What is low libido?
Low libido (hypoactive sexual desire disorder, HSDD) is decreased interest in sex causing distress. Common in both men and women, with significant impact on relationships and quality of life.
Causes are numerous: hormonal (low testosterone in men, perimenopause/menopause in women), medications (SSRIs, hormonal contraceptives, beta blockers), depression, anxiety, sleep deprivation, relationship issues, chronic stress.
Do I have low libido? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Hormonal (low T, menopause), medications (especially SSRIs), depression, anxiety, sleep apnea, sleep deprivation, chronic stress, relationship dynamics, chronic illness, alcohol, smoking, certain birth control methods.
Is it contagious?
No.
Treating low libido often means treating depression, sleep apnea, or medication side effects — the underlying cause matters more than throwing a pill at the symptom.
Can it be treated online?
Low libido evaluation is well-suited to telehealth. Comprehensive history identifies cause. Severe cases or specialty treatments (testosterone for women, bremelanotide) may need specialty input.
How low libido is treated
Treat underlying cause — adjust SSRI dosing/timing or switch to bupropion, optimize sleep, treat depression. Men: testosterone replacement if low T documented. Women: flibanserin (Addyi) or bremelanotide (Vyleesi) for premenopausal HSDD; off-label testosterone for some postmenopausal women. Vaginal estrogen if dryness contributing. Couples counseling for relationship factors.
Self-care while you wait
- Optimize sleep — fatigue tanks libido
- Manage stress
- Limit alcohol — depressant effect
- Regular exercise — improves mood and energy
- Communicate openly with partner
- Address relationship issues directly
- Schedule intimacy if spontaneity is impossible
- Treat underlying depression/anxiety
How long does it last?
Variable. With identification and treatment of causes, often improves over months.
Frequently asked questions
Is it normal as we age?
Some decline is common but problematic low libido isn't 'just aging.' Causes can be addressed.
Can SSRIs cause this?
Yes — very common. Switching to bupropion or adding it can help. Discuss with prescriber.
Will testosterone fix it for me?
For men with documented low T, yes. For women, controversial — modest benefit in some postmenopausal women. Not universally effective.
Is it relationship-related?
Often partially — long-term relationships naturally see declining novelty. Communication and intentional effort help.
How do I know it's hormonal?
Labs help — testosterone in men, sometimes in women postmenopausally. Pattern of symptoms (especially with menopause) is suggestive.
