6 Common Causes of Low Libido in Women

Your libido (sex drive) is your interest in sex. It can change throughout your lifetime, or in different settings and situations. After all, your libido is affected by many different factors — including your mental and physical health and your personal experiences and relationships. 

Let’s take a closer look at what it means to have a low libido, as well as some common causes. 

What is low libido?

A low libido means you have little to no interest in sex. Here are some things you might notice:

• You’re not interested in sexual activity.

• You’re not interested in masturbating.

• You don’t think about sex very often.

• You’re not interested in initiating sex.

• You don’t find sex particularly exciting or enjoyable.

Not being interested in sex is totally normal for some people, including for people who are asexual. But if you’ve noticed a change in your libido, it’s possible there could be an underlying cause. 

6 common causes of low libido

If you're bothered by a low libido, you may be wondering why. 

Sometimes, the answer is simple — like a side effect from a single medication. Other times, the answer might be more complex, like if you’re dealing with hormonal changes, stress, and relationship challenges all at once. 

Let’s take a closer look at six common reasons for a low libido. 

1. Antidepressant medications

Antidepressants are a very common reason for low libido. This includes different types of antidepressants, such as: 

• Selective serotonin reuptake inhibitors (SSRIs)

• Serotonin and norepinephrine reuptake inhibitors (SNRIs)

• Tricyclic antidepressants (TCAs)

• Monoamine oxidase inhibitors (MAOIs)

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Sexual side effects are the least common with bupropion (Wellbutrin). In fact, this antidepressant is sometimes used to help with sexual side effects and low libido. 

2. Other medications

There are many other medications that can lower libido too. These include: 

• Heart failure medications: Examples include digoxin (Lanoxin), spironolactone (Aldactone), and thiazide diuretics like chlorthalidone (Diuril) and hydrochlorothiazide (Microzide).

• Blood pressure medications: These include clonidine (Catapres), beta blockers, ACE inhibitors, and alpha blockers. 

• Antiseizure medications: Examples include phenytoin (Dilantin, Phenytek), and phenobarbital (Luminal). 

• Cancer treatments: Low libido is common in women treated with chemotherapy and radiation therapy. 

• Opioid pain medications: OxyContin (oxycodone) is one example.

• Heartburn medications: Cimetidine (Tagamet) is one example. 

3. Pregnancy and childbirth

During and after pregnancy, your hormones go through big shifts. Many people notice that their sex drive is lower during pregnancy or the first couple months after a child is born. This may be due in part to the physical and hormonal changes in your body during these times. 

Plus, taking care of a new baby can take a toll physically and emotionally. Being sexually intimate with yourself or your partner might not be a top priority. The good news is that after recovering from pregnancy and delivery, many people find that their sex drive returns. 

4. Perimenopause and menopause

During menopause and the menopause transition, your body starts making smaller amounts of two sex hormones: estrogen and progesterone. This is linked to low libido, plus many different symptoms such as: 

• Hot flashes

• Night sweats

• Mood changes

• Vaginal dryness

Changes in your sex drive are also due, in part, to slowly decreasing testosterone levels.

All of these can combine to make you feel less interested in sex. Physical changes in your body can also make sex less pleasurable or even painful. This can have a major effect on your thoughts and feelings about sex. 

5. Psychological or emotional factors

Your emotional and mental health can affect your sex drive too. For example, depression and anxiety are both linked to problems with sexual arousal and desire. And feeling stressed or overwhelmed can make it hard to be in the mood. 

Relationship problems can also get in the way of intimacy. On top of that, your life experiences — including your past sexual experiences — can affect how interested you are in sex. These things all work together to influence how you feel. 

6. Painful sex

Pain during or after sex can make you less interested in having sex. It can also be hard on your self-image, sexual self-confidence, and relationships. All of these things can influence your sex drive even more. 

What is female sexual interest/arousal disorder (FSIAD)?

Most people use the term “low libido” to talk about low sex drive. And, as we mentioned above, having a low libido isn’t always a problem. 

But your low libido could be a sign of a health condition if both of these are true:

• Your low libido has lasted for more than 6 months.

• It’s making you feel down or distressed.

If you answered “yes” to both, then it’s possible you could have a sexual health condition called female sexual interest/arousal disorder (FSIAD).

To be diagnosed with FSIAD, at least three of the following must apply to you:

• You have little to no interest in sexual activity.

• You have very few — or no — sexual thoughts or fantasies.

• You’re not interested in initiating sex, or you’re not very responsive when your partner attempts to initiate sex.

• Sex isn’t very exciting or pleasurable for you at least 3 out of 4 times. 

• It’s hard for you to get interested in or aroused by sexual or erotic cues.

• You don’t have a lot of “feel-good” sensations in your genitals or other parts of your body at least 3 out of 4 times when you have sex.

To be diagnosed with FSIAD, your symptoms also can’t be caused by:

• Another mental health condition

• Severe relationship distress, such as intimate partner violence or other major stressors

• Substance use or medication

• A medical condition

What is hypoactive sexual desire disorder?

Hypoactive sexual desire disorder (HSDD) is an outdated term for FSAID. It’s an older diagnosis from the DSM-4, a clinical guidebook. The term was combined with female sexual arousal disorder (FSAD) to become FSAID when the newer DSM-5 came out in 2013. 

How to talk to a healthcare professional about low libido

If you’re troubled by your low libido, talking to a healthcare professional you trust is a great next step. This could be your primary care provider, your gynecologist, or another healthcare professional you feel comfortable with. 

Together, you’ll discuss your symptoms and your medical history. The healthcare professional might also recommend other tests or exams that can help guide treatment. These include: 

• A full physical exam

• A pelvic exam

• Blood tests 

Some healthcare professionals use a questionnaire called the Decreased Sexual Desire Screener (DSDS) to better understand your symptoms. The DSDS is a simple test that includes questions such as: 

• In the past, was your level of sexual desire or interest good and satisfying?

• Has there been a decrease in your level of sexual desire?

• Are you bothered by your decreased level of sexual desire or interest?

• Would you like your level of sexual desire or interest to increase?

And remember: Many people feel shy or embarrassed to talk about sex with a healthcare professional. But it’s an important part of your overall health. Sexual issues are very common, and it’s likely that the healthcare professional has dealt with your particular symptoms or situation before. 

Despite that, most healthcare professionals won’t ask you about sexual issues as part of your general exam. So it may be up to you to start the conversation.

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Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

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