What to know about very low sex drive

Libido naturally changes over time. It becomes worth discussing when the change is persistent, causes distress, affects intimacy, or feels different from your usual pattern. You do not need to wait until it has affected every part of your life before asking for help.

A lower desire may occur around perimenopause or menopause as hormone changes affect sleep, mood, vaginal tissues, and comfort during sex. Genitourinary Syndrome of Menopause can cause dryness, burning, irritation, or pain, which may reduce interest in sex. A condition presenting with low desire does not identify the cause by itself.

Other contributors include anxiety or low mood, exhaustion, ongoing stress, pain, concerns about body image, difficult experiences, or tension with a partner. Some medicines, including certain medicines for mood or blood pressure, can also affect desire. Desire may fall because sex has become uncomfortable, not because attraction or affection has disappeared.

Notice when the change began and whether it appeared after a new medicine, illness, pregnancy, childbirth, a sleep problem, or a change in your menstrual pattern. Write down related symptoms such as dryness, pain, hot flushes, fatigue, mood changes, or changes in bleeding.

Arrange a review with a GP, gynaecologist, or other qualified clinician if the change is troubling you. They may ask about your health, medicines, mood, relationships, and sexual comfort, and may examine you when appropriate. Do not stop a prescribed medicine without medical advice. If dryness or pain is present, mention it directly; treating discomfort may be part of improving sexual wellbeing. Testosterone therapy for women is a specialist treatment that requires an individual assessment.

Book a clinical appointment if low desire persists, causes distress, follows a medicine change, or occurs with vaginal pain, dryness, unusual discharge, sores, urinary symptoms, or troublesome bleeding. Seek prompt care for severe pelvic pain, heavy or unexpected bleeding, or symptoms that make you feel acutely unwell.

Tell a clinician if low desire comes with persistent sadness, loss of interest in other activities, panic, or thoughts of self-harm. If sex is pressured, unwanted, or unsafe, prioritise your safety and seek support from a trusted person or local emergency service.

You could ask: Could a medicine, hormone change, pain, or another health issue be affecting my desire? Could vaginal dryness or discomfort be contributing? What options could help, and what side effects should I know about? Should we review my mood, sleep, or menstrual changes?