Factors that Play a Part in Loss of Libido with DR. Philippa Kaye

Libido – it’s complicated right?

The word libido means your sex drive, for any kind of sexual activity. As for what is a ‘normal’ libido? There isn’t an answer here, it is simply what is normal for you; and even this may change at times, but if having a high or low libido is affecting your life or your relationships then that is the time to seek medical advice.

Your libido depends on lots of factors, from the physical such as levels of hormones such as testosterone; to the psychological such as your mood and stress levels, to social factors such as relationships and cultural or social constraints.

Physical factors impacting loss of libido

Physical factors affecting a low libido include hormones which have a direct effect on your sex drive and other physical factors. For example, if you are unwell with a cold, a fever, or a tummy bug, you are unlikely to want to have sex. If you have a medical condition which causes chronic pain such as arthritis your libido may be affected, and even if you do have sex, certain positions may be more uncomfortable. Vulval skin conditions and post menopausal changes to the vulva and vagina; or vaginismus may make sex painful, again affecting your libido.

You might notice that there is a change to your libido throughout your menstrual cycle, which is related to the changing hormone levels throughout the month. You may notice that your sex drive goes up during the first half of your cycle, before ovulation, due to rising oestrogen levels and then goes down in the time leading up to your period related to rising progesterone levels.

Falling levels of oestrogen and testosterone after the menopause can also lead to a drop in libido and low testosterone levels can also affect men. For more information on how to increase your sex drive after the menopause, read here. And while exercise has many positive physical and mental health benefits, overexercising has a negative impact on health including a loss of libido.

Psychological factors impacting loss of libido

There are many psychological factors which can influence your libido. Mental health disorders such as depression and anxiety, as well as low mood and high stress levels can all impact on your sex drive. If you have body confidence issues, perhaps after surgery, or having a baby, or in general, or have body dysmorphia, then anxiety about showing your body can then impact on your libido.

Medications given for mental health conditions such as antidepressants may also affect your sex drive, arousal and ability to reach orgasm. And there doesn’t have to be a mental health issue for psychological factors to be involved. If you are tired and had a bad day, if you are angry or fed up, or feeling worried, your sex drive may lessen.

All these factors can link and interplay with each other. For example. let’s say sex was painful last time and this time you are worried about it hurting again, you are less likely to want to have sex.

And then we need to consider social factors such as the state of your relationship, if you have a baby or young children who regularly disturb you, if you are living with lots of people and are worried about them hearing and any number of culture or societal expectations around sex. All of which can affect your desire for sex.

If you feel like you have no libido and it’s affecting your life, then please seek medical help. The treatment will depend on the cause of the loss of libido and some factors may be easier to treat than others. For example, vaginal dryness might be treated with lubricants or vaginal moisturisers to make sex not painful but if there are other issues in the relationship then treating the vaginal dryness alone will not help your libido. In this case, relationship or psychosexual counselling may be needed.