Decreased Sex Drive: Causes & How to Get Your Libido Back

Mild chronic depression (dysthymia)

Mild chronic depression is also called dysthymia, dysthymic disorder, or persistent depressive disorder. It is a long-term, low-grade depression that may last for years and periodically swings from mild to severe, but never really lifts.

The cause of is not certain. Heredity and brain chemistry may make it more difficult to cope with stressful life events. Dysthymia often begins early in life and may appear in childhood, especially among those with other mental health disorders.

Symptoms include feeling hopeless and inadequate; loss of interest in normal activities; trouble sleeping; irritability; and difficulty relating to others.

Long-term depression can seriously affect anyone's quality of life. If there is talk of suicide, it should be considered a medical emergency. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination and blood testing to rule out any physical cause, and through psychological evaluation.

Treatment involves antidepressant medication and "talk therapy," as well as help with life management and coping skills.

Rarity: Uncommon

Top Symptoms: fatigue, depressed mood, irritability, difficulty concentrating, impaired social or occupational functioning

Symptoms that always occur with mild chronic depression (dysthymia): depressed mood

Symptoms that never occur with mild chronic depression (dysthymia): severe sadness

Urgency: Primary care doctor

Premenstrual syndrome

Premenstrual syndrome, or PMS, refers to a set of symptoms experienced by some women just before the start of a menstrual period.

The exact cause of PMS is uncertain, but changing hormone levels are always involved. Ongoing depression will make the symptoms worse and may be connected to low levels of the brain chemical serotonin, which influences mood, food cravings, and sleep patterns.

Symptoms include irritability, mood swings, insomnia, difficulty concentrating, weight gain, fluid retention, bloating, abdominal discomfort, food cravings, and breast tenderness.

PMS normally fades within a day or two of start of the menstrual period. If the symptoms are interfering with activities of daily living, a medical provider may be able to help. Some symptoms can be treated for improved quality of life.

Diagnosis is made through patient history.

Treatment primarily involves making lifestyle improvements in diet, exercise, and stress management. Nonsteroidal anti-inflammatory drugs can address the physical discomfort, and diuretics will help with fluid retention. Hormone-based contraceptives can regulate the cycle and ease symptoms. In some cases, antidepressants are helpful.

Pregnancy- or childbirth related depression

Depression is a mental disorder in which a person feels constantly sad, hopeless, discouraged, guilty, and loses interest in activities and life on more days than not. These symptoms interfere with daily life, taking care of your baby, work, and friendships. Postpartum or peripartum depression occurs in mothers or future mothers and is linked to pregnancy and childbirth.

You should visit your primary care physician who will likely coordinate care with a psychologist or other mental health professional. Depression is treated with counseling, therapy and medication.

Rarity: Uncommon

Top Symptoms: fatigue, depressed mood, difficulty concentrating, loss of appetite, impaired social or occupational functioning

Urgency: Primary care doctor

Late onset hypogonadism

Late onset hypogonadism is also called LOH, androgen deficiency, or testosterone deficiency syndrome (TDS.)

It is a reduction in testosterone production sometimes found in men over 50. A small amount of loss is natural due to aging, but LOH causes symptoms that may be severe and can interfere with quality of life.

Testosterone is needed to maintain the male reproductive system, but it also influences many other functions including metabolism, bone density, muscle strength and formation, and clear thinking.

LOH is most often caused by a direct loss of functioning in the testicles due to the combination of aging and other illnesses, especially those which interfere with circulation such as obesity, diabetes, or heart disease.

It may also be due to malfunction in the hypothalamus and/or pituitary glands in the brain, which control hormone levels.

Symptoms include erectile dysfunction as well as a decrease in libido, muscle strength, and energy. Osteoporosis is also a risk.

Diagnosis is made through patient history and blood tests. Treatment involves testosterone replacement therapy, which usually has very positive effects.

Rarity: Common

Top Symptoms: fatigue, difficulty concentrating, trouble sleeping, depressed mood, irritability

Urgency: Primary care doctor

Hypothyroidism

Hypothyroidism, or "underactive thyroid," means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body's metabolism.

The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.

Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.

Diagnosis is made through a simple blood test.

Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It's important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches

Urgency: Primary care doctor

High prolactin hormone level

Hyperprolactinemia means the pituitary gland secretes too much prolactin, the hormone responsible for producing milk in a new mother. The condition can appear in both women and men.

It can be caused by pregnancy; by an ovulatory disorder; by some psychiatric medications; or by a prolactin-secreting tumor of the pituitary (prolactinoma.)

Women with other reproductive disorders, such as polycystic ovary syndrome (PCOS,) are most susceptible. Hyperprolactinemia is also seen in those with hypothyroidism and chronic renal failure. Many patients on hemodialysis have elevated prolactin levels.

Symptoms in both women and men include reduced libido (sex drive) and infertility. Men may show breast enlargement and women may develop breast milk.

