Desire is the symptom people are quickest to read as a verdict on their relationship and slowest to check for a physical cause. It is also the one with the longest list of physical causes. A change that arrived over weeks usually has a trigger; a change that arrived over years usually has several.
How common: Low desire is the most commonly reported sexual difficulty at every age and in every gender, and it is the one people wait longest to raise. Reported prevalence varies wildly between studies, mostly because it depends on whether the study asked whether the person was bothered by it — and that distinction matters more than the number.
See someone about this if
Low desire alongside unexplained weight change, persistent fatigue, or feeling cold all the time — thyroid and hormone testing is the next step, not a product.
Low desire alongside unexpected breast milk, breast tenderness, or periods stopping — this pattern points at a raised prolactin level and is worth a prompt appointment.
Low mood, hopelessness, or loss of interest in everything rather than only in sex — that is depression and it deserves treating in its own right.
Narrow it down
This page narrows the question; it does not answer it. Everything below is written so that you can walk into an appointment with a date, a pattern, and a specific thing to ask — which is the difference between a consultation that goes somewhere and one that does not.
Did it start within a few weeks or months of a new medicine, or a dose change?
That timing is the strongest single clue available and is worth checking against the classes that are actually associated with it before anything else.
Is it gone in every situation, or only with one partner?
Desire that is absent alone, in fantasy, and on waking points more toward a physical or hormonal cause. Desire that is present alone but absent with a partner points elsewhere.
Is fatigue there too, all day, not only at night?
Fatigue plus low desire is the classic pattern for thyroid problems, low testosterone, anaemia, and sleep apnoea — all testable, none of them guessable.
Is sex uncomfortable or painful when it does happen?
Then desire may be the symptom and pain the cause. The body stops wanting what has been hurting, and treating the pain often restores the wanting without anything else changing.
27 classes of commonly prescribed medicine are associated with lower sexual desire. Associated does not mean responsible in your case, and it never means stop taking anything — this is a list of things worth raising with whoever prescribed them.
Bupropion — The antidepressant least associated with sexual side effects. More often helps
Menopausal hormone therapy — Usually treats the symptoms this tool is about rather than causing them. More often helps
Conditions associated with this
33 conditions on this site list lower sexual desire among their effects. A condition appearing here is not a suggestion that you have it — it is a list of things a clinician can rule in or out, several of which are a single blood test away.
Anxiety disordersCommonly reportedArousal and anxiety compete for the same nervous system.
Breast cancer treatmentCommonly reportedEndocrine therapy causes severe dryness for years, and it is treatable.
Desire runs on hormones more than most people are told, and several of the relevant levels are measurable rather than guessable.
Falling oestrogen through perimenopause and after, which affects desire both directly and through sleep, comfort, and hot flushes.
Low testosterone, which matters in every body and not only in men, and which can be suppressed by long-term opioid use, some antiseizure medicines, and anti-androgen treatment.
Thyroid problems, which produce fatigue and low desire together and are cheap to test for.
Raised prolactin, which is a specific and testable effect of several antipsychotic medicines.
The postpartum period and breastfeeding, where the hormonal picture is expected to suppress desire temporarily.
Sleep, energy, and load
Desire is expensive. It is the first thing the body stops funding when something else is draining the account.
Chronic sleep debt and untreated sleep apnoea both suppress desire and both are treatable.
Persistent pain, chronic illness, and long recovery periods.
Caring load, work stress, and the plain mechanics of never being alone and awake at the same time as a partner.
Mood and mind
Depression lowers desire, and so do most of the medicines that treat it — which makes untangling the two a genuinely difficult clinical question rather than a personal failure.
Depression and anxiety both reduce desire independently of any treatment.
Anticipating pain, or anticipating a performance problem, reliably suppresses desire — the body learns to stop asking for something that has been going badly.
Body image after weight change, surgery, or treatment.
Relationship and context
This is a real cause, not a default explanation to reach for when the physical ones have not been checked.
Desire discrepancy between partners is extremely common and is a difference rather than a disorder.
Responsive rather than spontaneous desire — needing arousal before wanting, rather than the reverse — is a normal pattern and not a deficiency.
Unresolved conflict, resentment, and imbalance in domestic load all show up here before they show up anywhere else.
What helps in the meantime
Track when it changed against when anything else changed — a medicine, a diagnosis, a job, a birth. A date is the most useful thing you can bring to an appointment.
Treat sleep as a sexual health intervention, because for a large share of people it is the highest-yield one available.
Separate 'I do not want sex' from 'I do not want sex the way we currently have sex' — they lead to completely different conversations.
Take these to an appointment
Could we check thyroid function, and — depending on my situation — testosterone or prolactin?
Do any of the medicines I take have this as a recognised effect?
Is there a psychosexual or menopause service I could be referred to?
Matters more if: menopause-related dryness.
Common questions
What causes low sex drive?
Desire is the symptom people are quickest to read as a verdict on their relationship and slowest to check for a physical cause. It is also the one with the longest list of physical causes. A change that arrived over weeks usually has a trigger; a change that arrived over years usually has several. The causes worth ruling out fall into a few groups: hormonal, sleep, energy, and load, mood and mind, relationship and context, and medicines. Most people turn out to have more than one contributing at once.
How common is low sex drive?
Low desire is the most commonly reported sexual difficulty at every age and in every gender, and it is the one people wait longest to raise. Reported prevalence varies wildly between studies, mostly because it depends on whether the study asked whether the person was bothered by it — and that distinction matters more than the number.
Can medication cause low sex drive?
Yes — 27 classes of commonly prescribed medicine are associated with it, most frequently anti-androgen medicines, antipsychotic medicines, antiseizure medicines. Never stop, pause, or change a prescribed medicine because of that; take the observation and the date it started to the person who prescribed it, who can weigh a review against what the medicine is doing for you.
When should I see someone about low sex drive?
Sooner than most people do. Specifically and without waiting: Low desire alongside unexplained weight change, persistent fatigue, or feeling cold all the time — thyroid and hormone testing is the next step, not a product.
What can I do about low sex drive myself?
Track when it changed against when anything else changed — a medicine, a diagnosis, a job, a birth. A date is the most useful thing you can bring to an appointment. Treat sleep as a sexual health intervention, because for a large share of people it is the highest-yield one available. Separate 'I do not want sex' from 'I do not want sex the way we currently have sex' — they lead to completely different conversations.
Educational information about why a symptom happens — not a diagnosis, and not a way to work out what is wrong with you. Most of these changes have more than one cause at once, and the causes on this page overlap. Nothing here can examine you, look at your history, or run a test. Pain, bleeding, a lump, or a symptom that is new and unexplained always deserves assessment.