My low libido is affecting my relationship: what should I know?

Desire can fall when sex is painful, when sleep is poor, or when anxiety, depression, exhaustion or relationship conflict is present. Medicines and health conditions can contribute too. During perimenopause and menopause, hormone changes may bring vaginal dryness, hot flushes, sleep disruption and mood changes. Genitourinary syndrome of menopause can cause dryness, burning or pain that makes intimacy difficult.

A lower level of desire is not a personal failure and does not automatically mean that attraction or love has disappeared. The most useful clue is often what changed first: pain, stress, medication, mood, cycle or relationship circumstances.

Tell your partner what you are experiencing and what kind of closeness feels safe, without promising sex or accepting pressure. If pain or dryness is present, mention it directly to a clinician; treatment can focus on comfort as well as desire. Review medicines and mood with a healthcare professional before stopping anything.

A clinician can assess symptoms and discuss counselling, pelvic-floor support or menopause care where appropriate. Testosterone therapy for women is not a universal solution; its suitability depends on the individual assessment and the reason for low desire. Couples or sex therapy may help both partners communicate without blame.

Arrange an appointment if low desire lasts, causes distress, follows a medicine change, or comes with painful sex, bleeding, unusual discharge, urinary symptoms or significant mood changes. Seek urgent help for thoughts of self-harm, sexual coercion, severe pelvic pain, heavy bleeding, or sudden serious illness symptoms. Your safety and consent come first.

Ask: Could pain, dryness, hormones, mood, medicines or sleep be affecting desire? What can make intimacy more comfortable? Would counselling or pelvic-floor care help? Is any hormone treatment appropriate for my symptoms, and how would we review it?