Clinical Causes of Low Libido: Hormonal, Psychological, and Physical Factors

Clinical Causes of Low Libido: Hormonal, Psychological, and Physical Factors

Low libido—also described as reduced sexual desire—is a common concern for people of all genders and ages. While occasional changes in sexual interest are normal, ongoing or distressing changes can signal underlying health issues. Understanding low libido causes can help you decide when lifestyle changes may be enough and when it's important to seek medical care.

This article explains the clinical causes of low libido, focusing on hormonal, psychological, and physical factors, using clear language and evidence-based medical understanding.

---

What Is Low Libido?

Low libido means a persistent decrease in sexual thoughts, interest, or motivation compared to what feels normal for you. It becomes clinically relevant when it:

• Causes distress or frustration
• Affects relationships or self-esteem
• Persists for weeks or months
• Occurs alongside other symptoms

Low libido is not a moral or personal failure—it is often a medical or psychological issue with identifiable causes.

---

Hormonal Causes of Low Libido

Hormones play a central role in sexual desire for both men and women. Even small imbalances can significantly affect libido.

1. Low Testosterone

Testosterone is essential for sexual desire in all sexes.

• In men, low testosterone can result from:
  • Aging
  • Testicular disease or injury
  • Obesity
  • Type 2 diabetes
  • Chronic illness
• In women, testosterone also supports sexual interest, and low levels may occur after:
  • Oophorectomy (ovary removal)
  • Menopause
  • Long-term use of certain medications

Common symptoms alongside low libido:

• Fatigue
• Reduced muscle mass
• Mood changes
• Decreased motivation

2. Estrogen and Progesterone Imbalances

In women, estrogen affects vaginal health, arousal, and comfort.

Low estrogen levels may lead to:

• Vaginal dryness
• Pain during sex
• Reduced sensitivity
• Lower desire due to discomfort

This often occurs during:

• Menopause
• Postpartum periods
• Breastfeeding
• Certain cancer treatments

3. Thyroid Disorders

Both hypothyroidism and hyperthyroidism can reduce sexual desire.

Possible signs include:

• Weight changes
• Sensitivity to cold or heat
• Hair thinning
• Irregular menstrual cycles
• Low energy

Thyroid conditions are a well-established medical cause of low libido and are treatable once diagnosed.

---

Psychological and Emotional Causes of Low Libido

Mental and emotional health is just as important as physical health when evaluating low libido causes.

4. Depression

Depression commonly reduces interest in activities that once felt pleasurable—including sex.

Contributing factors include:

• Low mood
• Emotional numbness
• Fatigue
• Negative self-image

Some antidepressant medications can also lower libido, even while improving mood.

5. Anxiety and Chronic Stress

Long-term stress keeps the body in a heightened "fight-or-flight" state, which suppresses sexual desire.

Stress-related causes include:

• Work pressure
• Financial concerns
• Caregiving responsibilities
• Chronic illness

Anxiety may also lead to performance worries, which can further reduce interest in sex.

6. Sexual Trauma and Past Experiences

A history of sexual trauma can affect desire, arousal, and emotional safety during intimacy—even years later.

Signs this may be affecting libido:

• Feeling disconnected during sex
• Avoidance of intimacy
• Emotional distress triggered by touch
• Guilt or confusion about desire

If past experiences are affecting your intimacy or desire, using a free Sexual Trauma symptom checker can help you privately explore whether trauma may be connected to your current symptoms and guide your next steps.

---

Physical and Medical Causes of Low Libido

Many medical conditions directly or indirectly affect sexual desire.

7. Chronic Illness

Long-term health conditions often reduce libido due to fatigue, pain, or medication effects.

Common examples include:

• Diabetes
• Heart disease
• Autoimmune disorders
• Chronic pain conditions
• Neurological disorders

In some cases, reduced blood flow or nerve damage may impair sexual response.

8. Medications

Several commonly prescribed medications list low libido as a side effect.

These include:

• Antidepressants (especially SSRIs)
• Blood pressure medications
• Hormonal contraceptives
• Opioid pain medications
• Certain cancer treatments

Never stop medication without speaking to a doctor, as safer alternatives may be available.

9. Sleep Disorders

Poor sleep disrupts hormone production and energy levels.

Conditions such as:

• Insomnia
• Sleep apnea
• Shift-work sleep disorder

are associated with lower testosterone, reduced mood, and diminished sexual interest.

---

Lifestyle Factors That Contribute to Low Libido

While not always the root cause, lifestyle factors can worsen existing issues.

10. Alcohol and Substance Use

• Excessive alcohol can blunt sexual response
• Recreational drugs may interfere with hormones and mood
• Long-term use increases the risk of erectile and arousal problems

11. Poor Nutrition and Inactivity

Low libido may be linked to:

• Nutrient deficiencies
• Significant weight changes
• Lack of regular movement

Physical activity supports blood flow, mood regulation, and hormone balance.

---

When Low Libido May Signal Something Serious

While low libido itself is not usually life-threatening, it can be a sign of a more serious condition, such as:

• Severe depression with suicidal thoughts
• Undiagnosed endocrine disorders
• Cardiovascular disease
• Cancer-related hormonal changes

If low libido occurs alongside:

• Chest pain
• Severe fatigue
• Sudden weight changes
• Loss of body hair
• Ongoing pain
• Thoughts of self-harm

Speak to a doctor immediately, as these symptoms may require urgent evaluation.

---

How Low Libido Is Diagnosed

A healthcare provider may assess:

• Medical history
• Mental health status
• Medication use
• Hormone levels (blood tests)
• Sleep and lifestyle factors

This process helps identify the true low libido causes, rather than guessing or self-blaming.

---

Treatment Depends on the Cause

There is no single solution for low libido. Treatment may include:

• Adjusting medications
• Treating hormonal imbalances
• Managing chronic illness
• Counseling or trauma-informed therapy
• Stress reduction strategies
• Sleep and lifestyle improvements

Many people see improvement once the underlying issue is addressed.

---

A Final Word

Low libido is common, complex, and often treatable. Understanding the clinical causes of low libido—hormonal, psychological, and physical—can help you take informed, practical next steps.

If low libido is persistent, distressing, or linked with other symptoms, speak to a doctor. This is especially important if anything feels serious or potentially life-threatening. You deserve clear answers, respectful care, and support that addresses the whole person—not just the symptom.