Maintaining a normal, healthy sex drive is not as easy as you might think. In fact, when a man or woman realizes they are experiencing a low sex drive or low libido for whatever reason, it can quickly become a great source of anxiety, embarrassment, and tension.
“It may feel uncomfortable to talk about low libido with your partner and your health care team,” writes Graham King, MD, Family Medicine, Prenatal Care for The Mayo Clinic Health System. “Unfortunately, it’s a common problem that affects adults everywhere, yet many people have never been asked about their sexual health by their health care teams.”
If you or your partner are encountering difficulties with low libido, don’t despair. It’s not uncommon, and there are often a range of causes to consider, as well as a plethora of potential treatments and solutions. As Dr. Graham continues, however, there is no one magic pill for low libido. So consulting with an expert or your health care time is absolutely an essential first step.
“The desire for sex is based on a complex interaction of many things that affect intimacy, including physical and emotional well-being, experiences, beliefs, lifestyle and relationship status,” he says. “A thorough evaluation of your symptoms and possible causes, along with an individualized treatment plan, may put you in the mood more often.”
For men, there a wide range of causes, many of them stemming from physical issues. For example, according to The Mayo Clinic, increased weight, diabetes, high blood pressure, endocrine disorders, and high cholesterol can affect a man’s ability to maintain an erection or decrease sex drive. These conditions also can lead to low energy and low self-image, which can cause a significant loss of libido. The good news is, many of these issues can often be corrected through diet, exercise, and medical management.
There are a number of other potential causes for men, too, Dr. Graham explains, including the following:
Pornography
“Pornography permeates many committed relationships and can change how men view sexuality,” he says. “For some, it causes pseudo-low libido, which is when a person is still interested in sex but not in a healthy way. This often leads to unrealistic expectations of body image, confusion about what an intimate encounter is and, in some cases, negative sexual behavior.” Because of the easy availability, the internet is a sizable contributor. Men who find this is cause can seek counseling for sex addiction.
Loss of intimacy
I’m always amazed at how dedicated and committed people are to their jobs, sports teams or extracurricular activities but treat relationships like a given, self-maintaining entity. This simply isn’t the right approach. Relationships, intimacy and sexual health require work and effort. In many cases, a lack of emotional connection can lead to low libido in both partners.
Medications
Many medications used for anxiety and depression can lower libido in men and, in some cases, delay orgasm. While some men have no side effects, others may encounter significant issues. It’s important to note that you should not stop taking any medication without first talking with your health care team.
Alcohol and drug use
Increased alcohol use can reduce testosterone levels and increase the risk of erectile dysfunction and low libido. Illicit drugs often increase sex drive in the short term but have significant long-term negative effects on sexual function. Depending on the substance, drug use can cause a decrease in testosterone levels and erectile dysfunction or change how the brain responds to activities that were previously viewed as pleasurable, like sex.
For women, the issue of low libido can be even more complex, with causes ranging from past negative and abusive experiences with sex to fatigue and stress. While women may have some of the same causes as men as listed above, the most common causes of low libido in women include:
Life stressors and fatigue
Particularly after growing their families, many women are not only weeks behind on quality sleep but also haven’t exercised in months and eat only when they can find a spare second. It’s no wonder they say that they feel exhausted and sexually dead. Especially after they’ve given birth they (sadly and often incorrectly) may not feel that they are desirable to their partner anymore. They often confide that they don’t feel like they could have a sexual or intimate encounter even after a long time. Women, in general, also tend to feel like they have the weight of the world on their shoulders. This exhaustion builds up over time until sex is out the window with the energy they do have left.
Hormone changes
Estrogen levels drop during menopause and can greatly affect libido. It can cause vaginal dryness and lead to painful or uncomfortable sex, even in women who have not experienced that before. While not as common, hormonal contraceptives also can cause lower libido. In some women, they cause vaginal irritation which may lead to a decreased desire and willingness to initiate a sexual experience.
Sexual pain or dyspareunia
If it hurts, why would you do it? The good news is that pain during sex can often be treated. The first step is to be evaluated by a sexual health specialist who will recommend a treatment plan, which could include a referral to a psychology specialist or pelvic floor physical therapist.
Previous trauma
Previous physical or emotional trauma can affect the way people experience sex and lead to low libido. Sexual desire and arousal often are numbed in people who have been physically or sexually abused. Women who have been abused often avoid sexual contact because the neural networks in their brains associate sex with power, fear, or pain. This makes intimacy difficult. Even a previous consensual, yet negative, sexual experience can reduce a woman’s desire for sex in the future. An experienced therapist can usually help people work through a traumatic past and reframe their thinking so sex can be pleasurable once again.
Additionally, for men, medical experts estimate that 30 million men suffer from erectile dysfunction or ED, which can cause problems in a relationship. Defined as trouble getting or keeping an erection, ED ranks as the most common problem that men report to their doctors. ED can happen when blood flow to the penis is limited or nerves have been damaged or if the man is experiencing stress or emotional issues.
ED might also be an early warning of a more serious illness, like: atherosclerosis (hardening or blocked arteries), heart disease, high blood pressure or high blood sugar from Diabetes
According to the Urology Care Foundation, “finding the cause(s) of your ED will help treat the problem and help with your overall well-being. As a rule, what’s good for your heart health is good for your sex health.”
Women with a pervasive loss of libido, so bad that it affects their daily functioning and happiness, may also have a diagnosable condition contributing to it. Hypoactive Sexual Desire Disorder (HSDD) is a physical & mental dysfunction in which women lack the desire or motivation for sex for an extended period of time. It has only recently started being seriously investigated and diagnosed, but it is a very real and potentially common sexual dysfunction. HSDD often mimics and/or accompanies symptoms of depression, anxiety, and many other conditions, so it can be difficult to diagnose and treat. There is presently only one medication approved to treat it according to University of Colorado Ob-Gyn, but hopefully more help and hope is on the way in the future as more research is done.
So if you or your partner have been struggling with a slumping sex drive, it really may not be “all in your head”…and it definitely doesn’t mean you don’t love each other anymore. While the first step in dealing with a lack of sexual desire should obviously be talking to your partner, the next step should always be talking to your doctor. They may have some very real medical answers for your sexual problems you’ve thought you were imagining.
