Opinion article
Low sexual desire: when it’s a cause for concern
Low sexual desire is a common complaint, in both men and women, and it doesn’t always amount to a clinical problem. It’s considered a sexual desire disorder when the persistent absence or reduction of sexual thoughts, fantasies or interest in sexual activity causes significant distress, usually defined as lasting at least six months.
Common causes
- Hormonal: menopause, low testosterone in men, thyroid changes.
- Medication-related: some antidepressants and, in some women, hormonal contraceptives.
- Psychological: depression, chronic stress, anxiety or relationship conflict.
- Contextual: fatigue, sleep deprivation and the demands of a particular life stage, such as the postpartum period or caring for young children.
How it differs from normal variation
Sexual desire naturally fluctuates with age, stress, the relationship and life stage. What defines a clinical problem isn’t how often it happens per week or month, but whether the decrease is causing personal distress. Lower libido that doesn’t bother the person isn’t, by definition, a dysfunction.
Treatment
- Identifying and addressing modifiable causes, such as reviewing medication or treating an underlying depression.
- Hormonal correction when indicated, under medical guidance.
- Sex therapy or couples therapy, especially when a relational component is present.
- In selected women, specific pharmacological options for sexual desire disorder, evaluated case by case.
Before treating low desire as a problem to fix, it’s worth asking whether it’s actually causing distress, or whether it’s simply different from what the person, or the couple, expected.
This article is for information only and does not replace a medical consultation.
Sources
- International Society for the Study of Women’s Sexual Health (ISSWSH). Process of Care for the Management of Hypoactive Sexual Desire Disorder in Women. Mayo Clinic Proceedings. 2017.
- International Society for the Study of Women’s Sexual Health