How to Increase Your Libido — And Why It May Be Low
Experts share the meaning of the word libido, what can cause low sex drive, and the treatments and lifestyle changes that can help.
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What is libido?
Libido is another word for sexual desire or sex drive. That includes an overall sexual drive or desire for sexual activity, and the motivation to get into a sexual act with yourself or another person, according to OB/GYN Leah S. Millheiser, MD, a female sexual medicine expert and faculty at Stanford University. Not everyone wants or desires to be sexually active—or experiences sexual attraction—and there’s nothing wrong if you have little or no libido. If having low or no sex drive doesn’t interfere with your quality of life, no problem.
However, it can be frustrating, even emotionally devastating, if you want to feel sexual desire but simply do not. (Or you find your feelings of sexual desire have declined over time in general, or with a specific partner.)
There are so many different things that impact the desire for sex. And that also means there are treatment options. “You shouldn’t suffer in silence,” says Dr. Millheiser.
We asked sexual health experts about the causes of low libido, how it can affect life and relationships, and what you can do to treat low libido, or increase sexual desire, if that’s important to you.
(Related: Female Libido: Say Good-bye To Low Sex Drive)
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So what impacts libido?
Libido is a barometer of health in so many ways because many different things or factors could affect it simultaneously, according to Ian Kerner, author of She Comes First. Many factors that negatively impact libido are possible for everyone, regardless of gender, although there are specific factors that can affect libido in men and libido in women.
“I often like to say that libido is like the stock market,” he says. “When you look at it from a distance, it’s going up or down, but when you get into the weeds and look closely, there are thousands of little movements and variables that are impacting it at any time.”
Not only do many things in life affect libido, but libido affects many things in life. Dr. Millheiser compares low libido to octopus tentacles that extend to all areas. It can affect friendships, wellbeing, body image, and relationships, Dr. Millheiser says. “All of these things can be affected by chronic low sexual desire, or just low sexual desire in general.”
Here are some of the variables that impact desire and libido in men and women.
(Related: An Expert Shares How to Have Good Sex)
Men who are dependent on alcohol are more likely to experience sexual health problems, according to research in the Indian Journal of Psychiatry.
A review in Addiction & Health found that alcohol-dependent men are more likely to experience a loss of libido, erectile dysfunction (ED), and premature ejaculation.
Meanwhile, research in the Archives of Sexual Behavior found that chronic alcohol abuse leads to higher rates of sexual dysfunction in women including, the inability to orgasm, lack of vaginal lubrication, and painful intercourse.
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Yes, even your sleep quality may impact libido. And the research on sleep and libido warrants its own section. One 2015 study in the Journal of Sexual Medicine on 171 women found that those with a longer average sleep duration reported better genital arousal and sexual desire the next day.
Other research in the Journal of Clinical Sleep Medicine looked at 523 men with obstructive sleep apnea (OSA). Researchers found that one-third of the men who had severe sleep apnea also had reduced levels of testosterone.
Another small study on 28 healthy young men found that after a week of sleep restriction to five hours per night, testosterone levels decreased by 10 to 15 percent, according to JAMA.
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As people age, hormonal changes are normal. This includes the natural decline of testosterone, resulting in lower levels of sexual desire. Drastic changes could decrease libido.
For men, testosterone levels below 300 nanograms per deciliter (ng/dL) are low, per the American Urological Association (AUA). Not only does low testosterone cause low libido in men, but other types of hormonal imbalances can, too. This includes high prolactin levels, high estrogen levels, low thyroid levels, or high cortisol (stress hormone) secretion, according to S. Adam Ramin, MD, a urologist and the medical director of Urology Cancer Specialists in Los Angeles.
Many women do not realize that menopausal hormonal changes, including that in testosterone, can affect their libido, says Maria Sophocles, MD, a board-certified OB/GYN, the medical director of Women’s Healthcare of Princeton in New Jersey. “Not only does estrogen and progesterone decrease after menopause, but the ovaries make testosterone, and this decreases as well,” she notes.
