Low Libido? Here’s What Your Body’s Trying to Tell You

When it comes to your sex drive, the saying "different strokes for different folks" applies. Some people enjoy sex every day while others are OK with occasional sexual intimacy.

Like most things in life, your libido (i.e., your desire for sexual activity) can ebb and flow over the years. You may have a high sex drive at one point in time and then experience low libido at another, which is totally natural.

Whether your sex drive is high or low, the only thing that matters is how you feel about it. As long as you're happy, your libido level is immaterial.

But if your interest in sex has hit a snag ‌and‌ it's bothering you (or your partner), you might wonder why you're not able to get in the mood more often.

We spoke with Allison K. Rodgers, MD, a board-certified ob-gyn, reproductive endocrinologist and director of education at the Fertility Centers of Illinois, to understand the many factors that affect sexual appetite and what you can do to increase your sex drive if it's a concern.

Low libido occurs when you experience a temporary or long-term decline in the frequency and/or intensity of previous desire for sex.

A drop in sexual drive is common. In fact, a fifth of people assigned male at birth (AMAB) and an even greater number of people assigned female at birth (AFAB) will experience low libido during their lifetime, according to the Cleveland Clinic.

Here are the signs of a low sex drive to look out for, per the Cleveland Clinic:

• No interest or a decrease in interest in any type of sex, including masturbation
• A decrease in sexual fantasies or thoughts of sex
• Feeling unhappy or distressed about having a low desire for sexual activity

Sexual desire depends on a complex interaction of physiological, psychological and social factors. In other words, many things can lower your libido. Here are some of the most common causes:

Put simply, stress is the opposite of an aphrodisiac. It's hard to focus on sex when you're feeling overwhelmed or tense.

Not only does stress deplete your desire and energy, but chronic stress can also affect your hormones, according to the Cleveland Clinic. And certain hormonal shifts can lower your libido, too (more on this later).

Turns out, your monthly cycle can minimize sexual desire.

From a physiological standpoint, hormones like estrogen and progesterone are at their lowest during your period, and this dip often causes a low libido, Dr. Rodgers says.

And this decreased interest in sex actually serves a purpose. "This is part of our bodies' natural drive to have the highest libido around ovulation, when you're most likely to get pregnant," she says.

Sometimes the contents of your pillbox can lower your libido.

"Certainly, some medications can affect libido," Dr. Rodgers says.

For example, "birth control pills can increase a hormone called sex-hormone binding globulin, which acts as a sponge and soaks up other hormones that help with libido," she says.

Other kinds of contraception that can decrease your sex drive include the following, per the Cleveland Clinic:

• Combined hormonal contraception, including the combined pill, vaginal ring or birth control patch
• Progestogen-only birth control pill
• Contraceptive implant
• Depo-Provera injection

Other drugs that can decrease your sex drive include:

• Antidepressants
• Antipsychotics
• Chemotherapy drugs
• Blood pressure medications

Sleep deprivation can negatively affect all aspects of your health, including your libido.

"Your body needs enough sleep to function properly, and when you're exhausted, using extra energy and mind power for sex isn't on the top of your body's list," Dr. Rodgers says.

Case in point: Insufficient sleep has been linked to low libido and sexual arousal in people AFAB and a heightened risk of erectile dysfunction in people AMAB, according to an October-December 2017 article in ‌Sleep Science‌.

"Exercise can boost your natural endorphins (i.e., your body's feel-good chemicals) and help with [libido and] general wellbeing," Dr. Rodgers says.

It's true: Making exercise a part of your daily routine can support your sexual health. And research has shown that people AMAB who engage in regular physical activity have a higher libido (as well as testosterone levels and fertility), according to UCLA Health.

This connection may also be associated with exercise's positive effect on your overall health, as regular physical activity helps you maintain a healthy weight and reduces your risk of disease.

Other health-related factors — like diabetes, high blood pressure and high cholesterol — can also decrease your sex drive (and minimize your ability to maintain an erection), per the Mayo Clinic.

All this is to say, when you don't get enough exercise, your libido may decline.

