Women's Wellness

Low Libido / Sexual Difficulties

at Cadogan Clinic, Leaders in Women’s Health and Wellness.

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What is a Low Libido?

A low libido is sometimes referred to as having a low sex drive. The loss of libido is something that affects up to one in five men, and even more women, at some point in their life. It is nothing to be ashamed of, but if left untreated, it can cause immense distress and relationship difficulties. So it is important to get to the root of what is causing a low sex drive.

There are many things that cause a person to experience a low libido, including stress, anxiety, pregnancy and childbirth and certain medications. In some people a low libido may have more than one cause.

A sudden loss of libidio, particularly if it lasts for a long period of time or keeps recurring, may indicate an underlying problem and is something that should be looked at more closely.

The good news is that there are a various treatments available for low libido, ranging from medication to counselling to dietary changes, but first it is important to identify what is causing your low sex drive.

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What causes a low libido?

There are a number of things that may be causing a low libido:

  • Anxiety and stress: Stress and anxiety can be exhausting, all-consuming and can have an overwhelmingly negative impact on most areas of your life, including your sex drive.
  • Depression: Depression is very different to just feeling sad or unhappy. It’s a serious mental health condition that can leave you feeling down and hopeless and it can last for a long time. Depression can impact on all areas of your life, including your sex life.
  • Medication: While depression is a well-known cause of low libido, this also comes as a side effect of many antidepressants, including SSRI antidepressants.  Other medication which may be responsible for low libido include medication taken for high blood pressure (including diuretics), medication taken for psychosis (such as haloperidol), medications that block the effects of testosterone or reduce testosterone production (including cimetidine, finasteride and cyproterone) and medication that treats seizures (for example, anti-epileptic drugs). It is important that you don’t stop taking any medication without speaking to a doctor first.
  • Contraception: Hormonal contraception has been shown to reduce libido in some women. Types of hormonal contraception include combined contraceptive pill, progesterone only pill, contraceptive implant, contraceptive injection (the Depo-Provera injection), vaginal ring and contraceptive patch. However this side effect is usually only temporary and improves within a few months.
  • Age and menopause: Growing older leads to a drop in hormone levels, along with more age-related health conditions, which may require medication. One or a combination of these can lead to a low libido.  Older men can develop low testosterone levels, which can cause depression, fatigue and a reduced libido, while women experience a drop in oestrogen levels as they approach menopause. This can also cause a low libido. Women may also suffer from low testosterone levels, particularly if they have undergone a hysterectomy (surgery to remove the uterus).
  • Health conditions: A number of chronic health conditions can cause a loss of libido. These conditions include diabetes, cardiovascular disease and obesity.
  • Hormonal problems: In a similar way to menopause and hormonal contraception, other hormonal problems can cause a low sex drive. This can include an underactive thyroid when the thyroid gland in the neck doesn’t produce enough hormones, leading to a loss of libido and other problems, such as depression, tiredness and weight gain. A hormonal problem called hyperprolactinemia, which causes a rise in prolactin levels, can also impact libido.
  • Alcohol and drug use: Using illegal drugs and drinking excessive amounts of alcohol can have a negative impact on libido. In the interest of good health, you should moderate your intake to the recommended three to four units a day if you're a man, and no more than two to three units a day if you're a woman.
  • Relationship issues: Perhaps one of the first things to consider if you are experiencing a loss of libido is whether there are any issues in your relationship which may be the root cause of your low libido. And conditions that make sexual intercourse difficult or unfulfilling, such as premature ejaculation or vagismus, can in turn cause libido issues. If there is a sexual condition that is getting in the way of you enjoying a fulfilling sex life, than you or your partner should seek treatment.

Are the causes of low libido different between men and women?

Some of the causes of low libido affect both men and women, for example drinking excessive amounts of alcohol, suffering from depression, anxiety or stress, and obesity.

However women can also be affected by hormonal contraception, such as the combined pill, implant or contraceptive injections.

The menopause often causes a drop in libido as oestrogen  levels fall, and this can be compounded if there is also a simultaneous drop in testosterone levels. Vaginal dryness is a common symptom of menopause and this can make penatrative sex painful, which in turn can make a woman reluctant to have sex and impact on libido.

Hormone levels also change during pregnancy and breastfeeding, which can often result in a low sex drive. And of course tiredness, changes in body image, the pressures of pregnancy and caring for a new baby and injuries sustained during childbirth can lead to an understandable reluctance to have sex. A woman who has given birth should only return to sexual activity when she feels ready.


What treatment options are available?

Low libido treatment depends on what is causing the problem. Some treatments for low sex drive include:

  • Counselling or Cognitive Behavioural Therapy (CBT): If your low libido is caused by problems in your relationship, then a qualified therapist can help you. You may wish to go and see a couples’ counsellor in order to work through any problems with your partner.
  • Hormone replacement therapy (HRT): HRT uses oestrogen to replace the body’s falling hormone levels and relieve most menopause and perimenopause symptoms, including low libido. By taking HRT, you should notice an improvement in your symptoms, which may also include vaginal dryness. There are different types and doses of HRT and the treatment comes in tablet form, a gel or spray that can be applied directly to the skin, skin patches or an implant.
  • Testosterone gel: If you are suffering from a reduced sex drive related to menopause and HRT is not helping, you may also be offered testosterone gel or cream. It can be used alongside HRT and can help improve sex drive, energy levels and overall mood.
  • Medication: If your low libido is in part caused by sexual problems, for example erectile dysfunction, then medication can help with this.
  • Antidepressants: If depression is the root cause of your low libido, then the doctor may prescribe antidepressants. However, some antidepressants can cause a low sex drive, so it may take a while to find an antidepressant which is suitable for you.
  • Medication changes: If hormonal contraception is causing you to have a low sex drive, then switching to another type of contraception may help, for example swapping the combined pill for an Inter Uterine Device (IUD). If you are on medication to control seizures, high blood pressure or similar, then you should speak to a doctor about whether it would be appropriate to change medication. You should not stop taking any long-term medications without consulting your doctor first.
  • Lifestyle changes: Low libido can be the side effect of excessive alcohol consumption, drug use or obesity. Making lifestyle changes, such as cutting down on the amount you drink, giving up drugs or losing weight, will help to boost a low libido. If you feel you may have a bigger problem with alcohol, drugs or an eating disorder, you should discuss this with your doctor who can help.

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Frequently Asked Questions

The symptoms of a low libido are being disinterested in sex and initiating any sexual activity, and finding it difficult to gain any pleasure if sexual activity does take place. A person with a low sex drive may have few, if any, sexual fantasies.

Vitamin deficiencies can contribute to a low libido. Men who do not get enough vitamin D may experience decreased sexual desire as well as erectile dysfunction. Women with low iron levels can also find this negatively affects their libido. Low iron levels can be caused by heavy periods and breastfeeding.

If vaginal dryness caused by menopause is a problem, then lubricants can help to make sexual intercourse more comfortable and enjoyable. This can help to boost libido.

If you are deficient in iron or vitamin D, which may be contributing to your low libido, over the counter supplements can help to bring your levels up to where they should be.

But you should go to a doctor who will help to pinpoint what is causing your low sex drive and treat you accordingly.

There is no such thing as ‘normal’ when it comes to sex. Some people may have, or want to have, sex every day. Other people may only want it a couple of times a week, a month, or less. Some people may not want to have sex at all and are perfectly happy and comfortable with that. If you have experienced a noticeable drop in your libido and this is causing you upset, distress or friction with your partner, then it is important to see a doctor.


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