Exploring Sexual Health And Libido: Causes Of A Loss Of Sex Drive

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated October 23, 2024by BetterHelp Editorial Team

Fluctuations and loss of sex drive can be common among most people, affecting roughly 20% of men (or AMAB—people assigned male at birth) and nearly 50% of women (or AFAB—people assigned female at birth). 

The impacts of symptoms aren’t necessarily limited to the context of a relationship. Loss of sex drive can include a decrease in desire for any sexual activity, including masturbation. Symptoms can also include a disinterest in thoughts of sex or sexual fantasies.

The causes for loss of sex drive can be individual. For example: People experiencing stress or a significant life event may have decreased sex drive. Hormonal fluctuations can also influence how much sex we want and when, and physical health conditions can impact sex drive as well. Some individuals do not experience a high level of interest in sex or sexual attraction in general, such as those who are a part of the asexual community. 

However, when a lack of sex drive occurs for seemingly no reason or seems uncharacteristically constant, it can signify something more serious, possibly causing strain in relationships, self-esteem and more. If you experience concerns related to loss of sex drive, there are strategies that couples and individuals can use to help resolve them. We’ve listed them below: 

Sexual intimacy can be hard to talk about

Possible causes of loss of sex drive

Hormonal changes

Hormonal imbalances and changes may account for the loss of sex drive someone experiences. There are many potential causes of hormonal imbalances, such as certain birth control methods, age and mental health shifts. Medical professionals can address this concern according to the cause. It can be relatively simple to determine if one has a hormonal imbalance, as these can be detected with a blood test.

Stress

Psychological stress can cause changes in sex hormone levels. Additionally, mental stress, particularly severe or ongoing, can come with several adverse effects that can profoundly strain the mind and body. These include but aren't limited to: trouble sleeping, body aches or muscle tension, fatigue, irritability, high blood pressure, strained interpersonal relationships, difficulty focusing or concentrating and more. Stress management, then, can be critical for our well-being—including our sexual health.

If stress can be contributing to the cause of sexual dysfunction, online therapy and medical intervention can be helpful to many. You might consider reaching out to book a formal appointment or evaluation to determine your next right step. 

Relationship difficulties

Unresolved issues within a relationship can significantly contribute to sexual intimacy hesitancy. If you and your partner are experiencing communication difficulties, feelings of resentment, trust issues or any other matters that cause strain within your relationship, consulting a couple’s counselor can help. 

Chronic physical health conditions 

Various physical health conditions, including chronic pain, irritable bowel disease (IBD), thyroid disorders and  diabetes can lead to a loss of sex drive or lowered sex drive. Medical conditions that may lower libido for people who are AFAB may include endometriosis, vaginal yeast infections, UTIs, vaginal dryness, painful sex and more. Conversely, people who are AMAB may experience a loss of sex drive because of issues like delayed ejaculation, premature ejaculation, erectile dysfunction and low testosterone.

Certain medications

Blood pressure medications, chemotherapy drugs, certain antidepressants, antipsychotic medications and others can negatively affect sex drive. If you are noticing possible symptoms or effects from medication use, you might consider consulting with your prescribing doctor. They can offer you possible alternative solutions or additional pharmaceutical therapies to address your symptoms.

Aging

Libido can wane with age because of hormonal changes, issues with body image, self-esteem and more.  This can be particularly common for those who are experiencing menopause or decreased testosterone levels. 

Depression, anxiety, and other mental health disorders

Depression and anxiety disorders are common mental health conditions that can feature a loss of interest in activities that one would typically enjoy—including sex. Aside from this, depression and anxiety disorders can have other common symptoms that can cause sexual hesitancy—including sleep disturbances, trouble concentrating, tiredness, changes in appetite and more. 

Research currently suggests that treatment for depression can help sexual libido, and a reduction in stress through psychotherapy can also have a positive, complementary impact.

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Trauma exposure and post-traumatic stress disorder

Trauma and trauma-related disorders, such as post-traumatic stress disorder (PTSD), can be linked to difficulties with one’s ability to maintain and other concerns that may impact a person's sex life. 

We do want to note: Not everyone who experiences a traumatic event will have problems relating to sexual intimacy, and they may not meet the criteria for or receive a diagnosis of PTSD—but this doesn't mean that the trauma one experienced may not affect one in other ways. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Sleep disorders and lack of sleep

Sleep disorders, such as sleep apnea, insomnia, and restless leg syndrome can impact a person's sex life. These disorders can cause exhaustion, which can directly impact one’s mental health and ability to perform or pursue sexually. Working with your practitioner to determine the root causes to your lack of sleep (and a subsequent fix) can be a powerful way to improve your sex life. 

Relationship problems

Just as the loss of sex drive can affect a romantic partnership, you may find that relationship problems may negatively affect your sex life. Speaking with a therapist can help many to resolve the underlying causes of relationship strain, possibly reducing stress later on. 

Treatments for low sex drive

Since sexual health can be connected to many different things, finding a solution for losing one’s sex drive generally depends on their unique circumstances. What works for one person may not work for another, so it can be helpful to seek professional guidance from licensed practitioners (such as doctors and therapists).  

Determining the cause of low libido

You may begin by visiting your doctor for an examination, beginning the steps necessary for lab work and a diagnostic review of your medical history. This can help you to determine if the source is physical, emotional or due to some other underlying cause. This can help your allied care team to lay out the next correct step. 

For example: If your doctor suspects the issue is hormonal, such as with menopause or low testosterone, they may send you to a specialist for hormone therapy. 

Seeking a therapist specializing in sexual health 

No matter what the suspected underlying cause is, your GP may refer you to a therapist specializing in sexual health and couples counseling for additional support in your specific case. Apart from couples therapy or sex therapy, your therapist may also work with you individually to decrease your stress levels and learn coping skills when stress becomes overwhelming. 

Sexual intimacy can be hard to talk about

How can online mental health professionals help those experiencing reduced libido? 

A therapist can help you and your partner explore the underlying causes of a decrease in sex drive, provide you with emotional support, and give you tips for improving relationship functioning.  

Addressing a decrease in sexual desire with online therapy

Online therapy can be a great way for couples and individuals to discuss sensitive topics like loss of sex drive or other intimacy issues. Online therapy platforms like BetterHelp can also make it easier to get the care you need from the comfort of your home or anywhere else with a reliable internet connection, possibly reducing barriers to care for some.

The effectiveness of online therapy for people experiencing a loss of sex drive

Research suggests that online therapy options can be effective in helping people with a wide range of concerns (including sexual intimacy and relationship management), and plans can be more affordable than traditional, in-person therapy services without health insurance. Plans can generally be billed monthly, and financial aid may be available for those who need it. 

Takeaway

Sexual health can be intensely personal, and dysfunction in the area can be influenced by a variety of factors. Understanding this variation can boost one’s acceptance and self-awareness as they continue to navigate their sexuality. 

Concerns related to relationships and sexual intimacy can be challenging to talk about. Many people might feel uncomfortable talking to a therapist in person about such matters, or they may feel awkward when encountering others in the office waiting room. Online therapy can provide an possible solution for many who may feel hesitant to speak about such matters in an office setting.

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