Women's health Life issue

Libido concerns (supportive)

Concerns about low libido or changes in sexual desire are very common and can affect people of all genders and ages. Desire is influenced by an enormously complex interplay of hormonal, psychological, relational and lifestyle factors. Therapy — whether individual, couples, or sex therapy specifically — can make a significant difference when libido concerns are causing distress.

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What is Libido concerns (supportive)?

Sexual desire is not fixed — it varies naturally across the lifespan, with life circumstances, relationship dynamics, hormonal changes, stress and physical health. A reduction in libido is only a concern when it causes personal distress or relationship difficulty — there is no "correct" level of sexual desire.

Low sexual desire (hypoactive sexual desire disorder, HSDD) is the most commonly reported sexual difficulty in women, and is also significant in men. It can be lifelong or acquired, generalised or situational (occurring only in certain contexts or with certain partners), and has multiple potential contributing factors.

Common contributors to low libido include: stress and burnout, relationship difficulties, depression and anxiety, hormonal changes (menopause, postnatal, testosterone deficiency), medication side effects (particularly SSRIs and the contraceptive pill), body image concerns, trauma, and loss of emotional intimacy in a relationship.

Signs and symptoms

Libido concerns may present as:

Persistent or recurrent absence of sexual thoughts, fantasies or desire
Lack of responsive desire — not responding to a partner's initiation even when circumstances are favourable
Personal distress about low or absent desire
Relationship friction related to mismatched desire levels
Avoidance of intimacy or physical contact
Loss of desire that is noticeably different from your previous experience

How therapy can help

Treatment depends on the underlying cause and context:

Sex therapy — specialist therapy addressing the psychological and relational aspects of sexual desire, including psychoeducation about desire models, sensate focus exercises, and communication skills
Couples therapy — when libido concerns are embedded in relationship difficulties, addressing the relationship is as important as any individual intervention
Individual CBT or counselling — for libido concerns driven by stress, anxiety, depression, body image or trauma
EMDR — for libido concerns linked to sexual trauma
Menopause support — for women whose libido concerns are driven by menopause or perimenopause; HRT often improves desire, particularly testosterone
Lifestyle approaches — stress reduction, exercise, sleep improvement and relationship quality all have meaningful effects on libido

Seeking help

If libido changes are causing distress, starting with your GP is helpful to rule out hormonal or medication-related causes. A sex therapist or psychosexual therapist (accredited by COSRT or BASRT) can provide specialist psychological support. For concerns embedded in relationship dynamics, a couples therapist is the appropriate starting point.

Therapies that may help with Libido concerns (supportive)

Therapy	Evidence	Notes
Sex Therapist	strong	Core use for libido concerns.
Cognitive Behavioural Therapist	strong	CBT for libido concerns.
Counsellor	strong	Core use for libido concerns.
Hypnotherapist	moderate	Commonly used for libido concerns.
Psychotherapist	strong	Core use for libido concerns.
Relationship Therapist	strong	Relationship therapy for libido concerns.
Acupuncturist	limited	Supportive for libido concerns; evidence limited.
EMDR Practitioner	moderate	EMDR for libido concerns with trauma.
EFT Practitioner	moderate	EFT for libido concerns.
Havening Techniques Practitioner	moderate	Havening for libido.
Matrix Reimprinting Practitioner	moderate	Matrix reimprinting for libido.
Mindfulness Practitioner	moderate	Mindfulness for libido concerns.
NLP Practitioner	moderate	NLP for libido concerns.
Psych-K Practitioner	moderate	PsychK for libido concerns.
Regression Therapist	moderate	Regression therapy for libido concerns.
Though Field Therapy Practitioner	moderate	TFT for libido concerns.
Herbal Medicine Practitioner	limited	Herbal support for libido concerns.
Reflexologist	limited	Used supportively for libido concerns.

Frequently asked questions

Is low libido a medical problem?

Low libido can have medical causes — including hormonal changes (low testosterone or oestrogen), thyroid dysfunction, chronic illness, and medication side effects — and these should be assessed. It also frequently has psychological, relational and lifestyle contributors. A GP can assess for medical causes; a sex therapist or psychosexual therapist addresses the psychological and relational dimensions.

Can antidepressants cause low libido?

Yes — reduced libido and sexual dysfunction are among the most common side effects of SSRIs and SNRIs. If you are experiencing significant sexual side effects, discuss with your GP — dose adjustment, switching to a different antidepressant, or adding a low dose of another medication may help. Do not stop antidepressants without medical guidance.

Is it normal for libido to change over time?

Yes — sexual desire naturally fluctuates with stress, relationship stage, health, life events, hormonal changes and ageing. A reduction in libido is not inherently a problem. It only warrants attention when it causes personal distress or significant relationship difficulty.

What is sensate focus and how does it help?

Sensate focus is a behavioural technique used in sex therapy involving gradual, non-goal-oriented touch exercises that rebuild physical connection and reduce performance pressure. It is one of the most evidence-based interventions for sexual difficulties including low libido and sexual anxiety, and is typically prescribed as homework between therapy sessions.

Can menopause cause low libido and what can help?

Yes — menopause commonly reduces libido through falling oestrogen and testosterone levels, vaginal dryness, and the broader hormonal and psychological changes of this transition. Effective options include HRT (particularly with testosterone), local oestrogen for vaginal dryness, sex therapy, and lubricants. A menopause specialist or GP can advise on hormonal options.

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