Women’s libido may especially dip during this time if they are experiencing a common side effect of menopause, painful sex. And up to 45 percent of women have painful sex after menopause, according to the North American Menopause Society. If sex is painful, there’s a high likelihood you may have less interest in it.
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Health conditions and medications
Health issues could take a toll on your libido including:
- endocrine disorders
- high blood pressure
- high cholesterol
- sleep apnea
- heart disease
- low testosterone
- erectile dysfunction
- under-active thyroid levels
Medications and treatments that affect testosterone also impact libido. These include:
- antidepressants (SNRIs and SSRIs)
- blood pressure medications
- anabolic steroids
- birth control pills
- cholesterol-lowering medications
(Related: 5 Foods That Kill Your Sex Drive)
Pregnancy, giving birth, and breastfeeding
People who are pregnant, recently gave birth, or are breastfeeding experience changes to hormone levels that may lead to a loss of interest in sex. It may also be because of body changes or painful sex due to issues related to childbirth.
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Hypoactive sexual desire disorder
Hypoactive sexual desire disorder (HSDD) is a sexual dysfunction where a person has a low sexual desire for an extended period of time (more than six months) and to the point where it causes them personal distress. Specifically, people with this disorder lack responsive and spontaneous desire, causing them distress, Dr. Millheiser says. For example, during a sexual act, the person doesn’t feel arousal building up. The most recent official list of psychiatric diagnoses, the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), includes male hypoactive sexual desire disorder for men and female sexual interest/arousal disorder in women.
About 10 percent of women in the United States could have what would be considered female sexual interest/arousal disorder, according to Dr. Millheiser.
This is different from other things that contribute to or cause of low libido. In this case, things like medications, medical conditions, or relationship issues are absent, and the person still has low levels of sexual desire.
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Mental health and psychological issues
Stress, anxiety, and depression can reduce your sex drive. Research in Sexual Medicine Reviews suggests that depression, anxiety, and partner-related difficulties for men with erectile dysfunction experience reduced libido and increased sexual dysfunction. Low libido and depression also overlap in women, too. Researchers found that 40 percent of women with a sexual disorder also experience depression, according to the Journal of Clinical Psychiatry. About 3.7 percent have an issue with both desire and depression.
“Our psychological state can have a big impact on sexual desire especially as we age,” says Rachel Needle, a psychologist in West Palm Beach, Florida, and the co-director of Modern Sex Therapy Institutes. “Anxiety, stress, depression, and relationship issues can all play a huge role in our sexual desire.”
Although the Covid-19 vaccine is here, there’s still a chance that pandemic-related issues may impact libido.
Another thing that affects libido is relational issues with a partner or partners. This could affect libido in terms of the extent to which you feel connected or disconnected from your partner, Kerner says. Maybe you feel too close or enmeshed or too distant.
Other relationship issues like a lack of trust, boredom, and anger within a relationship may also put a damper on libido, too.
Lifestyle changes to increase libido
Getting in exercise, eating healthy, and quality sleep is a solid foundation for a strong sex drive, so start with those changes.
Dr. Ramin recommends sleeping at the same time every night and getting at least six to seven hours of sleep a night, consistently.
As for diet, Dr. Millheiser says some research shows the Mediterranean diet has positive benefits on sexual function in men and women. So if you’re thinking about going on a diet for sexual function, the Mediterranean diet may be a good option.
Drinking less and quitting smoking are other good ways to reduce the risk of low libido, and improve your overall wellbeing.
Relaxation is important for feeling desire, so Kerner recommends focusing on relaxation-based techniques to reduce stress.
“Some people do like to have a drink to relax or smoke some cannabis, and some people do take a Xanax or something to relax,” he says. “So I’m not ruling out pharmacology, but it would be in the spirit of a much broader plan.”
Get help for mental health or relationship issues
Kerner highly recommends speaking specifically with a sex therapist if libido issues persist. And research has found that it could be helpful. Needle says that mindfulness may help determine some contributing factors to low libido. “Mindfulness can help with increasing sexual desire by helping one stay in the moment, become more attuned to their body’s response,” she says.
