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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.

See therapies that may help

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

Showing 12 therapies linked to Low libido.

Therapy Evidence Notes
Cognitive Behavioural Therapist
strong

Helps identify and reframe anxious or self-critical thoughts about sex and performance that can dampen desire and arousal.

Counsellor
strong

Offers space to explore stress, body image or life changes affecting libido, and to talk openly about intimacy concerns.

ISTDP Practitioner
strong

Works to surface buried emotions and inner conflicts about intimacy that may be quietly suppressing sexual desire.

Mindfulness Practitioner
strong

Teaches present-moment awareness that reduces performance anxiety and helps you reconnect with bodily sensation and arousal.

Psychotherapist
strong

Explores deeper emotional patterns, past experiences and relationship dynamics that can shape and lower sexual desire.

Relationship Therapist
strong

Addresses relationship tensions, communication gaps and resentment between partners that often underlie a drop in sexual desire.

Sex Therapist
strong

Targets the sexual difficulty directly, using structured exercises and education to rebuild desire, arousal and intimacy.

EMDR Practitioner
moderate

May help where past trauma is dampening desire by reprocessing distressing memories; evidence here is limited and it supports, not replaces, proper care.

EFT Practitioner
moderate

A tapping-based approach some try to ease anxiety around intimacy; evidence for low libido is limited and it is not a substitute for professional care.

Herbal Medicine Practitioner
moderate

Some herbal remedies are taken hoping to support desire, but evidence is limited and quality varies, so discuss safety with a clinician first.

Hypnotherapist
moderate

Used to ease performance anxiety and shift unhelpful associations around sex; evidence is limited and it complements professional care.

NLP Practitioner
moderate

Some use NLP techniques aiming to reframe beliefs about sex and confidence; evidence is limited and it should support, not replace, professional care.

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.