Everything You Need to Know About Low Libido in Women
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Medically reviewed by Sanaz Ghazal, MD
It’s normal for women’s libido, or sex drive, to fluctuate across time, especially because of major life changes or stress. Sometimes, hormonal or physical changes are at play. Certain medications can lead to sexual dysfunction, including a low libido in women. In many cases, a reduced sex drive is nothing to worry about. However, if your low libido persists or is causing you personal distress, it could be classified as a condition.
Here’s everything you need to know about low libido in women, from common symptoms and causes to treatment options, coping tips, and more.
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What Is a Low Libido in Women?
Libido, or “sex drive,” refers to your sexual desire and appetite. This includes your desire to have sex and your sexual fantasies, thoughts, and pleasure.
Low libido is one kind of sexual dysfunction that affects women. Many women with a reduced sex drive may also have trouble becoming and remaining aroused, reaching orgasm, and/or enjoying sex. This can affect your personal life in several ways, from interfering with your sexual pleasure and self-esteem to causing problems with romantic partners.
Other Symptoms of Low Libido in Women
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) defines female sexual interest/arousal disorder (FSIAD) as a condition that causes women to have difficulty becoming sexually aroused and/or staying aroused during sex. Previously known as hypoactive sexual desire disorder (HSDD), this condition affects around 10% of women in the United States.
Signs and symptoms of a low libido in women include:
Difficulty in getting and staying aroused (i.e., lack of vaginal lubrication and swelling before and during sex)
Lack of desire to have sex or masturbate
Lack of sexual fantasies and thoughts
Not wanting to initiate sex
Lack of pleasure during sex
What Causes Low Libido in Women?
Women experience a reduced sex drive for many different reasons. Common causes of low libido include physical, hormonal, and psychological changes, as well as relationship concerns.
Physical Causes
Many women notice a downturn in their libido if they experience pain during sex. There are many possible reasons for painful sex, including:
Several prescription medications can reduce your appetite for sex. It may be the culprit if your symptoms started when you began taking a certain medication, .
Medications with low libido as a potential side effect include:
Hormonal birth control, such as “the pill”
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs)
Antipsychotic medications, such as Haldol (haloperidol)
Blood pressure medications, such as diuretics
Anti-seizure medications, such as Dilantin (phenytoin)
Finally, misusing drugs and alcohol can sometimes lead to low libido in women.
Hormone Changes
Your hormones play a key role in your sexual desire, drive, and pleasure. Hormone-related reasons that your sex drive may take a dip include:
Menopause: Many notice that their libido decreases as they age, especially when approaching menopause. This is due to changes in your body’s estrogen levels, which fall as you age.
Hormone-related conditions: Medical conditions that affect your hormones, such as hypothyroidism (underactive thyroid), can negatively impact your libido. Women often feel less interested in sex after having a hysterectomy (surgical removal of the uterus) due to falling testosterone levels.
Pregnancy and breastfeeding: Intense, rapid shifts in estrogen and progesterone levels related to pregnancy and breastfeeding can leave you less interested in sex. The sleep deprivation and stress of childbirth and raising a newborn may also play a role.
Psychological Causes
When it comes to sex, it’s difficult to separate your mind from your body. Your emotional and psychological well-being can affect your sex drive in a variety of ways.
For example, women can experience a loss of libido due to:
Stress: Whether due to a sudden life change or ongoing burnout, stress may affect your sexual appetite and response. Chronic stress can leave you too distracted or exhausted to think about sex much.
Anxiety: Anxiety is associated with increased levels of cortisol (the stress hormone), which can decrease your testosterone levels and reduce your libido. People with anxiety disorders are also more likely to experience pain during sex and worry about their sexual performance.
Depression: Depression is strongly linked to low libido in women. This may be due to the side effects of certain antidepressants, as well as the effect of depression on sexual self-esteem and confidence.
Past trauma: Survivors of sexual trauma, including childhood sexual abuse, often report low libido later in life.
Relationship Issues
If you’re having trouble connecting with your partner, your sex drive may follow suit. For example, the following relationship issues may have a negative impact on your desire to have (and especially initiate) sex:
Lack of emotional intimacy
Relationship conflicts
Negative body image
Poor self-esteem
Concerns about sexual performance
Being afraid of getting pregnant
Fears and distress about infertility
How Is Low Libido in Women Diagnosed?
To diagnose you with female sexual interest/arousal disorder or any other condition related to low libido, your healthcare provider may perform a physical examination (including a pelvic exam). They’ll also most likely ask you about your current symptoms, such as sexual pain, as well as your mental health, medical history, and any medications you’re taking.
