Depression and low sex drive

Depression may make pleasure, closeness and initiation feel difficult. Low energy, poor sleep, body-image concerns, pain or vaginal dryness can also affect sexual activity. Some antidepressants reduce desire, arousal or orgasm for some people, so do not stop one suddenly without medical advice. Low sex drive can also occur with perimenopause, menopause or genitourinary syndrome of menopause; the symptom alone does not identify one cause.

Track mood, desire, pain, dryness, sleep and medicines across several weeks, then share the pattern with a clinician. Treatment may involve therapy for depression, a medication review, relationship support, lubricants or treatment for genital symptoms. Talk openly with a partner about comfort and consent, without setting a deadline for sex. A clinician can explain whether options such as testosterone therapy for women are appropriate; it is not suitable for everyone.

Arrange a clinical assessment when low desire persists, causes distress, follows a medicine change, or occurs with pain, bleeding, marked dryness or mood symptoms. Seek urgent help for thoughts of suicide, self-harm or inability to stay safe. Sudden severe pelvic pain, heavy bleeding or fever also needs prompt medical attention.

Could depression, medication, hormonal changes, pain or dryness be contributing? Should my antidepressant be reviewed? What treatments could improve comfort and mood together? Would a menopause assessment or referral to a sexual-health clinician help?