# Low Libido in Women: Common Causes and What Can Help

> Low libido in women is common and has many causes, from hormones and medicines to stress. Learn when low desire is a medical problem and what can help.

URL: https://foundationmedicalwellness.com/low-libido-in-women/
Author: Dr. Paul Frandsen, MD (https://foundationmedicalwellness.com/about/paul-frandsen-md/)
Medically reviewed by: Dr. Paul Frandsen, MD (https://foundationmedicalwellness.com/about/paul-frandsen-md/)
Published: 2026-09-29
Updated: 2026-09-29

Low libido in women means a lasting drop in sexual desire. It's common, and it has many causes, from hormones and medicines to health problems, mood, and relationship strain. Low sex drive becomes a medical problem when it lasts for months and causes you real distress.

![Infographic showing 43.1% of women reporting a sexual problem and 12.0% with distress in a large US survey, the 6 month rule for diagnosing hypoactive sexual desire disorder, and testosterone giving an average of 1 extra satisfying sexual event a month versus placebo](/images/blog/low-libido-in-women/low-libido-in-women-infographic.webp)

## What Is Low Libido in Women, and How Common Is It?

Female libido, or sex drive, is your interest in sex. It rises and falls over a lifetime, and a woman's libido can change with stress, health, and life stage. Low libido is reduced sexual desire that lasts, rather than a quiet week or two. ACOG notes it can be normal not to feel desire until sexual activity has started. If that sounds like you, it may be a relief.

You're far from alone. [About 4 in 10 women have problems with sex at some point during their lives](https://www.acog.org/womens-health/faqs/your-sexual-health), according to ACOG.

A large US survey of 31,581 women found that 43.1% reported some kind of sexual problem, but [only 12.0% had a sexual problem that caused them distress](https://pubmed.ncbi.nlm.nih.gov/18978095/). That rate was 14.8% in women aged 45 to 64. These numbers cover any sexual concerns, not only low desire.

Here's what matters most. Decreased sexual desire is only a problem if it bothers you. If it does, it's a real part of your sexual health and women's health, and our [women's health and hormone care](/services/womens-health-hormones/) team is glad to talk about it.

## What Causes Low Libido in Women?

ACOG and MedlinePlus name several common causes of low sex drive:

- **Hormonal change.** Hormonal shifts at certain times of life, such as pregnancy, perimenopause, and menopause, can lower desire. Estrogen levels and other hormone levels change a lot in these years.
- **Medicines.** Hormone medications, including birth control pills and other hormonal contraceptives, can play a part. So can hormone therapy and SSRI antidepressants.
- **Health conditions.** MedlinePlus names diabetes, heart disease, nerve disorders, and hormone problems.
- **Mood.** Depression, anxiety, and stress can all lead to a decreased sex drive.
- **Your relationship.** Problems with your partner matter. It can run the other way too, with low libido putting its own strain on intimacy. Emotional intimacy and sexual intimacy are closely tied, so distance in one often shows up in the other.

If you suspect a hormonal imbalance, read our article on [signs your hormones might be off](/5-signs-your-hormones-might-be-off-that-most-doctors-miss/). We'll get to low testosterone below.

## When Is Low Sex Drive a Medical Problem?

![A clinician in a white coat talks with a woman about when low sex drive may point to a medical problem](/images/blog/low-libido-in-women/low-libido-in-women-inline-1.webp)

Low desire on its own isn't a disorder. ACOG says [a lack of desire is considered a disorder when at least three of these are true for at least 6 months and cause anxiety or sadness](https://www.acog.org/womens-health/faqs/your-sexual-health):

- You have no wish for any sexual activity.
- You have few or no sexual thoughts or sexual fantasy.
- You have no wish to start sex.
- You feel no pleasure during sexual activity.

Doctors call this hypoactive sexual desire disorder, or HSDD. It's one type of sexual dysfunction. Sexual function has several parts, including sexual interest, sexual arousal, and sexual desire, and a problem in one can affect the others.

You don't have to meet every criterion on that list to get help with low sexual desire. MedlinePlus advises a visit if problems last more than a few months or cause distress. In most cases, a doctor starts with your medicines, health and mood. And if it feels awkward to bring up, that's normal.

## How Do Menopause and Vaginal Dryness Affect Desire?

Menopause can affect your sex drive in two ways. Its hormonal changes are on ACOG's list of causes of low libido. And the physical changes of this life stage can make sex uncomfortable. ACOG lists vaginal dryness and pain during sex among menopause symptoms.

Painful sex and low desire often feed each other. ACOG notes that pain during sex may be caused by problems with sexual response, such as a lack of desire or a lack of arousal. It can turn into a frustrating loop.

For women who only have vaginal dryness, ACOG describes local estrogen as a vaginal ring, tablet, or cream. This is called vaginal estrogen. If dryness is one of several changes, our guide to [perimenopause symptoms](/perimenopause-symptoms/) can help you see the wider pattern.

## Can Testosterone Help Low Libido in Women?

Sometimes, for the right woman. A 2019 global consensus statement, endorsed by groups including The Endocrine Society and The North American Menopause Society, says the only evidence-based use of testosterone in women is for HSDD. For postmenopausal women with HSDD, it gave [an average of one extra satisfying sexual event per month compared with placebo](https://pmc.ncbi.nlm.nih.gov/articles/PMC6821450/).

