Having a low sex drive: what to know

Sexual desire is not fixed. It may rise and fall with sleep, emotional wellbeing, body image, privacy, relationship experiences, or the demands of daily life. A change matters clinically when it is persistent, causes distress, or differs from what feels normal for you.

Hormonal transitions such as perimenopause and menopause can affect desire, arousal, and comfort. Vaginal dryness or pain may make sexual activity difficult, which can then reduce interest. Genitourinary Syndrome of Menopause is one condition that can involve these symptoms. Depression, anxiety, thyroid problems, chronic illness, and some medicines can also contribute.

Start by noticing when the change began and whether it follows a new medicine, illness, childbirth, hormonal transition, pain, or a period of stress. Record related symptoms such as dryness, hot flushes, low mood, tiredness, or discomfort during sex. Do not stop a prescribed medicine without medical advice.

If dryness or pain is present, mention it directly during a consultation; treating discomfort may be part of improving sexual wellbeing. A clinician can review your health and medicines, discuss emotional or relationship factors, and suggest appropriate options. Open, pressure-free communication with a partner can also help identify what feels comfortable.

Arrange a medical appointment if low desire is new, continues, causes distress, affects a relationship, or occurs with pain, vaginal dryness, bleeding after sex, unusual discharge, marked tiredness, or changes in mood. Seek prompt help if low mood includes thoughts of self-harm.

A clinician can check for treatable contributors rather than assuming the change is simply part of ageing. Bring a list of medicines and supplements, along with the timing of your symptoms and any recent health or life changes.

You could ask: Could a medicine or health condition be affecting my desire? Could hormonal changes, dryness, or pain be involved? What examinations or tests are appropriate? Which treatments could improve comfort or desire, and what side effects should I know about? Would counselling or sex therapy be useful?