What should you know about extremely low sex drive?

Desire can change with perimenopause or menopause, sleep disruption, stress, depression, anxiety, relationship strain, pain, or concerns about body image. Vaginal dryness and burning related to genitourinary syndrome of menopause can make sexual activity uncomfortable, which may reduce interest. Some antidepressants, blood-pressure medicines, hormonal contraception, and other treatments can affect desire. Low sex drive is personal: a lower level is not a disorder unless it is unwanted or distressing.

A clinician can review your symptoms, medicines, menstrual or menopause history, pain, sleep, and mood in private. Treatment may focus on dryness or pain, medication changes, counselling, relationship support, or practical ways to create time and comfort. Do not start hormones or supplements without advice. Testosterone therapy for women may be discussed in selected situations, with benefits and drawbacks reviewed carefully.

Arrange an appointment if the change is sudden, persistent, distressing, or accompanied by pain, bleeding after sex, vaginal changes, low mood, or exhaustion. Seek urgent help if low mood includes thoughts of self-harm or you feel unsafe.

Could pain, dryness, menopause, mood, or a medicine be affecting my desire? What non-hormonal options could help? Is testosterone therapy appropriate for my situation?