexual confidence and presence.
- ADHD: Affects sexual presence (distraction during sex) and medication side effects.
Treating the underlying condition almost always restores some libido.
Lifestyle Causes
- Sleep deprivation: Below 6 hours/night reduces testosterone in both genders.
- Alcohol: More than 2 drinks reduces sexual response. Chronic heavy drinking reduces baseline testosterone.
- Exercise: Both extremes hurt libido — sedentary lifestyle reduces it; over-training (extreme endurance) reduces it.
- Diet: Severe caloric restriction reduces testosterone.
- Smoking: Reduces blood flow to sexual organs.
- Phone use, especially at bedtime: Reduces sleep quality and partner connection.
Relationship Causes
If low libido is situational (only with this partner, not with sexual thoughts in general), the cause is usually relational, not biological. Common patterns:
- Unresolved resentment or contempt
- Mental load imbalance (the partner carrying more household labor often has lower desire)
- Drift into parent-child dynamic with the partner
- Specific betrayal or trust rupture not yet processed
- Boredom or lost novelty
- Communication breakdown
For these, biological treatments don't help. The relationship work does.
What to Do First
Step 1: Distinguish situational vs generalized
Ask: do I experience sexual interest in any context (sexual thoughts, attraction to others, masturbation), but not with my partner? Or do I experience no sexual interest in any context? Situational suggests relational causes; generalized suggests biological/medical.
Step 2: Get a medical workup
For both situational and generalized, rule out: testosterone (men), estrogen/thyroid (women), medication side effects, sleep apnea, depression, anxiety. Many cases resolve at this step.
Step 3: Address lifestyle
Sleep, alcohol, exercise, smoking, mental load — the lifestyle factors compound. Improvements usually take 4-8 weeks to show in libido.
Step 4: Address relationship issues
If situational, the relationship work is essential. Communication, resolving resentment, addressing mental load imbalance, sometimes couples therapy.
Step 5: Consider sex therapy
An AASECT-certified sex therapist (find one at aasect.org) is specifically trained for low libido cases. Often the difference between progress and stuck.
Frequently Asked Questions
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What causes low libido in a relationship?
Common causes: hormonal changes (testosterone decline, perimenopause/menopause), medications (especially SSRIs and hormonal contraception), depression or anxiety, chronic stress, sleep deprivation, and unresolved relationship issues. Most cases have multiple contributing factors. The first step is a medical workup to rule out the biological causes.
Is low libido a sign my relationship is failing?
Not necessarily. Low libido is often biological (hormonal, medication, mental health) and can occur in healthy relationships. However, situational low libido (only with this partner, not in general) usually indicates a relational issue worth addressing — typically resentment, mental load imbalance, or unresolved conflict.
How do I increase my libido naturally?
Address the lifestyle factors first: prioritize sleep (7+ hours), limit alcohol, exercise moderately (not excessively), reduce chronic stress, address mental load imbalance, treat depression or anxiety if present, reduce phone use at night. Lifestyle improvements usually take 4-8 weeks to show in libido.
Can SSRIs cause low libido?
Yes — SSRIs reduce libido in roughly 50% of users and delay or block orgasm in roughly 70%. Different SSRIs affect different people differently; switching is sometimes effective. Bupropion (Wellbutrin) is a notable exception that doesn't typically reduce libido. Always discuss with the prescribing physician before changing.
What is the difference between low libido and asexuality?
Asexuality is a sexual orientation — someone who doesn't experience sexual attraction to others, often as a stable lifelong pattern. Low libido is a state, often temporary or treatable, where someone normally would experience sexual interest but currently isn't. The two are different. If someone identifies as asexual, that's their orientation, not a problem to be fixed.
Should I see a doctor about low libido?
Yes — especially if low libido is generalized (across all contexts), recent (started in the last year or so), or persistent (lasted 6+ months). A workup should include thyroid, hormone levels (testosterone, estrogen as appropriate), medication review, depression/anxiety screening, and sleep evaluation. Many cases resolve once the underlying cause is identified.
Related Reading
- Mismatched Libidos
- Sexless Marriage Guide
- Dead Bedroom Fixes
- Mental Health & Relationships Statistics
- Relationship Investments That Last
Last updated: April 27, 2026. This article is reviewed by Kayla Crane, LMFT. The information above is for educational purposes and not a substitute for medical advice or licensed therapy.