Low Libido — why you’re not in the mood and what you can do about it.
Man oh man, if I had a dollar for every time a patient came to me worried about their sex drive …
Seriously, though — low sex drive is an all too common occurrence, so if you’re experiencing a lack of desire, please know that you’re not alone. And also please know that it’s a BIG DEAL. No, I don’t mean that something is seriously wrong with your body. What I’m referring to is the impact that it can have. A lot of women dismiss their low sex drive as if they aren’t allowed to be concerned about it, but the consequences of a low libido go way beyond the bedroom. It affects your relationship, your confidence and your mental health. That being said, don’t stress — I’m here to give you all of the information that you’re looking for. We’ll talk about what low libido looks like, common underlying causes and what you can do to start getting your sex drive back.
What Does Low Libido Actually Mean?
Low libido simply means low sex drive — AKA, you’re just not in the mood, like ever. The tricky thing is that there is no clear diagnostic criteria or established way to measure libido. Instead, it’s an entirely subjective experience, and so a low sex drive can mean completely different things to different people. There’s simply no “normal” baseline to compare your level of desire to. That being said, when it comes to sex drive, you JUST KNOW when something is off, especially if your sex drive has changed over time.
Common symptoms of low libido:
No (or low) interest in sexual activities
No (or infrequent) sexual thoughts
Concern about your level of sex drive
This is an important one. Even if your sex drive has only decreased a little bit, if it’s bothering you and affecting your life, a little bit is a big deal and enough to warrant some investigation.
Decreased sense of arousal
Arousal is different than desire. Desire refers to you wanting to have sex, but arousal refers to the physical changes that happen in your body in response to desire — increasing heart rate, dilating blood vessels, increased vaginal lubrication. Some people WANT to have sex, but their body simply isn’t responding to stimuli.
Difficulty reaching orgasm
Vaginal dryness
Pain with intercourse
What Causes a Low Libido?
Let me first say that the cause of a low sex drive isn’t always cut and dry and it can be difficult to pinpoint one single thing— in fact, there are often multiple factors that contribute to low libido, including both physical and psychological causes.
Psychological Factors
When a woman comes to me with concerns about low sex drive, she is almost always convinced that the cause is hormonal. From my clinical experience, I will tell you that hormones aren’t always to blame and, especially for women, it more often than not comes down to a mental and emotional cause.
You’re lacking confidence.
Let’s start with self-esteem. I won’t speak for every woman, but in general, we are HARD on our bodies. A woman is often her own harshest critic, turning every minor imperfection into the most troublesome insecurity. This is the quickest way to extinguish your sex drive — If you’re not feeling desirable, you’re simply not going to desire sex.
You’re not attracted to your partner.
Another huge psychological factor is your perception of your partner. You may need to ask yourself some tough questions, especially if you’re in a long-term, loving relationship. Are you attracted to your partner? Are you having open conversations about your needs? If you’re able to have sexual thoughts about another person, but not your partner, the issue likely isn't libido.
You have a history of sexual trauma.
Another important factor to consider is whether you have a history of sexual assault or abuse. There is no denying that past trauma can have a huge impact on your current view of intimacy and ability to engage in an intimate relationship.
Your mental health is struggling.
Of course, anxiety and depression play a role in low sex drive, too — if you’re experience low mood, it’s hard to be in the mood.
Hormonal Factors
Now that we’ve covered the mental and emotional factors that could be hindering your sex life, let’s get to the hormonal component. First, let me clarify that it’s entirely normal to not be in the mood all of the time. While men have relatively stable testosterone levels and a consistent sex drive all month long, women are cyclical beings — our hormones and subsequently our libidos, fluctuate. This is why having a fundamental understanding of the menstrual cycle is so important.
Nature is smart. As a woman, you were designed to become pregnant (even if the isn’t your goal), and so to increase the chances of pregnancy occuring, you’ve evolved so that your libido is at its highest during your most fertile time of the month. This natural increase in sex drive occurs around ovulation, which is typically mid-cycle. Simply put, some ebb and flow in your sex drive is not only normal, but expected.
You have low testosterone.
Now although fluctuations in your hormones are normal, there are some specific hormonal imbalances that can contribute to low libido, such as low testosterone. Testosterone is typically thought of as a male hormone, but females have it, too! One of its main roles is to promote sexual function in women. If you’re experiencing low libido, low testosterone may be to blame.
You have low (or high) estrogen.
Estrogen also plays a role in libido. Low estrogen can cause vaginal dryness, which results in painful intercourse and subsequently a lack of desire.
Your cortisol is elevated.
Cortisol is your body’s stress hormone. Some amounts of stress are normal and healthy, but excessive and prolonged stress can negatively effect your body. Listen, your body is smart — when you are highly stressed, your body registers that it’s likely not a good time to create a baby and an adaptive response to this is to decrease your libido.
Additional Factors
You’re taking a medication that has side effects.
