A person may experience a decreased libido from time to time during their lifetime, and for a variety of reasons. This could stem from being hit with a bout of stress, having a few late nights in a row or coming down with the flu.
But while this ebbs and flows depending on the circumstances, there are times when a sudden decreased sex drive can be a cause for concern. Sleep disorders, vitamin deficiencies and other health conditions can all affect your sex life.
Below are some of the reasons you might have a low sex drive, plus steps on what to do about each:
1. Your hormones are out of wack.
If your sex drive has declined as a male, it may mean that you have low testosterone, said Stanton Honig, a urologist and director of the Male Urology Program at Yale Medicine. Other symptoms that indicate this may be a problem include reduced energy levels and unexplained weight gain.
“Treat this by exercising, eating healthy and getting enough sleep,” Honig said. “Talk to your doctor who may test your testosterone levels and prescribe testosterone shots, pills, pellets or patches if needed.”
And know that a dip in testosterone is something that happens to a lot of men. In fact, an estimated “30 to 40% of men over the age of 50 have low testosterone,” according to Damon Davis, a urologist with Mercy Medical Center in Baltimore. The condition can be confirmed with a simple blood test.
Imbalanced hormones can also affect women, especially over the age of 35, as they start to have a decline in their natural hormones, said Alex Spinoso, an internist in Las Vegas and Palm Springs, California.
“These hormones are the most important contributor to our sex drive,” he said, noting that one viable option may be hormone replacement therapy.
2. Your medication may be to blame.
Been using a new prescription? Kimberly Langdon, medical advisor at Dr Felix, a digital health company based in the United States and the United Kingdom, said that certain prescription drugs or a “medicine reaction” can sometimes cause low libido. Chronic steroids for autoimmune diseases or asthma can lower testosterone production and lower sex drive.
Cancer drugs, opioids, anti-anxiety medications, antifungal treatments and some diuretics can also ”impact normal sexual function through impact on the cardiovascular system and impacting testosterone levels,” added Joel J. Heidelbaugh, director of the medical student education with the University of Michigan Medical School.
3. You have depression.
Having a low sex drive could signify that your mental health may need some TLC. “How you’re feeling inside can be a cause of low libido,” Honig said.
Low sex drive could indicate depression due to the element of anhedonia, known as the inability to enjoy things that you would normally enjoy, explained Ashwini Nadkarni, an associate psychiatrist and instructor at Harvard Medical School.
“Depression ― changes in the brain’s levels of dopamine and serotonin or your ‘feel good’ chemicals ― not only affect one’s mood, they also affect the ability to experience pleasure from sex,” Nadkarni said.
If you suspect you may be experiencing depression, Honig suggested seeing a mental health professional to address what you’re feeling. It’s possible to manage it through therapy and medications, if needed.
“When you’re in a better place emotionally and in your relationships, and have good coping skills for stress, sex drive can improve naturally,” Honig added.
Heidelbaugh warned that “many antidepressants may contribute to decreased libido.” He noted, however, that there are a variety of pharmacologic options available to effectively treat both concerns, so ask your doctor to find an option without these side effects.
4. You’re going through menopause.
Morgan West, an OB/GYN at Wyckoff Heights Medical Center in Brooklyn, said low sex drive is fairly common in women around ages 40 to 60 and that “it’s no coincidence that this coincides with the average age of menopause.”
West added that low estrogen can cause mood disorders, low sexual desire, vaginal dryness and pain with intercourse. These are normal changes, she stressed, and you should discuss your concerns and learn about treatment options with your gynecologist.
Brittany Denny, an obstetrician with ProMedica, a health care company in Ohio, added that “with menopause, estrogen is lower and that can affect the vagina and vulva, which could become more dry and prone to injury during sex.” So, sometimes when women have a low sex drive, it’s because sex is painful.
5. You’re lacking some key vitamins or minerals.
An unbalanced diet may be to blame for not wanting to hit the sheets. Langdon said that iron, iodine and folate levels are important for maintaining sex drive.
“Iron reduces anemia and fatigue. Iodine keeps the thyroid healthy, while zinc and folate deficiencies can lead to anemia, fatigue, hence low sex drive,” she said.
Langdon added that anemia, which can also affect a man’s libido, can also be due to an underlying loss of blood from the gastrointestinal tract. This can be a sign of some medical issues like cancer or ulcers. If you’re feeling more tired than normal, check in with your doctor. “Anemia presents with fatigue and exercise intolerance, both of which lower sex drive and stamina,” she said.
