What is decreased libido?

A decline in sexual desire, characterised by reduced frequency and intensity, is commonly referred to as low libido. This condition can manifest as either a temporary or chronic state. Libido represents your overall sexual drive, encompassing both partnered sexual activity and self-stimulation. It is a complex aspect influenced by various factors, including biological, psychological, and social elements.

From a biological perspective, sex hormones like testosterone and oestrogen, along with neurotransmitters such as dopamine and oxytocin, contribute to the regulation of libido. Naturally, libido varies greatly among individuals and can also shift throughout different stages of life. There is no universally defined benchmark for what constitutes a "normal" or "ideal" level of libido. Sexual activity and desire can vary significantly, ranging from daily occurrences to infrequent occurrences or even a complete lack of interest. The appropriate level of libido for each person is subjective, determined by personal preferences and individual life circumstances.

What causes decreased libido in women and men?
In women:

Low libido in women or individuals assigned female at birth (AFAB) can be influenced by various medical conditions. These include perimenopause and menopause, which can lead to decreased oestrogen production and lower libido. Sexual dysfunction, such as painful sex, vaginal dryness, and difficulties reaching orgasm, can also contribute to a decrease in sexual desire. Pregnancy, childbirth, and breastfeeding can cause hormonal fluctuations, physical discomfort, and increased stress, all of which can impact libido. Infections like vaginal yeast infections or UTIs, as well as reproductive health conditions like endometriosis, PMS, and PCOS, can further contribute to a decrease in libido.

In men:

Low libido in men or individuals assigned male at birth (AMAB) can be attributed to medical conditions such as low testosterone (male hypogonadism) and sexual dysfunction. Male hypogonadism occurs when the testicles do not produce enough testosterone, which can happen at any age but also naturally declines with ageing. Sexual dysfunctions like erectile dysfunction, premature ejaculation, or delayed ejaculation can lead to anxiety around sexual performance, resulting in a decrease in sexual desire.

How is decreased libido treated?

The treatment for low libido depends on its underlying cause, and there are various options available. Depending on the cause, it may be helpful to consult medical specialists such as a primary care physician (PCP), sex therapist, psychologist, gynaecologist, urologist, or endocrinologist.

Treatment approaches for low libido include:

• Medication adjustment: If a medication is causing low libido, your healthcare provider may suggest changing the medication.
• Hormone therapy for menopause: Hormone therapy, such as oestrogen therapy or oestrogen-progesterone/progestin hormone therapy (EPT), can boost hormone levels and alleviate menopause symptoms, including low libido.
• Hormone therapy for low testosterone: Testosterone replacement therapy, available in various forms like pills, creams, injections, or patches, can be used to treat low testosterone levels (male hypogonadism).

The optimal treatment approach will depend on the individual's specific situation, and a urologist can provide guidance in determining the most suitable course of action.