In fact, one study in the journal Behaviour Research and Therapy looked at the impact of four mindfulness-based group intervention sessions on 117 women. They found that the treatment significantly improved sexual desire, sexual arousal, lubrication, sexual satisfaction, and overall sexual functioning. Plus, the women retained the positive effects of mindfulness from the post-treatment to the 6-month follow-up assessment point.
Speaking with a sex therapist will also help relationships, mental health problems, and stress affecting your libido.
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Speak with a doctor
So you’ve made some lifestyle changes and started reducing stress and practicing mindfulness. Maybe you’ve seen a therapist, too. Still, your libido is low. If you’re truly not sure what’s exactly behind your low libido, Dr. Millheiser urges you to bring it up to your primary care doctor or OB/GYN. Don’t be afraid to ask for a referral if libido or pain during sex is not their area of expertise. “Women don’t report [low desire] to their doctors as often as they should because women fear stigma, and fear being judged by the clinician,” she says.
But Dr. Millheiser highlights that 44 percent of women in the U.S. have sexual complaints, which is different from a “dysfunction” or disorder. Still, this is a person who should receive treatment for their concerns. “Of those 44 percent, the most common complaint is low sexual desire,” Dr. Millheiser says. “So I think the most misunderstood thing is even if you don’t have female sexual dysfunction, there is still treatment for you.”
(Related: Which Libido Type Best Describes You?)
Consider medication additions or changes
If you’re on medications known to impact libido, Dr. Millheiser recommends speaking with your prescribing doctor to see if there are alternatives or additional medicines that could help. Low libido in women is an issue that doesn’t have many medication solutions. “I think we need more research and development of medical therapies for female sexual dysfunction,” Dr. Sophocles says.
Here are some of the medications and treatments you may want to discuss with your doctor.
Testosterone replacement therapy
The only medication that can help libido in men is testosterone, according to Dr. Ramin, and it may only help a subset of people. It’s not uncommon for men with low libido to also have low testosterone levels. Men with borderline normal testosterone levels might not be a good fit for this course of treatment. “If they already have kind of a normal level, and you add testosterone to it, it’s just gonna shut off the natural levels,” Dr. Ramin says. “And the addition of the testosterone treatment may not be high enough to bring [levels] above what they were before.”
In men with hypogonadism, testosterone deficiency, testosterone replacement therapy could improve libido. It may also reduce depression, and improve erectile function, according to a 2017 review in BMJ Open. It’s available as an injection, pellet, patch or gel.
Testosterone hormone replacement therapy in men could cause minor potential side effects such as acne, fluid retention, and increased urination.
Potentially severe side effects are an increased number of red blood cells, which could lead to other health issues or an increased risk of stroke or blood clots, per the American Family Physician.
“In men who are more on the obese side, sometimes we give them medications that inhibit the conversion of testosterone to estrogen,” Dr. Ramin says. “And therefore their natural testosterone levels go up. So that particular medication is one that may work in some patients.” In fact, Dr. Ramin says losing belly fat can help men to boost testosterone and up libido naturally.
Side effects of anastrozole include weakness, headache, nausea, and constipation. Call your doctor if you experience any of the following serious side effects including chest pain, sore throat, swelling in the hand or arm, or blurred vision.
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Viagra is a drug that improves blood flow to the penis and leads to erections. In short, it’s an arousal medication that relies on blood flow. But Dr. Ramin notes that it’s not a direct treatment for low libido in men. An inability to get an erection and low libido are not interchangeable. Having said that, there is a component of low libido in men who are not confident about their quality of erections.
“In men who aren’t able to get a good erection, they may psychologically develop low libido because they are afraid of not being able to perform well,” Dr. Ramin says. “So when you treat the erectile dysfunction (ED), and they are more confident about their ability to successfully have intercourse, then psychologically their desire for sex and libido will increase.”
