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26th July, 20219 min read

What are the medical causes of low libido?

Medical reviewer:Dr Adiele Hoffman
Author:Alex Bussey
Last reviewed: 24/06/2021
Medically reviewed

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Losing your libido – or sex drive – can be difficult, especially if it happens suddenly or goes on for a long time. You may find that losing your desire for sex puts pressure on your personal relationships and affects your self-esteem and sense of wellbeing – which may make you feel unhappy.

Many people think that low (or reduced) sex drive usually happens as we age, and it’s true that getting older may change the hormone levels in your body, triggering a natural decrease in your libido.

But your sex drive can change at any time and you may have a low libido due to many different causes, including medical problems and mental and emotional (psychological) issues that may affect you at any age.

Relationship problems, a low self-esteem and work-related stress may all affect your sex drive, as can smoking, drinking too much alcohol or gaining weight over a short period of time.

A lot of medical conditions, including diabetes, cancer, cirrhosis of the liver, heart disease, depression and hormonal imbalances are also known to reduce your libido. Then there are medicines like birth control pills and antidepressants that can also affect it.

Find out more about the main medical causes of a low sex drive, your treatment options and when to get help from a doctor.

What are the common medical causes of low libido?

The menopause

The menopause is a natural part of the ageing process that happens when your periods stop and you’re unable to get pregnant naturally. It changes the balance of hormones in your body like oestrogen and progesterone, and often causes symptoms like hot flushes, fatigue or anxiety.

The menopause can also cause a decrease in sexual desire, and studies show that up to 40% of people with a vagina report loss of libido while going through the menopause. Doctors can’t be sure if this loss of libido is directly linked to the changes in oestrogen and other hormones in your body during the menopause, or if it’s a side effect of menopause symptoms like fatigue or anxiety.

The menopause can make your vagina dry and irritated too, which may make sex less enjoyable and, in turn, lower your desire to have sex.

If you think you may be going through the menopause and that this is lowering your libido, see a doctor for advice. They may recommend hormone replacement therapy (HRT) to help relieve the symptoms and boost your sex drive too.

Read more about sex after the menopause.

Low testosterone

Testosterone is a hormone that’s closely linked to sexual arousal in both people with a vagina and a penis. Some studies have shown a possible link between low levels of testosterone and low sex drive, especially in men aged 40 to 79.

Your testosterone levels gradually go down as you age, which may explain why low libido seems to be more common in older people. But testosterone levels can also drop if you have a condition like hypogonadism, where your testicles or ovaries stop working properly.

Hypogonadism can be caused by an underlying medical condition like Klinefelter's syndrome or Turner syndrome. It can also develop after you’ve had mumps or an autoimmune condition like Addison’s disease.

Your testosterone levels can also be affected by weight gain, injury to your testicles, infection and certain cancer treatments.

See a doctor if you think you may have low testosterone levels, as they can be treated with testosterone replacement therapy. You may also be able to relieve some of the symptoms – including low libido – by making changes to your diet or lifestyle.

Hormonal contraceptives

Hormonal contraceptives like the combined pill, the patch or the contraceptive implant change the normal balance of hormones in your body. Because hormones like oestrogen are responsible for controlling your sexual function, you may find that using hormonal contraceptives lowers your sex drive.

If you’re taking a hormonal contraceptive and you notice a change in your libido, you should speak to a doctor. They may be able to help you switch to a different type of contraception or give you advice on how to cope with the change.

Read more about the different types of contraception that you can choose from.

Other medications

Certain prescription medicines may cause a low libido. They include:

Some of these medicines may reduce blood flow to your genitals, which makes it hard to keep an erection and may lower your interest in sex. Others may change your brain chemistry, which may lower the level of testosterone in your body and cause a drop in your sex drive.

A doctor may be able to change your medication and give you something that doesn't affect your libido. But don’t stop taking any medication before speaking to a doctor about it because doing so could put your health at risk.

Type 2 diabetes

Sexual problems, like having a low libido, not being able to get and keep an erection (erectile dysfunction) or not being able to have an orgasm, can be a complication of type 2 diabetes.

And because type 2 diabetes damages your blood vessels and can reduce blood flow to your genitals, it can make sex difficult or painful. It also affects the balance of hormones in your body, which may prevent you from getting sexually aroused or decrease your libido by affecting the release of testosterone in your brain.

But you help your sex drive by managing your diabetes well. This may mean adjusting your diet and lifestyle and/or taking medication. A doctor may suggest a medication that helps to tackle sexual dysfunction directly, particularly if your low libido is because of erectile dysfunction.

