Low Libido in Women: Common Causes and What Helps

Low libido in women means a lasting drop in sexual desire that bothers you. It is often caused by a mix of stress, tiredness, relationship difficulties, hormone changes in pregnancy, breastfeeding or menopause, low mood, long-term health conditions, and some medicines. Finding the cause matters, because treatment depends on it, and help is available.

What low libido means — and what it does not mean

Desire naturally rises and falls through life. Mayo Clinic states that women’s sexual desire changes over the years, that highs and lows commonly coincide with the start or end of a relationship or major life changes such as pregnancy, menopause or illness, and that there is “no magic number” to define low sex drive — it varies (Mayo Clinic).

Mayo Clinic lists symptoms as having less or no interest in any type of sexual activity, never or only seldom having sexual fantasies or thoughts, and being sad or concerned about the lack of sexual activity or fantasies. Importantly, Mayo Clinic also notes that sexual dysfunction is a problem only if it bothers the person — if it does not bother her, she does not need treatment (Mayo Clinic). A lower level of desire than you once had does not automatically mean something is wrong; it becomes worth addressing when it persists, causes distress, or strains a relationship.

Common causes at a glance

Low libido is usually multifactorial: several causes overlap rather than a single one acting alone. The main groups are stress and tiredness, low mood, relationship difficulties, hormone changes, medicines, and long-term health conditions.

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Stress, tiredness and mental health

Mayo Clinic lists psychological causes including anxiety or depression, stress tied to finances, relationships or work, poor body image, low self-esteem, a history of physical, emotional or sexual abuse, and past negative sexual experiences (Mayo Clinic). It also lists fatigue separately, including exhaustion from caring for young children or ageing parents, and fatigue from illness or surgery. NHS Wales likewise lists relationship problems, stress, anxiety or depression, and drinking too much alcohol among the main causes of low sex drive (NHS Wales).

Relationship factors

For many people, emotional closeness is key to sexual intimacy. Mayo Clinic lists lack of connection, unresolved conflicts, poor communication of sexual needs and desires, trust issues, concern over a partner’s ability to have sex, and not enough privacy (Mayo Clinic). NHS Wales lists relationship problems first among main causes, and relationship counselling as a possible treatment where relationship problems are the cause (NHS Wales).

Hormone changes: pregnancy, breastfeeding and menopause

Mayo Clinic states that oestrogen levels drop during menopause, which can make a woman less interested in sex and cause vaginal dryness, leading to painful or uncomfortable sex, while also noting that many women still have satisfying sex during menopause and beyond (Mayo Clinic). Pregnancy and breastfeeding are other turning points, when hormone changes, fatigue and changes in body image can dampen sex drive. NHS Wales lists pregnancy and having a baby — hormone changes plus the stress and tiredness of looking after a baby — and lower hormone levels as women get older, particularly during the menopause (NHS Wales).

Medicines: SSRIs and hormonal contraception

Mayo Clinic states that some prescription medicines lower sex drive, “especially depression medicines called selective serotonin reuptake inhibitors (SSRIs)” (Mayo Clinic). NHS Wales lists taking certain medicines, such as medicine for high blood pressure or antidepressants, and using hormonal contraception like the pill, patch or implant, among main causes, and advises seeing a GP if a medicine or hormonal contraception may be affecting sex drive (NHS Wales). Never stop a prescribed medicine on your own: a clinician-led review may involve changing to a different medicine or type of contraception, or treating another cause entirely. Depression itself can also lower desire, so the picture is rarely simple.

Health conditions and pain during sex

Mayo Clinic lists diseases that can affect sex drive, including cancer, diabetes, high blood pressure, coronary artery disease and neurological diseases, and sexual conditions such as pain during sex or being unable to orgasm (Mayo Clinic). NHS Wales lists long-term conditions including heart disease, diabetes, an underactive thyroid and cancer (NHS Wales). Pain or dryness during sex can itself lower desire, so treating dryness or pain is often part of the answer rather than a separate problem.

When low desire becomes HSDD

An American College of Obstetricians and Gynecologists guideline summary defines hypoactive sexual desire disorder (HSDD) as a persistent or recurrent deficiency or absence of sexual desire or receptivity to sexual activity, and states that sexual dysfunction in women should be diagnosed when symptoms cause distress or interpersonal problems (AAFP / ACOG guideline summary). The same summary gives an older estimate that HSDD affects between 5.4 and 13.6 percent of women, peaking in women aged 40 to 60 and in those who have undergone surgical menopause. You do not have to meet a medical definition to seek help, and a GP can assess whether your symptoms fit a treatable pattern.

What helps

NHS Wales says treatment depends on the cause, and that a GP can advise on help and treatments including relationship counselling, medicines for problems such as vaginal dryness, HRT for menopause, antidepressants or cognitive behavioural therapy (CBT) for mental-health problems, and changing a medicine or contraception type (NHS Wales). Mayo Clinic lists non-medical options including talking openly with a partner, living healthily by limiting alcohol and being physically active, learning ways to lower stress, seeking counselling or therapy, using a lubricant for vaginal dryness or pain, using a vaginal moisturiser, and staying sexually active (Mayo Clinic).

For menopause-related low sexual desire, NICE guideline NG23 recommends considering testosterone supplementation if HRT alone is not effective, noting this was an off-label use (NICE NG23). That is a clinician-led decision after assessment, not something to try on your own. Mayo Clinic notes that a mix of treatments addressing medical, relationship and emotional issues most often works best. Be wary of unproven quick fixes marketed for libido: talk to a doctor or pharmacist before trying any product, and never stop a prescribed medicine without advice.

When to see a doctor

See your GP if low desire distresses you, strains your relationship, started after a new medicine, came on suddenly or is worsening, does not return after pregnancy, or comes with fatigue, low mood, pain during sex, vaginal dryness or a long-term condition. Talk to a doctor or pharmacist about any medicines or products rather than starting or stopping treatment on your own.

In an emergency call 911 (US), 999 (UK) or 112 (EU).