Loss of Libido: Causes and Treatments Explained
Also called hypoactive sexual desire disorder (HSDD), loss of libido defines a loss of sexual desire or sex drive. It’s a common problem, and many of us – men and women – are affected at some point in our lives.
The Diagnosis and Statistical Manual of Mental Disorders fifth edition (DSM-5) i – an authoritative guide compiled by hundreds of international experts – suggests between 1 - 20 per cent of men are affected by loss of libido, as well as 26 - 43 per cent of women.
However it’s difficult to put an exact number on how many people experience loss of libido, since experts believe few people who experience it ask their doctor for advice, even when it causes difficulties in their relationship.
Indeed, even in this day and age many of us feel embarrassed to talk about loss of libido. Doctors claim people who do for help are more likely to mention it in connection with another complaint than refer to it directly, or they may mention it as an afterthought.
How to get help
If you’re worried about a problem with your sex drive, try not to feel embarrassed about it. Remember it’s a really common problem, and your doctor will have helped many others with the same issues before you.
However, you don’t have to see your family GP. There are other health professionals who can offer help and advice, including the following:
Relate is an organisation that offers relationship support, including help with sexual problems. Its website has advice about sex and relationships that you may find useful, or you could talk to a Relate counsellor over the phone or online. If you’d prefer to speak to a counsellor in person, Relate has local offices around the country.
Sex therapists are qualified counsellors, doctors or healthcare professionals who have been trained to help people who are having difficulties with sex. Your GP may be able to refer you to a therapist, but sex therapy isn’t available on the NHS in all areas of the UK. If that’s the case where you live you could pay for private sex therapy. Find a therapist online by visiting the Institute of Psychosexual Medicine’s website.
The Sexual Advice Association is a charity that aims to improve sexual health. It has a range of factsheets about sex problems on its website that you may find useful.
Also use the online NHS sexual health services finder to locate your nearest contraception and sexual health clinic, where you can also get advice for a range of sexual health problems.
What causes loss of libido?
There are many things that can cause loss of libido. Some are things that can happen to you every day, such as being under a lot of stress or feeling tired, while others may be more complicated, such as having an underlying medical problem. Here are the most common culprits:
Any mental health problem can cause loss of libido, the most common of which is depression. Indeed, depression is a serious illness that can affect your sex life significantly. Besides a lack of interest in sex there are many other symptoms of depression, including the following:
Lack of energy or feeling tired all the time
Restlessness and agitation
Having difficulty sleeping or sleeping more than usual
Poor appetite, which may lead to weight loss
Feeling sad and in low spirits all the time
Not finding any pleasure in life
Having difficulty making decisions
Low self-confidence and self-esteem, withdrawing from family and friends
Feeling generally helpless and hopeless
If you think you may be depressed, consider seeing your GP as there are several treatments that you may find helpful. However it’s also important to know that loss of libido can be a side effect of taking antidepressants, which are often prescribed as a treatment for moderate to severe depression. If you’re taking antidepressants and are experiencing a lower-than-usual sex drive, tell your GP about your concerns.
Since libido is linked with wellbeing, most types of long-term illness can send it plummeting. This can be the result of the emotional strain of having a long-term illness, or it could even be caused by certain treatments. The main conditions associated with loss of libido include:
Cancer (loss of libido is very common among those having treatment for cancer)
Hypothyroidism (underactive thyroid)
Some types of surgery are also known to cause loss of libido, such as hysterectomy (removal of the womb) and oophorectomy (removal of one or both ovaries) in women, and radical prostatectomy (removal of the prostate gland and tissues surrounding it) in men.
Stress and anxiety
If you’re under a lot of stress or are affected by anxiety, it can have a big impact on your libido. You may be under more pressure than usual for a variety of reasons – perhaps you’re experiencing problems at work, for instance, or in your relationship, or you may be going through a major life change. Any of these things can sap your energy, which can also make your sex drive plummet.
Changing hormone levels can also have an effect on your sex drive. This is common in women after pregnancy and also during the years before and after the menopause, when levels of oestrogen fall. Men can be affected by hormone changes too, with testosterone levels declining naturally with age. If you think your hormones may be to blame, your GP may be able to offer blood tests to check their levels.
