Decreased libido means a lower interest in sexual activity. Many physical, psychological and lifestyle factors can contribute. This page gives general information about possible causes, the typical evaluation pathway, and which specialists might be consulted. For personalized diagnosis and care, see a health professional.
A drop in sexual desire rarely has a single cause. Hormonal changes, chronic conditions (for example diabetes or heart disease), some medications or medical treatments, mental health issues (stress, depression, anxiety), relationship difficulties and lifestyle factors (poor sleep, heavy alcohol use, lack of exercise) all play a role. Often several factors are present together and they affect people differently.
Primary care physicians are usually the first point of contact. Depending on the initial assessment, referral may be appropriate to Endocrinology (hormonal causes), Psychiatry or Psychology (mental health and sex therapy), Gynecology or Urology (physical sexual-function concerns) or specialized sexual health clinics. Couple therapy or sexual educators can support relationship and communication aspects.
Evaluation typically begins with a medical and sexual history covering sleep, stress, relationship factors, current medications and other health conditions. A physical exam and selected laboratory tests may be used to assess overall health and hormonal status. A mental health assessment helps identify psychological contributors. The combined information guides which specialty care is most appropriate.
General measures can help many people: improving sleep, regular physical activity, reducing alcohol and tobacco use, and stress management. Strengthening partner communication, seeking couple therapy or sex education may also be beneficial. These are general suggestions and not a substitute for professional evaluation. If you experience sudden severe physical symptoms (for example severe chest pain or fainting) or intense depressive symptoms including suicidal thoughts, seek emergency care immediately.
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