To qualify for a diagnosis, your symptoms must have persisted for six months or more and can’t be caused by any other underlying condition. They also must cause you personal distress. For example, your low libido may impact your relationship(s), self-esteem, or social life.
Possible Conditions That Cause Low Libido in Women
In some cases, low sex drive is due to an underlying health condition. Long-term health conditions that have been linked to low libido in women include:
Bladder and bowel disorders
Kidney disease
Cancer
Low Libido Treatment Options
There are many different treatment options available for low libido, depending on the cause. If your low sex drive is related to an underlying physical or psychological condition, treating that condition may help to improve your sex life as well. Other options include sex therapy, counseling, medications, and hormone therapy.
Sex Education and Counseling
In some cases, counseling and sex education can help you address an unwanted low libido and its underlying causes. For example, you and/or your partner could reach out to:
A marriage and family therapist (MFT) to help you reconnect with your partner and improve your overall relationship.
A sex therapist to address your specific sexual concerns and find new ways to enjoy intimacy.
An obstetrician-gynecologist (ob-gyn) to answer any questions you have about painful sex, vaginal dryness, your anatomy, or reproductive health.
Medications
Sometimes referred to as “female Viagra,” the following prescription medications have been approved by the U.S. Food and Drug Administration (FDA) to treat pre-menopausal women for low libido:
Addyi (flibanserin): Addyi is taken orally, typically once a day at bedtime. It works by changing the way that serotonin, dopamine, and norepinephrine function in your brain.
Vylessi (bremelanotide): Vylessi is an injectable medication that comes in a pre-filled automatic syringe. You can inject it yourself at least 45 minutes before having sex.
Hormone Therapy
If your libido has decreased due to menopause or a hormonal imbalance, your healthcare provider may recommend hormone replacement therapy (HRT). HRT involves taking synthetic hormones, typically estrogen and progesterone, to increase your sex drive and relieve vaginal dryness, among other symptoms.
These hormones may be delivered in the form of:
Pills
Vaginal creams
Skin patches
Rings
Gels
Some serious potential side effects are associated with HRT, such as an increased risk of blood clots and stroke. Talk to your healthcare provider about whether it’s the right choice.
Lifestyle and Home Remedies for Low Libido
There are several steps you can take to boost your sex drive and make sex more pleasurable, including:
Using vaginal lubricant
Limiting your drug and alcohol intake
Incorporating more foreplay, different sexual positions, and toys into your sex life
Doing Kegel exercises to strengthen your pelvic floor
Drinking plenty of water throughout the day
Going to the bathroom before sexual activity
Setting the mood and taking a relaxing bath before having sex
There is some evidence that certain supplements may help to boost women’s libido, such as:
Ginkgo biloba
Ginseng
Black cohosh
Chasteberry fruit
Dehydroepiandosterone (DHEA)
Coping and Support
Dealing with low libido can sometimes make you feel alone. Here are a few ways to cope with a reduced sex drive and find the support you need:
Manage stress by getting plenty of rest, exercising regularly, eating nutritious foods, and using mindfulness techniques.
Reach out to a psychotherapist if you struggle with your body image, self-image, or self-esteem.
Join a peer support group for women dealing with reduced sexual desire.
Keep an open dialogue with your partner to discuss your feelings and concerns.
Tips for Talking to a Healthcare Provider
You might want to talk to a healthcare provider about your low libido if:
It seems sudden or unexplainable
It has persisted for six months or more
It’s affecting at least one major area of your life, such as your relationships
It’s causing you distress or harming your mental health
It can seem intimidating to talk to a healthcare provider about your sex life, but it doesn’t have to be. To start the conversation, you can say something as simple as “I’m not enjoying physical intimacy as much as I did before” or “I have some concerns about my sex drive.” Before your appointment, you may also want to keep a journal of your physical and emotional symptoms for a few weeks so you can take note of any patterns and discuss them with your healthcare provider.
Summary
Your sex drive will most likely fluctuate throughout your life. In most cases, that’s perfectly normal. Factors like hormonal changes, stress, aging, certain medications, and relationship issues can all affect our desire for sex.
However, if you’re frustrated with your lack of sexual desire and arousal, you’re not alone. Don’t be afraid to talk to your healthcare provider about your low libido. They can help you find a wealth of support, resources, and effective treatment options. They can also rule out any underlying physical conditions that could be affecting your sex drive.
