Low libido, or low sexual desire, is one of the most common sexual concerns women have. A large UK survey found that around a third of women had lacked interest in sex for at least three months in the past year. It only becomes a problem if it bothers you or affects your relationship, and if it does, there is plenty that can help.
How Desire Works
Desire is often pictured as something that appears out of nowhere. This is called spontaneous desire, and many women feel it less often, especially in long-term relationships. Another type, called responsive desire, builds once you are already close or touching. Both are normal, and knowing this helps many women worry less.
What Can Lower Desire
Tiredness and stress, especially with young children or a demanding job
Relationship difficulties, including unresolved conflict
Pain during sex, which understandably makes the body less interested
Depression and anxiety, as well as some antidepressants, particularly a group called SSRIs
Hormonal changes after birth and during breastfeeding, and in perimenopause and menopause
Hormonal contraception, which affects some women's desire, although the evidence is mixed
Worries about body image
Health conditions such as an underactive thyroid or diabetes, and some blood pressure medicines
What Helps
Looking at the whole picture. Several factors are often involved at once. A doctor can check for physical causes and review your medicines, and should ask about your mood and your relationship.
Psychological approaches. Sex therapy and couples therapy have good evidence. Mindfulness programmes teach you to notice physical sensations without judging them, and several studies show they can improve desire and arousal.
Changing medicines. If an antidepressant is affecting your desire, your doctor may be able to change the dose or type. Avoid stopping an antidepressant suddenly without advice.
Testosterone. Testosterone is sometimes prescribed for low desire. The evidence supports it only for women after menopause whose low desire upsets them and has no other clear cause. In these women, it can modestly improve desire and satisfaction. There is not enough evidence to use it before menopause. Products made for men should never be used, as the doses are far too high.
Other medicines. Two medicines for low desire, flibanserin and bremelanotide, are approved in the United States for women before menopause. Their effects are small and side effects are common, and neither is widely available in Europe.
Treating pain or dryness. If sex is painful, treating the cause often brings desire back. Our article on painful sex explains the options.
There is no normal amount of desire that everyone should have. If your libido has changed and it bothers you, it is a reasonable thing to raise with your doctor, and there are more options than many women realise.