But there are two important limits. The same statement found there aren't enough data to recommend testosterone for premenopausal women. It also says compounded "bioidentical" testosterone cannot be recommended for HSDD because of a lack of evidence for efficacy and safety, unless an authorized equivalent isn't available. So bioidentical hormone replacement therapy isn't automatically the answer.

Any hormone therapy or hormone replacement plan is a decision you make with a licensed clinician. Our team doesn't prescribe hormones based on age or a single lab value. For more on hormone replacement therapy, see our page on [HRT in Utah](/hormone-replacement-therapy-utah/).

| Cause type | Examples in the sources | What to raise with a doctor | Options named in the sources |
|---|---|---|---|
| Hormonal | Pregnancy, perimenopause, menopause (ACOG) | Life stage and menopause symptoms | Vaginal estrogen for dryness only (ACOG); testosterone for postmenopausal HSDD (2019 consensus) |
| Medication | Birth control pills, hormone therapy, SSRIs (ACOG) | Every medicine you take | Not reported (review with your prescriber) |
| Physical or pain | Diabetes, heart disease, nerve disorders (MedlinePlus); pain during sex (ACOG) | Pain and health history | Not reported beyond treating the cause |
| Mood or stress | Depression, anxiety, stress (ACOG) | How you feel day to day | Counseling on your own (ACOG) |
| Relationship | Problems with your partner (ACOG) | Strain or distance at home | Sex therapist, couples therapy (ACOG) |

In practice, the right option depends on the cause.

## Does Sex Therapy Help Low Desire?

It can. ACOG says you may be referred to a sex therapist even if you're also getting medical treatment. Couples therapy or counseling on your own may also help.

Low libido often has more than one cause, so this support can sit alongside medical care. Foundation Wellness does not offer sex therapy, but your clinician can talk with you about outside referral options.

## Talking to a Doctor About Low Libido at Foundation Wellness

![A clinician walks over to greet a Utah woman arriving for a private talk about low libido](/images/blog/low-libido-in-women/low-libido-in-women-inline-2.webp)

Low libido is on the list of concerns our Women's Health and Hormone Optimization service is built for. That care includes comprehensive lab work, bioidentical hormone therapy, and ongoing monitoring. We start with detailed bloodwork and a thorough medical history.

We see women at 456 E State Street, Suite 1400, American Fork, UT 84003, and through telemedicine across Utah. We're accepting new patients. Foundation Wellness accepts many insurance plans. Coverage depends on your plan, so check with our office first.

If low desire is weighing on you, you're welcome to reach out to our office. Bringing it up can be the hard part.

## Key Takeaways

- About 4 in 10 women have problems with sex at some point in life.
- Low desire is a disorder only when it lasts 6 months or more and causes distress.
- Hormones, medicines, health, mood, and relationships can all lower a woman's sex drive.
- Vaginal estrogen is for dryness; testosterone has evidence only for postmenopausal HSDD.
- Sex therapy or counseling can help alongside medical care.

## Sources

- American College of Obstetricians and Gynecologists, [Your Sexual Health](https://www.acog.org/womens-health/faqs/your-sexual-health).
- American College of Obstetricians and Gynecologists, [When Sex Is Painful](https://www.acog.org/womens-health/faqs/when-sex-is-painful).
- MedlinePlus, [Sexual Problems in Women](https://medlineplus.gov/sexualproblemsinwomen.html).
- Journal of Clinical Endocrinology and Metabolism, [Global Consensus Position Statement on Testosterone Therapy for Women, 2019](https://pmc.ncbi.nlm.nih.gov/articles/PMC6821450/).
- American College of Obstetricians and Gynecologists, [Hormone Therapy for Menopause](https://www.acog.org/womens-health/faqs/hormone-therapy-for-menopause).
- Obstetrics and Gynecology, [Sexual problems and distress in US women, Shifren et al. 2008](https://pubmed.ncbi.nlm.nih.gov/18978095/).

## Frequently Asked Questions

### Can hormonal contraceptives lower a woman's libido?

They can for some women. ACOG lists hormone medications, including birth control pills, among the medicines that can affect sexual desire. If you think your birth control is playing a part, do not stop it on your own. Talk with your prescriber about your options first.

### Is it normal for a woman's sex drive to change?

Yes. ACOG says a lack of desire is common and can happen at any age. It can also be normal not to feel desire until sexual activity has started. Low desire only becomes a medical concern when it lasts and causes you distress.

### Does testosterone help premenopausal women with low libido?

The research does not support it yet. A 2019 global consensus statement found there are not enough data to make any recommendation on testosterone for premenopausal women. Its only evidence-based use in women is for hypoactive sexual desire disorder after menopause.

### When should I see a doctor about low sex drive?

MedlinePlus advises seeing a doctor if sexual problems last more than a few months or cause distress. You do not need to wait until it feels like a crisis. A visit can help sort out hormones, medicines, health conditions, and mood.

### Does menopause cause low libido?

It can play a part. ACOG lists the hormonal changes of perimenopause and menopause among the causes of low desire. Vaginal dryness and pain during sex can also lower desire, and vaginal estrogen is one option for women who only have dryness.


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Source: https://foundationmedicalwellness.com/low-libido-in-women/
Clinic: 456 E State Street, Suite 1400, American Fork, UT 84003
Phone: (800) 983-1974