Loss of libido

Loss of libido (sex drive) is a common problem. Up to 1 in 5 men will have it at some point in their life, and even more women. It's often linked to stress at work or at home, or to big events in life such as pregnancy, childbirth or breastfeeding.

But a loss of libido that comes without any obvious reason can point to an underlying personal, medical or lifestyle problem, especially if it lasts a long time or keeps coming back. That can be upsetting for both partners in a relationship.

If you're worried about your libido, particularly if your lower sex drive distresses you or affects your relationship, make an appointment to see a doctor. You can talk through the possible causes and the medical or psychological treatments that might help. Doctors at your nearest family planning clinic, Integrated Sexual Health clinic, or Contraceptive and Sexual Health (CASH) clinic may also be able to help.

In the meantime, the information below may be useful. It explains some of the most common reasons for loss of libido.

Start by asking yourself if you're happy in your relationship. Do you have doubts or worries that might be the real reason you've lost your sexual desire?

If you've been with your partner for a long time, you may have grown too familiar with them and feel a degree of erotic dissatisfaction. This is quite common, and it can lower your sex drive.

Relationship problems are among the most common causes of loss of libido.

Another thing to think about is a performance problem that makes sex difficult or unfulfilling. Many men have ejaculation problems or erectile dysfunction, for example, and women can have painful sex or vaginismus (when the muscles around the vagina tighten involuntarily before penetration). See your doctor if these problems affect you, because they're often treatable.

Your doctor may feel you will benefit from psychosexual counselling. This is a form of relationship therapy where you and your partner can talk about any sexual or emotional issues that may be adding to your loss of libido.

Stress, anxiety and exhaustion can take over your whole life, and they can badly affect your happiness. If you feel tired, stressed or anxious all the time, you may need to change some things in your daily life, or talk to your doctor for advice.

For more information and advice, read about beating stress at work and 10 stress busters.

Depression is very different from feeling unhappy, miserable or fed up for a short while. It's a serious illness, and the sadness can be extreme and last a long time. It can get bad enough to interfere with your daily life, including your sex life.

You're probably depressed if you feel low or hopeless, or if you've lost interest or pleasure in things you used to enjoy. If that sounds like you, it's really important to see your doctor. They may feel you'll benefit from antidepressants.

But low sex drive can also be a side effect of many antidepressants. If you're already taking antidepressants and think they may be causing your problems, speak to your doctor. You may be able to switch to a different medicine.

Drinking too much alcohol can reduce your sex drive. It's a good idea to keep your intake to no more than three to four units a day if you're a man, and no more than two to three units a day if you're a woman.

You can read more about alcohol misuse, and about how to get support for a drinking problem.

Drug misuse is also linked to a loss of libido. You can read more about drugs for information and advice.

Many people lose some interest in sex as they get older. The main reasons are falling levels of sex hormones, health problems that come with age, or the side effects of medicine.

Older men especially can develop low testosterone levels, and this can cause fatigue, depression and a reduced sex drive. If this worries you, speak to your doctor. They may do a blood test to check your testosterone level, and they can tell you about treatments if it's low.

As women approach the menopause, levels of the female hormone oestrogen begin to fall, and this can affect libido. Women can also have low testosterone levels, especially after a hysterectomy. Testosterone is another hormone that can affect sex drive.

If you're concerned that the menopause may be affecting your libido, speak to your doctor. They may be able to offer you a trial of hormone replacement therapy (HRT) if it's suitable for you.

Less often, a low sex drive is caused by an underactive thyroid. This means your thyroid gland, which sits in your neck, isn't making enough hormones. The common signs of an underactive thyroid are tiredness, weight gain and feeling depressed.

An underactive thyroid is easy to treat. You take hormone tablets that replace the hormones your thyroid isn't making.

Another hormonal problem, called hyperprolactinaemia, can also have a negative effect on your sex drive. Here, the level of a substance called prolactin in your blood is raised.

Some women have reported a lower sex drive while using certain types of hormonal contraception, such as:

• combined contraception, including the combined pill, vaginal ring, or contraceptive patch
• the progestogen-only pill
• the contraceptive implant
• the Depo-Provera injection

But side effects of these contraceptives tend to improve within a few months, and they're generally well tolerated.

If you're worried that your contraception is causing a loss of libido, speak to your doctor or a family planning clinic. They may suggest trying an alternative method.

Long-term (chronic) conditions such as cardiovascular disease, diabetes and obesity can also lower your libido.

Loss of libido can sometimes be caused by certain medicines, such as:

• medicine for high blood pressure, including diuretics
• medicines for depression, including SSRI antidepressants
• medicines for seizures (fits)
• medicines commonly used to treat psychosis (a mental condition where a person can't distinguish between reality and their imagination), such as haloperidol, as well as many other conditions
• medicines such as cimetidine, finasteride and cyproterone, which block the effects or reduce the production of testosterone

See your doctor if you're worried that a medicine you're taking is responsible for your reduced sex drive. They can review your medicines and, if necessary, switch your prescription to something less likely to affect your libido.