Many medicines can sometimes affect sexual function. These include certain types of the following:
Blood pressure management medicines
Antidepressants and tranquilisers
Medicines used to treat epilepsy
Medicines for prostate cancer and prostate enlargement
Medicines used to treat cancer
If you’re taking regular medicines, check the leaflet that comes with the packaging – if low libido is a possible side effect, it will be listed.
Drinking high levels of alcohol over a long period can have an effect on your sex drive too. Try to stick to the government’s recommendation of 14 alcohol units a week on a regular basis.
Sexual health problems
Several physical issues may make your sex drive lower, such as vaginal dryness, painful sex and recurrent bouts of cystitis in women, and ejaculation problems and erectile dysfunction in men.
How is it treated?
There are several treatment methods that may improve a flagging sex drive. However the treatment used will depend on what’s causing the problem. Sex therapy can be a good place to start – your GP can refer you and your partner to a therapist, or you can find one privately.
If the problem is that you’re stressed, anxious or permanently exhausted, you may need to address parts of your lifestyle. Finding ways to reduce your workload, for instance, may be helpful, or perhaps you could try to find more time in your day to relax.
Your GP can also help with stress and anxiety, plus offer plenty of advice if you’re not sleeping well and feeling tired during the day as a result. If you think you may be depressed, your GP may advise you to take antidepressants. However, since some antidepressants are associated with loss of libido, go back to your GP if you start taking them and your sex drive doesn’t improve (though it may be difficult to determine whether it's the depression or the medication at fault).
Other medical treatments that may be used to treat loss of libido include hormone replacement medicines including oestrogen and testosterone, or thyroxine to treat an underactive thyroid.
Meanwhile, your GP may also be able to switch your medication if you think something you’re taking is affecting your libido.
Ways to help yourself
Besides medical treatments there are several changes you can make to your lifestyle that may give your libido a boost…
Eat healthy foods
Certain foods are thought to have aphrodisiac effects. But enhancing your sex drive isn’t just a matter of eating lots of exotic treats. Instead it’s more a case of eating really healthily. The more nutritious foods you eat, the better, so try to make sure you get at least five portions of fruit and vegetables in your diet every day.
Many experts also recommend foods containing plant hormones called phytoestrogens for women with libido problems, as these may help balance levels of female hormones. Such foods include many types of seeds and whole grains, some nuts (almonds, cashews, hazelnuts, peanuts and walnuts), soya beans and soya products, some fruits (apples, avocados, bananas, mangoes, papayas and rhubarb), dark green leafy vegetables and wild flower honey.
It’s also be a good idea to make sure your diet includes a good amount of high-quality protein, as protein helps your body make hormones. Try eating more fish, poultry, eggs, low-fat dairy, nuts, beans and a small amount of lean meat. At the same time, try cutting back on stimulants such as sugar, refined carbohydrates, tobacco, alcohol, tea and coffee.
Take a deep breath
If you’re under a lot of stress, breathing exercises can have an instant calming effect. Place one hand just below your navel and breathe slowly in and out through the nose, observing the sensation of your hand moving in and out with the breath. Just five minutes should help you clear your head.
Another way to relax is to take a long bath in mineral salts, such as alkaline or Dead Sea salts. As well as making you feel more serene this may help improve your body’s acid-alkaline balance, as the beneficial minerals are absorbed through the skin and into the bloodstream.
Improving your acid-alkaline balance may be helpful as over-acidity in the body – which can be caused by anything from stress to eating processed foods and drinking too much alcohol – may be associated with many types of health problems, including low energy and low libido.
Give up smoking
If you smoke, here’s another reason to try quitting your habit. It’s thought that there’s a direct relationship between smoking and sex drive in both men and women. And since smoking affects your circulation – including blood flow to the genitals – it may also be linked with sexual difficulties, such as erectile problems in men.
If you need support for giving up smoking there are several products available at pharmacies that could help you manage withdrawal symptoms such as nicotine cravings, including nicotine patches, gum and lozenges.
Drink in moderation
Alcohol may also be a problem if you’re a heavy drinker with a history of alcohol abuse. The odd tipple can help you lose your inhibitions and help increase sexual experience. But too much alcohol can interfere both with sexual interest and sexual functioning.
Try to stick to current guidelines for alcohol intake, which is no more than 14 units of alcohol a week on a regular basis (the same guidelines apply to men and women). For more help with making better choices about drinking, visit the Drinkaware website.