Medications have side effects, and a common one is diminished sex drive, so it’s important to check your medicine cabinet and see what you’re taking. One particular medication that is known to cause low libido is hormonal birth control and this decrease in desire can last for months after discontinuing the pill. Another common culprit is the family of Selective Serotonin Uptake Inhibitors (SSRIs), which are used to treat depression.
You have chronic fatigue.
If you’re constantly exhausted, sex is likely the farthest thing from your mind. It’s hard to even think about sex, when what you really need is sleep.
It’s important to note that fatigue is a symptom and you need to investigate what the underlying cause is, whether it’s lack of sufficient sleep, cortisol dysfunction, blood sugar swings, hormonal imbalances, nutrient deficiencies, a thyroid disorder or something else.
For example, deficiencies in iron, vitamin D and zinc have all been linked to poor sexual function in women. Women with hypothyroidism are also more likely to report low libido. This makes sense since some of the most common symptoms of hypothyroidism are fatigue and weight gain, both of which can put a damper on your sex drive.
You recently had a baby.
Let me take a deep breath here and try not to go on a rant. If you’ve ever given birth, you know that not much is offered at your 6-week postpartum visit other than a prescription for birth control and the go ahead to resume intercourse. For many women, this is no where near the amount of time that they actually need in order to recover both physically and mentally from birth and to be ready to resume intimacy with their partner.
If this is you, please give yourself grace, be patient and know that your low libido is likely due to the season of life that you’re in and have faith that it will return.
How can you restore your libido?
Start with the basics:
There is no magic pill or quick fix for low libido. Instead, solving the issue often requires addressing multiple factors and like most things, starts with the foundations — are you eating a nutrient dense diet, are you moving your body regularly, are you properly managing stress, are you getting sufficient sleep?
Move your body for 150 minutes each week.
Have practices like mindfulness meditation or journaling that help you to manage stress.
Stick to a regular sleep and wake time.
Decrease your alcohol intake.
Stop smoking.
Eat a variety of whole plant foods.
Check-In with your partner:
If your’e covering all the bases and addressing your general wellness needs, it may be time to talk to your partner. Communicate your needs, prioritize foreplay and make sure that your sexual relationship is getting the attention that it needs and deserves. It’s also important to address the non-intimate portion of your relationship — spend quality time together.
See your doctor:
It’s important to be evaluated by a functional medicine provider who will take the time to investigate the root cause instead of dismissing your concerns. I offer functional medicine lab testing in my practice to thoroughly investigate the root cause of low libido. One of my favorites is adrenal and sex hormone testing, but I also often run comprehensive stool testing, comprehensive thyroid panels, micronutrient testing and general annual labs. Talk to your provider to see what is most appropriate for you.
Balance your hormones:
I caution against trying to balance your hormones on your own and urge you to work with a practitioner who does functional hormone testing and can offer you a targeted approach to balancing YOUR specific hormonal imbalance. That being said, some general things that gently support hormone balance include:
Start seeding cycling
Clean up your personal care products to avoid hormone disrupting chemicals
Eat liver supporting foods like cruciferous vegetables and beets
Ditch plastic water bottles
Move your body
Eat healthy fats. All hormones are made from cholesterol, so high quality dietary fats are essential for healthy hormones.
Support your digestion:
Digestion is intimately related to your hormones. Excess hormones leave your body in two ways — your urine and your poop. If you’re not pooping daily, you’re not getting rid of extra hormones. Those hormones are allowed to recirculate in your body and contribute to hormonal balances.
Proper digestion is also necessary for nutrient absorption. If you’re not adequately digesting your food, you may not be absorbing the nutrients that you need.
Address nutritional deficiencies:
Nutrient deficiencies like vitamin D, iron and zinc have all been linked to sexual dysfunction. It’s important to investigate if you’re meeting your nutritional needs through your diet and to supplement if necessary.
Herbs:
There are some herbs that have been traditionally used to enhance sexual desire in women and while I will list them here, it’s important to note that these are not a quick fix and will not give you the same result as addressing the underlying cause. It’s also important to check with your doctor before taking any new herbs or supplements.
Tribulus terrestris is a natural aphrodisiac that has been shown to increase desire in women, possibly by helping to balance estrogen and testosterone levels.
Maca is a root with a slightly nutty flavor and a long history of being used to enhance fertility, sex drive and energy. It supports hormone balance and can reduce vaginal dryness.
Ginkgo has been shown to improve sexual desire, specifically when caused by antidepressant use.
Damiana is an aphrodisiac herb traditionally used to boost sexual function.
Ashwagandha is one of my favorite herbs for regulating the nervous system, improving your response to stress, increasing mood and combating fatigue. It has been shown to increase sexual function by improving arousal, vaginal lubrication and orgasm.
Shatavari is an Ayurvedic herb with a long history of being used as a female tonic. It’s been used to support everything from female infertility, lactation issues, hormonal imbalances and yep, you guessed it — low libido.
You can find my favorite libido supporting supplements through my personal dispensary by following this link and viewing Libido Support under my favorites.
If you found this information helpful, but still need some help (and more personalized recommendations, please), I’m your girl. You can apply to be a client here.
