So you just haven’t been feeling it lately—sex with your partner, sex in general. Maybe you’re even feeling meh about your other bedside BFF. While there’s no one cause of low libido and no “right” level of sexual interest—it’s different for everyone—a noticeably low sex drive in women is almost always a symptom of something that requires attention in your life or your body. “To begin to figure it out, ask yourself how you feel about your body and your partner. Evaluate the stresses in your life, and look at your lifestyle choices: sleep, foods, exercise, job satisfaction, friends,” advises ob-gyn Felice Gersh, M.D., founder and director of the Integrative Medical Group of Irvine, in Irvine, California, and author of PCOS SOS: A Gynecologist’s Lifeline To Naturally Restore Your Rhythms, Hormones and Happiness.
Here are some of the most common causes of low libido; it’s helpful to consider which might apply to you before you seek advice from your physician or ob-gyn.
You have small kids.
“It makes evolutionary sense that we don’t feel like procreating when we’re not feeling up to the demanding task of child rearing,” says endocrinologist Romy Block, M.D., cofounder of Vous Vitamin and co-author of The Vitamin Solution: Two Doctors Clear the Confusion About Vitamins and Your Health. Coming off childbirth and breastfeeding, it can also take time for your sex hormones to get back in balance, so don’t sweat it if you’re not feeling back to your sexual norm right away.
You’re aggressively trying to lose weight.
While maintaining a healthy weight can help you maintain a healthy sex drive, “a starvation or radical diet can shut down libido—nutrient deficiencies take a huge toll,” Dr. Gersh says. Extreme restriction isn’t healthy, nor is an extreme gym routine. “While moderate exercise increases libido, extreme exercise has the opposite effect.” In other words, everything in moderation—if you’re hitting the gym so hard that you’re always worn out, laying off a little could help reenergize your interest in sex.
You’re low on certain vitamins.
Even if you’re not crash-dieting, it’s possible you could still have a vitamin deficiency that’s depleting your interest in sex. “Vitamin deficiencies are a very common cause of fatigue and low libido, and should not be overlooked,” Dr. Block says. One potential culprit she names: low iron, which years of periods, pregnancies, and nursing can deplete. “In addition, most of us are deficient in vitamin D if we are not taking the proper supplements.”
Sleep hasn’t been happening.
Skimping on sleep is another surefire way to feel disconnected from your sexy side. “Our bodies lose the desire for sex whenever we’re struggling to meet our own energy needs,” Dr. Block says. If you religiously get to bed on time but are still waking up exhausted, you might not be getting the quality sleep you need. It’s worth talking to your doctor about what might be the cause.
You’re unhappy in your relationship.
If you used to be all over your partner but now rarely feel into the idea, it might be time for couples’ counseling—or at least an honest, open-minded talk. Maybe underlying tension is pre-empting your arousal, or maybe you two just need to take some time to focus on your intimate connection. “Physicians can always refer patients to sex therapists, who can suggest new ways to help increase your desire,” says ob-gyn Jill Hechtman, M.D., medical director of Tampa Obstetrics.
Your hormones are off-kilter.
“Sex-hormone deficiencies—estrogen and testosterone in particular—are the number one reason I see in my practice for a lowered libido,” Dr. Gersh says. The culprit could be the pill or another hormonal contraceptive, like a progestin IUD, but that’s not always the case. (In fact, some women find that hormonal contraceptives actually increase their desire). Pregnancy/breastfeeding can also alter your hormones. So can age. “By age 40, the average woman has a testosterone level half of what it was at age 20,” says Dr. Gersh; your doctor can test your levels and give you a prescription if they’re low.
Your sex drive can also be swayed by imbalances of non-sex hormones, including thyroid and adrenal hormones, oxytocin, and melatonin. If you can’t think of any other obvious causes for your lack of desire, ask your doctor about doing a full hormone workup.
You’re super stressed-out.
If you’ve been pouring all your emotional energy into your job or worrying about finances or family drama, there might not be much left for sex. “What can help is finding a form of mind-body medicine you love,” Dr. Gersh says. “Consider guided imagery, meditation, yoga, progressive relaxation, and others. Or learn about essential oils—vanilla essential oil is an aphrodisiac.”
You’re on antidepressants.
“Antidepressants like Prozac or Paxil notoriously cause low sexual desire,” Dr. Hechtman says. If you suspect this is an issue for you, talk to your doctor, who may be able to switch you to another medication not associated with this side effect.
You’re not on antidepressants.
Untreated depression is strongly linked to low libido, so don’t let the potential side effects mentioned above scare you off seeking treatment, if you think you might need it. “Sometimes, treating underlying anxiety and depression with an SSRI (selective serotonin reuptake inhibitor) can actually improve libido, in spite of the potential side effects,” notes Eliza Orzylowska DeBow, M.D., an ob-gyn in New York City.
Sex just doesn’t feel good.
If pain or dryness keep you from fully enjoying intercourse, it makes sense that you’ll crave it less. Talk to your gynecologist, who may prescribe medication for dryness or refer you to a specialist if a solution isn’t straightforward. “Pinpointing a reason for pain can sometimes be difficult, so a referral to a clinician who specializes in sexual health or a pelvic physical therapist is often needed,” Dr. DeBow says.