Reduced sexual desire or low libido is a condition that can affect both men and women of all ages. Libido is a drive that is controlled by several hormonal, biological, psychological and social factors in humans. Gender, age, medical conditions, lifestyle choices, religious choices, relationship issues, stress, personality, etc. can also play a role in lowering or increasing the drive. Lowered libido doesn’t always occur as a single symptom. It may be found in conjunction with chronic fatigue, anxiety, and depression.

Though each person’s libido is individual and unique and it is not possible to arrive at a “normal” or “typical” level, if a person feels that it affects their intimate relationships and sense of well-being or causes them to feel distressed or under-confident, it’s important to consult a healthcare professional. This helps to rule out any serious underlying medical conditions.

Human libido is controlled mainly by the activity in an area of the brain called the mesolimbic dopamine pathway. Dopamine is one of the main hormones that play a vital role in modulating libido. Other hormones such as testosterone and androgens, estrogen, progesterone, oxytocin, serotonin, norepinephrine, acetylcholine are also involved. The drive is a complex one with several other factors that can be the causes of low libido. These are:

1. Chronic diseases and conditions
Certain diseases and chronic illnesses can affect libido. Diabetes results in vascular and nerve damage, leading to erectile function in men and increased risk of infection in women. Osteoarthritis causes chronic pain, decreasing the desire to engage in sexual activity. Heart diseases result in reduced blood flow to the sexual organs while cancer disease and treatments including chemotherapy, radiation, and surgery may lower the libido. Obstructive sleep apnea and sleep disturbances are other factors involved in lowered sex drives.

2. Age
Though it is not a typical cause, aging does lower certain hormonal levels. Typically, males reach the peak of sex drive by age 15, while in females, it is thought to peak gradually by age 30. Estrogen and testosterone levels are lowered pre- and post menopause in women. Age-related health issues and mobility problems along with psychological factors can also play a role.

3. Pregnancy
Loss of interest in females during pregnancy and after giving birth, while breastfeeding, etc. are major causes of low libido. This can be caused by fluctuations in hormone levels, body changes, the psychological impact of body image, lack of sleep and tiredness, post-surgery pain, altered priorities due to childcare, etc.

4. Physical issues
Certain physical problems like erectile dysfunction, ejaculation problems, dryness, painful sex, and inability to achieve satisfaction are common causes of low libido. Smoking, alcohol and drug abuse, anemia, the effect of certain medications, the perceived attractiveness and fitness of the partner, lifestyle choices, etc. can play an important role too.

5. Psychological and emotional factors
Stress, anxiety, depression, poor self-esteem, traumatic experiences, abuse in childhood, can affect one’s sex drive. Other factors include relationship issues like infidelity, lack of compatibility, poor communication, lack of trust, physical and emotional abuse, and social isolation, among other things.

It is important to identify the causes of low libido and get the right treatment from a qualified, trained, healthcare professional.