Sexual health · Condition guide

Low sexual desire

Losing interest in sex is common, has many possible causes, and is worth looking into when it bothers you or your partner.

Written and medically reviewed by Dr Shivadev M, MBBS, MD (Psychiatry), FECSMLast reviewed November 2026

What counts as low desire

Desire naturally varies between people and across life. Low desire becomes a medical concern when it has lasted for several months and causes you distress, or causes strain in your relationship.1

Desire doesn't always come first. Many people, especially in long relationships, feel desire only after they start to feel close or aroused. This is normal, not a disorder.2

Common causes

  • Depression and anxiety. Low desire is often an early sign of depression. See Low desire or depression? How to tell the difference.
  • Medicines. Some antidepressants, hormonal contraceptives, and medicines for blood pressure or prostate enlargement can reduce desire.3
  • Hormones. Low testosterone in men, thyroid problems, raised prolactin, and changes after childbirth and around menopause.4
  • Other sexual problems. Pain during sex, erectile difficulty or premature ejaculation can quietly switch desire off.
  • Health and lifestyle. Diabetes, chronic illness, poor sleep, exhaustion, alcohol.
  • The relationship. Unresolved conflict, resentment, routine, or very different expectations.
  • Life stage. A new baby, caring for parents, work pressure.

How I assess it

  • A detailed history: when it changed, whether it affects all sexual interest or only with your partner, and what else has changed in your life.
  • Screening for depression and anxiety with validated questionnaires.
  • A review of every medicine and supplement you take.
  • Blood tests where indicated: thyroid, prolactin, and in men, morning testosterone.4
  • With your permission, the relationship side, alone or with your partner.

Treatment

Treatment depends on what is driving the problem, and usually combines more than one approach.5

  • Treating depression or anxiety, choosing medicines that are less likely to affect sexual function.
  • Adjusting medicines that may be contributing. Please don't stop any medicine on your own.
  • Treating hormonal causes, such as low testosterone confirmed on repeat testing, or thyroid disease.
  • Treating linked sexual problems, such as pain or erectile difficulty.
  • Psychosexual and couple therapy, including sensate focus, to rebuild closeness without pressure.
  • Practical changes to sleep, stress, alcohol and time together.

Common questions

Is it normal for desire to fade in a long relationship?

Some change is normal. Spontaneous desire often becomes less frequent, and desire may start to follow closeness rather than come before it. It becomes worth assessing when it distresses you or strains the relationship.

Can antidepressants lower sex drive?

Some can. That doesn't mean you should stop them. There are often ways to adjust the dose or switch to a medicine with fewer sexual side effects.

Should I get my testosterone checked?

Men with low desire should usually have a morning testosterone test, repeated if it is low. Testosterone treatment is only appropriate when low levels are confirmed and there are matching symptoms.

What if only one of us has low desire?

That is the most common situation. Mismatched desire is a shared problem, and both partners usually benefit from being involved.

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Related guides

References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: APA; 2022.
  2. Basson R. Human sex-response cycles. J Sex Marital Ther. 2001;27(1):33–43.
  3. Kennedy SH, Rizvi S. Sexual dysfunction, depression, and the impact of antidepressants. J Clin Psychopharmacol. 2009;29(2):157–164.
  4. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715–1744.
  5. Clayton AH, Goldstein I, Kim NN, et al. The International Society for the Study of Women's Sexual Health process of care for management of hypoactive sexual desire disorder in women. Mayo Clin Proc. 2018;93(4):467–487.

This page is general information and does not replace a consultation with a doctor who has assessed you. Read how these pages are written in our editorial policy.

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