Read more about tips for a healthy, balanced diet and how to lose weight safely.

Depression and anxiety

If you have depression, anxiety or other mental health disorders, you may find you have a low libido too. The exact reasons for this aren’t understood as yet, but if you have depression, you may find that you often feel tired or hopeless and don’t have any energy, which may make you want sex less.
Some depression medications may also affect libido.

If you think you may have a serious mental health issue, see a doctor as soon as you can, as they can help you treat the underlying condition with medication and therapy.

Read more about how self-care can help manage depression.

Heart disease and other long-term illnesses

Long-term (chronic) diseases like heart disease, arthritis and cancer can put a lot of strain on your body, lowering your energy levels and leaving you feeling really tired. According to the American Association of Sexuality Educators, Counselors and Therapists (AASECT), the high levels of fatigue caused by chronic illness often cause a low sex drive.

Some long term diseases can affect how your nerves or blood vessels function and may cause pain that makes sex difficult. Certain medications – including some cancer treatments and heart disease medications – may also lower your libido.

If you have an ongoing illness and notice a drop in your libido, see a doctor. They may be able to help you deal with any symptoms by treating the condition and recommending other therapies that may help to increase your sex drive. They can also help you find a counselling service to help you work through this difficult time.

Read more about how to manage mental health issues when you have a chronic illness.

Sexual problems

Erectile dysfunction, premature ejaculation, vaginal dryness and pain during sex can all lower your sex drive. This is because sex may become difficult or stressful over time as you try and cope with these sexual problems, which, in turn, may reduce your libido.

Don’t be embarrassed to speak to a doctor if you’re having sexual problems. They may be able to help you treat the underlying cause and provide support and advice on how to cope with sexual dysfunction.

Find out about exercises that may help with premature ejaculation.

Other hormonal problems

It’s less common, but sometimes, an underactive thyroid (hypothyroidism) can cause low libido.

Common signs are tiredness, weight gain and feeling depressed, but studies suggest that low sex drive may be a common symptom too.

If you think you may have this hormonal disorder or are worried about any other hormonal problems, see a doctor. An underactive thyroid can usually be treated by taking hormone tablets to replace the hormones your thyroid isn't making.

When to see a doctor about low libido

Everyone’s sex drive is different. Some people simply want more (or less) sex than others, and there’s no such thing as a ‘normal’ libido. It's normal to lose interest in sex for short periods of time, particularly if you’re feeling stressed, overworked or anxious.

But you should see a doctor if:

  • you think your libido may have dropped because of a medical condition
  • you notice a sudden decrease in your libido
  • your libido has been lower than normal for a long time
  • your low sex drive is negatively affecting your relationship(s)
  • your loss of libido is lowering your self-esteem or affecting your general sense of wellbeing

In many cases, low libido is caused by a psychological issue like stress, low self-esteem or a lack of connection between partners. But, as it can be a symptom of some serious medical conditions, it’s worth ruling out these issues with a doctor’s help before you start looking into the mental and emotional causes of low libido.

There are some things you can do to manage a low libido on your own, including making healthy changes to your diet and lifestyle, or trying therapy. But you should always seek medical advice first.

Discover how to increase your sex drive naturally.

Your health questions answered

  • How can I support my partner with low libido?

    A low libido or loss of sex drive can be a difficult thing to deal with in a relationship and there are many things that can cause it. If your partner has a low libido, try talking openly with them about what they feel may be causing it. Talking to a doctor together can also help – a doctor can help find out what the cause is and offer advice for treatment options, including relationship counselling if it’s needed. Read more about how to talk about sex with your partner and how to support your partner if they’re going through the menopause.

  • Can a vasectomy cause low libido?

    There’s no evidence to suggest that a vasectomy will affect your sex drive or sexual performance. After surgery, you may have side effects like bruising of the skin around your testicles (scrotum), swelling and mild pain or discomfort. It will take about a week or so for you to fully heal and for the side effects to go away, which may stop you from having sex – but this won’t affect your libido in the long term. Read more about when you can have sex after a vasectomy.

Key takeaways

  • having a low libido is common and can affect you at any age
  • it has many different causes, including medical problems and mental and emotional (psychological) issues
  • medical conditions, including heart disease, diabetes, cirrhosis, depression and hormonal problems, can trigger it, but medication can also lower your sex drive
  • erectile dysfunction, premature ejaculation, vaginal dryness and pain during sex can all affect your sex drive negatively
  • see a doctor if you think an underlying medical condition is causing your low libido, so that they can diagnose your condition and help you find the best treatment
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