Note that common side effects are headache, flushing, and upset stomach. The rare but serious potential side effects include vision loss, an erection that won’t go away, or sudden hearing loss. A sudden drop in blood pressure if taken with certain other medicines is also a possibility.
(Related: 6 Ways to Build Trust in a Relationship)
One prescription drug that is is available for treating low sexual desire in premenopausal women is called Addyi. Dr. Sophocles notes that although it’s groundbreaking, there are plenty of menopausal women in the U.S. who could benefit from the medicine, but may not receive medication coverage because of its limited approval. “I think it is safe and easy to take, and I wish more clinicians knew about it,” Dr. Sophocles says.
Dr. Millheiser agrees that Addyi is a medication for the right candidate who truly has female sexual interest/arousal disorder. (Note: Dr. Millheiser is the former chief medical officer at Sprout Pharmaceuticals, but no longer as an affiliation or financial interest in the company.) Addyi’s approval was controversial. That’s partly because Food and Drug Administration (FDA) advisory panels voted against the drug a couple times, citing its side effects, including potentially dangerous interactions with alcohol and other drugs, and relatively low efficacy. (The drug was finally approved in 2015.)
Other critics think that low sexual desire, the symptom Addyi is meant to treat, is not a real disease, but rather a way to shame women. Negative side effects of the drug include sleepiness, fatigue, insomnia, dizziness, low blood pressure, and dry mouth.
Vyleesi also treats premenopausal women with female sexual interest/arousal disorder. Unlike Addyi, a daily oral pill, Vyleesi is a stomach or thigh injection 45 minutes prior to sexual activity. Serious side effects of Vylessi include a temporary increase in blood pressure and decrease in heart rate, darkening of the skin on certain parts of the body, and nausea.
The most common ones, however, are headache, dizziness, and injection site reactions.
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Set the mood to increase libido
The most misunderstood thing about libido is that people believe it should occur spontaneously, Kerner says. Some people believe that sex should just happen or people should just spontaneously desire or feel desired by a partner.
“One misconception [is] that desire and libido should look a certain way and turn on spontaneously when in fact that’s often not the case,” Kerner says. “You need to work on creating an environment for libido and for increasing the turn-ons and decreasing the turn-offs.”
(Related: Can Cannabis Help Kick-Start My Sex Drive?)
Try something new
Dr. Sophocles recommends considering ways to bring sexuality to your brain. For some, that may mean watching movies, reading books or articles, or listening to audio porn, podcasts, or stories that include erotic content, she says.
Kerner agrees and adds that some people may simply need new psychological arousal in the form of fantasy. Incorporating adult sex toys, exploring kinks, or even having sex at different times of the day or in different rooms, could spice up your sex life.
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Remember, you don’t need a high libido to enjoy sex
Kerner explains one misconception about low libido is that it’s always very elusive. However, you don’t need desire to have sex, if you want it.
Needle agrees, saying that sometimes people have to make a conscious effort to be more sexual with themselves or with their partners.
If you want to experience sex and sexual desire, willingness to put yourself through the motions could be helpful. Especially if sex is something you enjoy and something you remember enjoying, Kerner notes. “You may find that arousal starts to take over, and it isn’t as hard to get in the mood or feel desire as you thought,” he says.
This doesn’t mean forcing yourself to do something you don’t want to do. It means if you want to have sex, but don’t feel desire, willingness to go through the sexual motions may move things in the right direction.
(Related: What to Know About Aphrodisiac Supplements)
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Similar to the above, Kerner recommends that people who have a partner schedule sex once a week and try to make it a ritual. As part of that day, Kerner poses this question: What would it be like to live that day with the sex you’re gonna get to as a priority? That may mean making decisions like not bringing work home from the office that day, planning another time for a stressful conversation with your partner, or making sure you don’t have looming deadlines.
“I often tell couples you don’t need to have the desire to get going, you need to have the willingness, and then if you have the will, then you sometimes put yourself through the motions that desire will emerge,” Kerner says.
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