If not treated, hyperprolactinemia can result in loss of bone density in both women and men.

Diagnosis is made through blood testing to measure hormone levels, and sometimes MRI of the pituitary gland underneath the brain.

Treatment may include "watchful waiting," or a period spent observing the symptoms to see if they change; drug therapy; or surgery.

Rarity: Rare

Top Symptoms: headache, vaginal bleeding, irregular period, decreased sex drive, enlargement of breasts

Urgency: Primary care doctor

Generalized anxiety disorder (GAD)

Generalized anxiety disorder, or GAD, refers to an ongoing feeling of worry and anxiousness about everything and nothing at once. The feeling never really lifts no matter what steps might be taken.

GAD seems to run in families, making some individuals more vulnerable to stress and environmental factors than others.

Symptoms include constant feelings of worry over everyday things and major events; difficulty concentrating or sleeping; being jumpy or easily startled; always feeling tired; irritability; and physical symptoms of headaches and body aches.

Ongoing GAD can be quite debilitating and interfere with quality of life. Any medical provider can send the patient to an appropriate physician for further help.

Diagnosis is made by patient history, followed by a physical examination to rule out any physical cause. The patient will be referred to a psychiatrist or psychologist for further evaluation.

Treatment involves cognitive behavioral therapy, which helps the patient learn to respond to the world in healthier ways and, especially, to manage stress. Antidepressant medication may be prescribed, since it can be helpful for anxiety.

Rarity: Common

Top Symptoms: fatigue, trouble sleeping, general anxiety (stress), irritability, nausea

Symptoms that always occur with generalized anxiety disorder (gad): general anxiety (stress)

Urgency: Primary care doctor

Depression

Moderate depression, also called dysthymia or dysthymic disorder, is one of the three general forms of : mild, moderate, or severe. About half of all people suffering from have the moderate form.

The causes of any depression are not known for sure. Some may be situational, such as grief or other difficult life events. Others may be due to physiological causes such as chemical or hormonal imbalances.

Symptoms include loss of interest in normal activities; neglect of activities of daily living; and loss of productivity, though the person will continue going through the motions of attending work or school.

If not treated, moderate depression can worsen into major depression.

Diagnosis begins with physical examination and blood tests to rule out any physical causes. A mental health professional will talk to the patient to learn about any difficult situational factors.

Treatment may or may not involve antidepressant medication, since antidepressants generally work best for severe depression. Psychotherapy, exercise, relaxation techniques, and lifestyle improvements are usually tried first for moderate depression, and are often very effective.

Rarity: Common

Top Symptoms: fatigue, depressed mood, headache, anxiety, irritability

Symptoms that always occur with depression: depressed mood

Urgency: Primary care doctor

What are the common reasons for a decreased sex drive?

The most common reasons for decreased sex drive include medications like anti-depression medications or medications that counteract androgens (male sex hormones), alcoholism, depression, fatigue, hypoactive sexual disorder, recreational drugs, relationship problems, fear of humiliation, sexual aversion disorder, systemic illness, and testosterone deficiency.

Can prescription drugs lead to decreased sex drive?

Yes. Most commonly, antidepressants like selective serotonin reuptake inhibitors or SSRIs (Prozac) and tricyclic antidepressants can decrease sex drive [7]. Many of these drugs affect libido by increasing the amount of serotonin within the synaptic clefts of the brain. There are alternatives to these drugs, however. Bupropion, for example, is known to treat depression without decreasing libido. Drugs for benign prostatic hyperplasia, like finasteride, for example, can decrease the amount of testosterone as can birth control pills. Both can cause a decrease in libido.

Can too little exercise lead to decreased sex drive?

Yes, exercise transiently increases the amount of testosterone in the body over time which can lead to increased sex drive. It also increases the amount of endorphins and may also lead to increased self-esteem which may increase chances of initiating sex or desiring sex. Too little exercise may deprive an individual of these benefits and contribute to a lower sex drive depending on the cause of the low libido.

What is low libido?

Low libido is a decrease in an individual's baseline sexual desire or desire for sexual activity. This level is different for different individuals and can even vary throughout an individual's lifespan. It can be the product of a chemical imbalance produced by medications, physical illness, psychological diseases, or a physical problem with obtaining and maintaining an erection in the case of men or adequate lubrication in the case of women.

Can low testosterone or estrogen levels have an effect on sex drive?

Yes. Low testosterone levels in particular can decrease sex drive. Testosterone is responsible for both aggression and desire which are components of sex drive. In the absence of high levels of testosterone, it may become more difficult to initiate sexual activity. Low levels of estrogen can have an effect on readying the body for sexual activity.

Questions your doctor may ask about decreased sex drive

• Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
• Are you having difficulty concentrating or thinking through daily activities?
• Have you had any changes in your weight?
• Do you currently smoke?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.