Be more active
Regular exercise may be helpful because it boosts your circulation – which can help with sexual functioning – reduces anxiety and helps your body to produce feel-good hormones called endorphins. It takes 20 to 30 minutes of aerobic exercise to stimulate the release of endorphins in the brain – try jogging, dancing, cycling or any activity that raises your heart rate.
Vaginal dryness isn’t exactly a turn-on where your love life is concerned – and it can be a problem for women around the time of the menopause, thanks to declining oestrogen levels. However lubricant gels can help support the delicate skin in the genital area.
Natural libido-supporting supplements
Meanwhile there are several natural supplements you could try for a loss of libido problem, including the following:
High-strength multivitamin and mineral
A high-potency multivitamin and mineral supplement could help boost your sex drive if you’re deficient in one or more nutrients.
Low levels of folic acid may be linked with erection problems and premature ejaculation, either or which can have an effect on male libido. One study has shown a relationship between blood levels of folic acid and sexual dysfunction, which the authors say may be caused by the effect of folic acid on the metabolism of nitric oxide and other substances ii. Foods such as dark leafy greens, asparagus, broccoli, beans, peas, lentils, avocados and citrus fruits contain folate (the form of folic acid found naturally in food).
Some natural health practitioners recommend the antioxidant mineral selenium for loss of libido problems. Indeed there is some evidence that it may help with testosterone production in men who have fertility problems iii. Foods that contain selenium include Brazil nuts, fish, red meat, poultry and fortified food products.
Magnesium is another mineral that may help with testosterone levels, but only if you don’t get enough of it in your diet. It’s found in foods such as leafy greens, dark chocolate, seeds, nuts, beans, bananas, yoghurt and avocados. However, despite being found in a variety of foods, low intakes of magnesium are thought to be common in the UK. According to the British Nutrition Foundation, one in five women aged 19-34 years and more than half of teenage girls have intakes below the lower reference nutrient intake (LRNI) and more than 20 per cent of boys aged 11-14 years are also at risk of low intakes iv.
Deficiency in this essential mineral is also thought to be linked to low testosterone. One study, carried out by experts at the Shiraz University of Medical Sciences in Iran, found that taking zinc supplements may help improve testosterone levels in men, and may improve their sexual functioning in some aspects v. Zinc is also found in foods such as shellfish, nuts, seeds and oysters.
There is some evidence that Korean red ginseng may improve libido in women who are going through the menopause. In one study, women taking red ginseng reported significant improvements in sexual arousal compared with those taking a placebo (dummy pill) vi. The writers of the study concluded that Korean ginseng might be used as an alternative medicine in menopausal women to improve their sex lives.
Korean ginseng may also help men with sexual functioning, with studies suggesting it may be helpful for those who have erection problems vii.
Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition. Available online: https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
Wen-Jie, Y., et al. A new potential risk factor in patients with erectile dysfunction and premature ejaculation: folate deficiency. Asian J Androl. 2014 Nov-Dec; 16(6): 902–906. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236337
Safarinejad, M.R., Safarinejaf, S. Efficacy of selenium and/or N-acetyl-cysteine for improving semen parameters in infertile men: a double-blind, placebo controlled, randomized study. J Urol. 2009 Feb; 181(2):741-51. Available online: https://www.ncbi.nlm.nih.gov/pubmed/19091331
British Nutrition Foundation. Minerals and trace elements. Available online: https://www.nutrition.org.uk/nutritionscience/nutrients-food-and-ingredients/minerals-and-trace-elements.html?showall=1&limitstart=
Jatali, G.R., et al. Impact of oral zinc therapy on the level of sex hormones in male patients on hemodialysis. J Urol. 2010 May; 32(4):417-9. Available online: https://www.ncbi.nlm.nih.gov/pubmed/20446777
Oh, K.J., et al. Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical study. J Sex Med. 2010 Apr; 7(4 Pt 1):1469-77. Available online: https://www.ncbi.nlm.nih.gov/pubmed/20141583
Choi, H.K., Seong, D.H., Rha, K.H. Clinical efficacy of Korean red ginseng for erectile dysfunction. Int J Impot Res. 1995 Sep; 7(3):181-6. Available online: https://www.ncbi.nlm.nih.gov/pubmed/8750052
de Andrade, E., et al. Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction. Asian J Androl. 2007 Mar; 9(2):241-4. Available online: https://www.ncbi.nlm.nih.gov/pubmed/16855773