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Sexual health Symptom

Low libido

Low libido — reduced or absent sexual desire — is one of the most common sexual concerns for both men and women, affecting around 1 in 5 men and up to 1 in 3 women at some point. It has multiple causes including hormonal factors, medication effects, relationship issues, mental health, stress and life stage changes. Identifying the specific contributors directs the most effective management.

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What is Low libido?

Sexual desire is influenced by a complex interplay of hormonal, neurological, psychological and relational factors. Low libido may be lifelong (primary) or acquired (developing after a period of normal desire), global (affecting all sexual contexts) or situation-specific (absent with a partner but present in other contexts), and may or may not be associated with distress.

Common causes include: hormonal changes (menopause, low testosterone, thyroid disorders, hormonal contraception); medication side effects (particularly SSRIs, antihypertensives, antipsychotics); depression and anxiety; chronic illness and fatigue; relationship dissatisfaction or conflict; stress and exhaustion; body image concerns; past trauma; and simply a mismatch in desire levels between partners.

Signs and symptoms

Low libido presentations include:

Reduced or absent interest in sexual activity that represents a change from previous levels
Infrequent or absent sexual thoughts or fantasies
Lack of response to sexual stimuli that previously generated interest
Avoidance of sexual situations
Distress about reduced desire — either personal or relationship-related
Low libido specific to partnered sex rather than solo activity (suggesting relationship factors)

How therapy can help

Management of low libido depends on the underlying cause:

Medical assessment — hormonal evaluation (testosterone, thyroid, oestrogen), review of medication contributors, assessment for depression and chronic conditions
Hormone therapy — HRT for menopause-related low libido; testosterone supplementation for hypogonadism in men; off-label testosterone for women with significant libido concerns (discussed with specialist)
Psychosexual therapy — addressing psychological, relational and contextual contributors to low desire; sensate focus and desire-building approaches
CBT — for low libido associated with anxiety, depression, body image concerns or negative beliefs about sex
Couples therapy — for desire discrepancy and relationship factors maintaining low libido
Mindfulness-based approaches — building sensory awareness and reducing spectatoring that impairs arousal

Seeking help

A GP is the appropriate first contact for low libido — to assess for hormonal, medication and health contributors. A psychosexual therapist (COSRT-accredited) is most appropriate for the psychological dimensions. For menopause-related libido concerns, a menopause specialist or GP with menopause training can advise on hormone therapy options.

Therapies that may help with Low libido

Therapy	Evidence	Notes
Cognitive Behavioural Therapist	strong	Core use for low libido.
Relationship Therapist	strong	Core use for low libido.
Counsellor	strong	Core use for low libido.
Hypnotherapist	moderate	Commonly used for low libido.
ISTDP Practitioner	strong	ISTDP for low libido.
Mindfulness Practitioner	strong	Mindfulness for low libido.
Psychotherapist	strong	Core use for low libido.
Sex Therapist	strong	Common presentation; explore stress, relationship, hormones/meds.
EMDR Practitioner	moderate	EMDR for low libido with trauma component.
EFT Practitioner	moderate	EFT for low libido.
Havening Techniques Practitioner	moderate	Havening for low libido.
Herbal Medicine Practitioner	moderate	Herbal approaches for low libido.
Matrix Reimprinting Practitioner	moderate	Matrix reimprinting for low libido.
NLP Practitioner	moderate	NLP for low libido.
Regression Therapist	moderate	Regression therapy for low libido.
Though Field Therapy Practitioner	moderate	TFT for low libido.
Naturopath	limited	Hormonal and nutritional approaches for low libido.

Frequently asked questions

Is low libido normal?

Fluctuations in sexual desire are entirely normal throughout life — desire is affected by stress, fatigue, health, life stage, relationship satisfaction and many other factors. Low libido becomes a concern when it causes significant personal distress or relationship difficulty. If low libido is distressing you or your relationship, it warrants attention regardless of what others might consider 'normal'.

Can antidepressants cause low libido?

Yes — SSRIs (the most commonly prescribed antidepressants) frequently reduce sexual desire, arousal and orgasm as side effects, affecting around 40–65% of people who take them. If this is a concern, discuss with your prescribing doctor — medication switches, dose adjustments or addition of other agents may help, and should be weighed against the benefits of the antidepressant.

Can menopause cause low libido?

Yes — falling oestrogen and testosterone levels during perimenopause and menopause commonly reduce sexual desire and arousal, and vaginal dryness makes sex less comfortable. HRT, vaginal oestrogen and testosterone supplementation (off-label for women) all have evidence for improving libido. A menopause specialist or GP with menopause training can advise.

What is desire discrepancy?

Desire discrepancy is when partners have significantly different levels of sexual desire. It is extremely common and not inherently problematic, but can become a source of significant relationship tension when poorly managed. Psychosexual therapy for couples helps develop communication strategies, expand the definition of intimacy and find approaches that work for both partners.

Can relationship problems cause low libido?

Yes — relationship satisfaction is one of the strongest predictors of sexual desire, particularly in women. Unresolved conflict, reduced emotional intimacy, communication difficulties and trust issues all commonly reduce sexual desire. Couples therapy addressing the relationship quality often produces significant improvement in desire independently of other factors.

Find a therapist for Low libido

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