Low libido and changes in desire

Desire doesn’t always come before touching. Some people only feel interested in sex once things have started. That doesn’t mean you have to start. Any contact needs to be something you freely choose.

Low libido means a low sex drive. What matters is whether anything about it bothers you. A clinician will think about how you feel about your desire. Having little interest doesn’t automatically make it a disorder. If the change worries you, you can ask for help.

Spontaneous and responsive desire

Spontaneous desire means sexual thoughts or fantasies that come before any activity. Responsive desire builds in response to touch or other sexual cues. These terms describe how interest starts. They don’t tell you to have sex. You can use them if they help you describe what you feel.

For example, you might want a cuddle without wanting anything more. If you choose to carry on because it feels welcome, interest may grow during that contact. If it doesn’t, you can stop there. A partner hoping you’ll become interested isn’t the same as you agreeing.

Arousal and desire are linked parts of how you respond sexually, but they’re not the same. Arousal includes the changes in your body and feelings when you’re touched. Desire is the feeling of wanting sex. It can help to say which part has changed: wanting sex, feeling comfortable in your body, getting excited or enjoying what happens.

What else has changed

Stress, anxiety, depression and problems in your relationship can affect desire. So can sexual problems such as vaginal dryness. You can talk about all of these together at an appointment. You don’t have to decide first whether the problem is physical or emotional.

Pregnancy and caring for a baby can bring changes in hormones, tiredness and stress. During menopause, changing hormone levels can also affect your sex drive. These changes may play a part, but they don’t set how interested you should feel. Tell the clinician what has changed and what matters to you.

Some long-term conditions, including diabetes and an underactive thyroid, may play a part. A clinician can look at these alongside your symptoms and medical history. Low desire on its own can’t tell you the cause. Talking it through can help you and the clinician think about treatment.

Medicines and contraception deserve a review

Some antidepressants, blood pressure medicines and hormonal contraceptives can affect sex drive. If you think there’s a link, tell your prescriber which product you use and when the change started. The NHS advises seeing a GP if a medicine or hormonal contraception seems to be affecting your desire.

Don’t stop a prescribed medicine without talking to your doctor. In particular, don’t stop an antidepressant suddenly or without medical advice. Your clinician can talk about the possible effect and other options. You can bring up a sexual worry as part of managing a health condition.

Support can take more than one form

Treatment depends on what’s playing a part. It may include help with dryness or pain, talking therapy, or a review of your medicines or contraception. ACOG also describes being referred to a sex therapist, sometimes alongside medical treatment. You can have therapy on your own or with a partner.

If you want to explore being close, ACOG suggests talking about what you like, making time together and thinking about touch without penetration. You can choose to be close without having sex. Let your own comfort and wishes guide you. There’s no target for how often to have sex.

Bring the concern in your own words

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, if the change bothers you or you think a medicine may be the cause. You could say: “My interest in sex has changed, and I’d like to talk about possible reasons.” Mention pain or dryness if either is part of it.

A short note can help you explain what you want from the appointment. You might want treatment for discomfort, a review of your medicines, or to understand the change better. Write down the question you most want answered. Before you agree to a next step, ask what it would involve.