And in females, “low iron levels and anemia from menstrual cycles can lead to fatigue and as a result, low sex drive,” Spinoso said.
6. You’re stressed out.
Untreated stress and anxiety conditions can be a catalyst for bedroom woes. “Especially in younger men, the vast majority of cases of lower libido is secondary to emotional difficulty,” said Scott Dalton, a psychiatrist in New York.
And stress can absolutely affect a woman’s sex drive as well, causing her to be far from in the mood. To overcome emotional distress, he suggested working toward a balanced life with activities such as exercise and meditation and seeing a mental health professional if symptoms persist. Heidelbaugh added that “appropriate psychotherapy and sex therapy [for] individual or couples has proven to be effective.”
7. You may have a thyroid issue.
“If you have a lack of sex drive, that may mean that you have thyroid disease resulting in low levels of thyroid hormone,” said Michael Eisenberg, director of male reproductive medicine and surgery at Stanford Health Care. Other symptoms of a thyroid condition include fatigue, weakness, cold sensitivity, dry skin and weight gain.
Langdon added that since “your thyroid is essential for maintaining many body systems,” a lack of thyroid function or excess thyroid function can cause sex drive disturbances.
Eisenberg suggested “talking to your doctor who may run tests and prescribe medications such as thyroid replacement.”
8. You’re having sleep troubles.
Not properly logging your z’s can lead to fatigue, which can alter your sex drive.
“An often missed ― but important ― cause of a low sex drive is sleep apnea,” explained Chirag Shah, a board-certified emergency medicine physician and medical reviewer for PollMed, adding that sleep apnea presents as episodes where your breathing stops or slows down during a period of sleep.
“Not only does sleep apnea cause fatigue and increase the risk of other medical issues, sleep apnea is associated with a low sex drive in men,” Shah said. In addition to low energy levels, sleep disorders affect libido by impeding the production of testosterone. The condition is often treatable and the first step is getting an evaluation from a sleep specialist.
Terry Cralle, a certified clinical sleep educator and co-author of ”Sleeping Your Way to the Top” pointed to a study published in 2011 which showed that even moderate sleep restriction reduces daytime testosterone 10 to 15%. That could make libido a problem for men.
“And in a 2015 study, researchers concluded that [for women], obtaining sufficient sleep was important to the promotion of healthy sexual desire and the likelihood of engaging in sexual activity with a partner,” Cralle said.
9. You’re experiencing erectile dysfunction.
A lack of sex drive could mean poor erectile or sexual function, Eisenberg said. Erectile or ejaculatory difficulties can lead to men wanting to avoid intimacy. Men should talk to their doctor, who may run tests, prescribe medications or provide guidance for other strategies.
Honig added that people commonly get a low libido and ED confused. “Low libido refers to ‘interest in sexual activity and intimacy.’ Sometimes this can be confused with problems with erections. Many times patients come to my office complaining of loss of libido but their main problem is with erection quality,” he said.
10. A heart condition could be at play.
If you’ve had cardiac problems in the past, that could be a factor here. Studies show that an estimated 60% to 87% of patients who experienced heart failure report sexual problems and that the prevalence of erectile dysfunction is reported in up to 81% of male cardiac patients.
“There are small studies showing eating the same foods that can stall and reverse heart disease … can improve blood flow to a man’s sexual organs,” said Columbus Batiste, a cardiologist at Kaiser Permanente in Southern California. Batiste said that eating more legumes, fruits and whole grains can help with both issues.
11. You may be dealing with another underlying illness.
In rarer cases, an underlying health issue may be the culprit. “These include poorly controlled diabetes, end-stage renal disease, cancers and autoimmune diseases,” Heidelbaugh said.
Women can develop a condition known as vaginismus, “a disorder of the pelvic muscles that causes pelvic pain and issues with penetration,” which can lead a woman to want to withdraw from having sex, West said. There are treatment options for vaginismus. And for other chronic conditions, proper management of the illness along with medication or guidance from your doctor can help increase your sex drive.
In general, staying healthy can also be key to warding off sexual apathy, Eisenberg said, which include habits like exercise and eating a proper diet.
If you are having any unfamiliar symptoms, it’s important that you talk to your doctor who may run tests and prescribe medications based on what you’re experiencing. They can help you get back to a state of bliss, since you deserve to enjoy what goes down in the bedroom.
Sex Ed for Grown-Ups is a series tackling everything you didn’t learn about sex in school — beyond the birds and the bees. Keep checking back for more expert-based articles and personal stories.