But keep in mind, the opposite is also possible. Too much exercise can sabotage your sex drive. That's because chronic endurance training can interfere with certain hormones that affect libido, per UCLA Health.

Sex hormones (such as testosterone and estrogen) and neurotransmitters (such as dopamine and oxytocin) play an important role in regulating libido, according to the Cleveland Clinic. This is why when hormones fluctuate, your sex drive declines, too.

While hormones are always shifting, hormonal changes are most prevalent during certain periods of life, including:

• ‌Pregnancy:‌ Throughout pregnancy and after birth, a flood of different hormones (all fluctuating at certain times) can affect your interest in sex. Though your levels of estrogen are higher when you're pregnant, the stress, fatigue and physical discomfort of pregnancy can put a damper on your sexual desire, per the Cleveland Clinic.
• ‌Postpartum and breastfeeding/chestfeeding:‌ "Times when hormones are low, such as during postpartum and breastfeeding, estrogen levels fall, and libido goes with it," Dr. Rodgers says.  Your sex drive can decrease even more when you're weaning, too. That's because hormones like prolactin (in charge of lactation) and oxytocin (which supports bonding with your body) will decline, according to Hackensack Meridian Health. When this happens, you might feel sad, anxious or irritable.
• ‌Perimenopause and menopause:‌ As your body transitions to the end of your reproductive years, your ovaries produce less estrogen, which can lessen libido. These lower estrogen levels can also cause vaginal dryness and uncomfortable or painful sex, which can be a big deterrent for sexual desire, per the Mayo Clinic.

It's important to remember, however, that every person is unique. Changes in hormones — and the way someone experiences these changes — are very individualized. While some may have a low sex drive during postpartum or menopause, others may have a higher sex drive.

"When you are facing medical conditions, especially something serious, it's normal to have a decrease in libido," Dr. Rodgers says. "Your body and mind are more focused on healing, not necessarily sex," she says.

Certain health issues that can negatively affect libido include (but are not limited to) the following, per the Cleveland Clinic:

• Cancer

• Chronic kidney disease

• Chronic pain

• Diabetes

• Headaches

• Heart disease

• Hyperprolactinemia (when you have elevated levels of prolactin in your blood)

• Hypertension (high blood pressure)

• Hypothyroidism

• Rheumatoid arthritis

• Infections such as vaginal yeast infections or urinary tract infections (UTIs)

• Reproductive health conditions such as endometriosis, premenstrual syndrome (PMS) and polycystic ovary syndrome (PCOS)

A little wine may help you relax and get in the mood, but drinking too much could decrease your sex drive, too.

In fact, too much alcohol can lead to lower testosterone levels and erectile dysfunction, according to the Mayo Clinic.

The same goes for smoking, which can also suppress testosterone and reduce blood flow, causing a less pleasurable sexual arousal, per the Mayo Clinic.

Other recreational drugs are bad news for your sex drive, too. Not only can substance use lower testosterone levels and increase your risk of erectile dysfunction, but it can also alter your brain's response to pleasure, according to the Mayo Clinic. For example, activities you once enjoyed — like sex — may not feel as good as they used to feel.

Your mental health plays an important role in many aspects of your life and health, so it's no surprise your emotional state can affect your libido as well.

Depression — which can contribute to low self-esteem, hopelessness and fatigue — may cut down your sexual appetite. It can also throw off your delicate balance of neurotransmitters that help control libido, according to the Cleveland Clinic.

Similarly, anxiety can affect your hormonal health by increasing your stress hormone cortisol, which, in turn, can subdue the hormones responsible for your sex drive, per the Cleveland Clinic.

Additionally, some medications used to treat anxiety and depression can cause sexual side effects, too.

If your libido is naturally low and you don't feel distressed by it, it is totally normal.

"There is a large range of normal libido, and it's important to realize that many outside conditions, hormone changes, medical issues and emotions can affect it," Dr. Rodgers says.

The only time it becomes a problem is if it's bothering you and your partner/s, or you aren't able to be intimate when you want to, she adds.

If your decreased sexual desire is distressing or affecting your quality of life, speak with a trusted doctor or mental health professional who can perform a proper evaluation and help you address and treat the reasons behind your reduced libido.