Lowered libido

Low libido is variously described as sexual dysfunction, low sexual desire, poor sexual arousal, sexual disorder, lack of sex drive or a new term, hypoactive sexual desire disorder (HSDD).

The causes can be classified as psychological, physical and endocrinologic:

Psychological

Psychological issues can include stress, depression, post natal depression, childhood trauma, previous sexual abuse or rape and problems in relationship.

Physical

Physical issue include for example low vitamin D and obesity. Also, women commonly lack sexual desire in the period immediately after giving birth. Moreover, any condition affecting the genital area can make women reject the idea of having intercourse. It has been estimated that half of women experience different health problems in the area of the vagina and vulva, such as thinning, tightening, dryness or atrophy. Frustration may appear as a result of these issues and because many of them lead to painful sexual intercourse, many women prefer not having sex at all.

Endocrinologic

Some specialists claim that women may experience low libido due to some hormonal abnormalities such as lack of luteinising hormone (LH) or androgenic hormones, although these theories are still controversial. Testosterone is one of the hormones controlling libido in human beings. Emerging research is showing that hormonal contraception methods like oral contraceptive pills (which rely on estrogen and progesterone together) are causing low libido in females by elevating levels of sex hormone binding globulin (SHBG). SHBG binds to sex hormones, including testosterone, rendering them unavailable.

Other causes of lowered libido can may be surgery or major health conditions such as arthritis, cancer, diabetes, high blood pressure, coronary artery disease.

Lowered libido affects approximately 20% of the total population and is far more common in females than males.

Both partners to be involved in therapy. Typically, the therapist tries to find a psychological or biological cause. If the cause is organically caused, the clinician may try to deal with that. If the clinician believes it is rooted in a psychological problem, they may recommend therapy for that. If not, treatment generally focuses more on relationship and communication issues, improved communication (verbal and nonverbal), working on non-sexual intimacy, or education about sexuality may all be possible parts of treatment. Sometimes problems occur because people have unrealistic perceptions about what normal sexuality is and are concerned that they do not compare well to that, and this is one reason why education can be important.

It appears that progesterone is essential for a normal sexual response. Women should use 100-200mg/day, dependant on symptoms. More if symptoms are severe. Men should use 10-100mg/day, again dependant on symptoms.

Erectile dysfunction

In men sexual dysfunction can lead to reduced smooth muscle function leading to impaired flow of blood to the corpora. This leads to erectile dysfunction or impotence, low libido and more. One of the causes of erectile dysfunction may be due to low testosterone levels. A man with low levels of testosterone may lose his desire for sex. Sexual stimulation and sexual activity cause testosterone levels to rise. Testosterone levels can drop during a long period of sexual inactivity.

Idiopathic male infertility

Idiopathic male infertility is infertility, that the causes are unknown. Medications used to treat infertility can lead to loss of libido.

Obesity

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health. It is known that obesity reduces libido. This happens especially aging men who experience a decrease in testosterone levels, which is associated with obesity.

Hyperprolactinemia

Hyperprolactinemia is the presence of abnormally high levels of prolactin in the blood.

Some women may experience a loss of libido (interest in sex) and breast pain, especially when prolactin levels begin to rise for the first time, as the hormone promotes tissue changes in the breast. Intercourse may become difficult or painful because of vaginal dryness.

In men, the most common symptoms of hyperprolactinaemia are decreased libido, sexual dysfunction (in both men and women), erectile dysfunction, infertility. Because men have no reliable indicator such as menstruation to signal a problem, many men with hyperprolactinaemia being caused by a pituitary adenoma may delay going to the doctor until they have headaches or eye problems caused by the enlarged pituitary pressing against the adjacent optic chiasm. They may not recognize a gradual loss of sexual function or libido. Only after treatment do some men realize they had a problem with sexual function.

Hypogonadism

Hypogonadism means diminished functional activity of the gonads—the testes in males or the ovaries in females—that may result in diminished sex hormone biosynthesis. Testosterone plays a critical role in sexual, cognitive, and body development in males. Symptoms of hypogonadism include decreased libido, erectile dysfunction, decreased vitality and decreased muscle mass. Hypogonadism is a common disorder in aging men with a significant percentage of men over 60 years of age having serum testosterone levels below the lower limits of young male adults.

Women with hypogonadism do not begin menstruating and it may affect their height and breast development. Onset in women after puberty causes cessation of menstruation, lowered libido, loss of body hair and hot flashes.

Anorexia Nervosa

Anorexia nervosa is an eating disorder we describe as addiction to starving. Sexual dysfunction is common across eating disorders. Low body mass index (BMI) is associated with loss of libido, sexual anxiety, and avoidance of sexual relationships. Women with restricting and purging anorexia nervosa had a higher prevalence of loss of libido than women with bulimia nervosa (an eating disorder characterized by binge eating followed by purging). Even though malnutrition may affect libido, other central features of eating disorders such as distorted body image, body dissatisfaction, and shame can also compromise healthy sexual functioning and relationships among individuals who struggle with eating pathology.

Tubal ligation

Tubal ligation is a surgical procedure for sterilization in which a woman's fallopian tubes are clamped and blocked or severed and sealed, either of which prevents eggs from reaching the uterus for implantation. This procedure affects sexual activity. Many studies of several clinical and other factors associated with sterilization showed that regret about the procedure was the only factor associated with a poststerilization decrease in sexual pleasure or interest.

XX male syndrome

XX male syndrome is a rare sex chromosomal disorder. Symptoms usually include small testes and subjects are invariably sterile. Individuals with this condition sometimes have feminine characteristics, with varying degrees of gynecomastia (enlarged breasts in men) but with no intra-abdominal Müllerian tissue. most XX males are not stereotypically feminine and are typical boys and men although other reports suggest that facial hair growth is usually poor and libido is diminished, with notable exceptions.

Premature ovarian failure

Premature ovarian failure is defined as a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles/arrested folliculogenesis before the age of 40 years (secondary amenorrhea). Usual signs and symptoms of premature ovarian failure include the following: irregular or skipped periods (amenorrhea), hot flashes and night sweats irritability, poor concentration, vaginal dryness, decreased sexual desire and infertility.

Ejaculatory disorders, Anejaculation, Azoospermia

Ejaculatory disorders such as anejaculation (the condition of being unable to ejaculate) and azoospermia (the medical condition of a man when sperm count is equal or less then 15 million/ml in his semen) are very unpleasant matter, which is also mentally exhausting. While these conditions do not pose any serious medical risks, it may create problems in your sex life such as decreased libido and personal relationships.

Ovariectomy

Ovariectomy is the surgical removal of an ovary or ovaries. Substantially more women who had both an oophorectomy and a hysterectomy reported libido loss, difficulty with sexual arousal, and vaginal dryness than those who had a less invasive procedure (either hysterectomy alone or an alternative procedure), and hormone replacement therapy was not found to improve these symptoms.

Hydrocele testis

A hydrocele testis is an accumulation of clear fluid in the tunica vaginalis, the most internal of membranes containing a testicle. Hydroceles will vary greatly in size and are normally painless and harmless. However, as the fluid continues to accumulate and the scrotum further enlarges, more discomfort can be expected. Large hydroceles will cause discomfort because of their size. Sometimes pain can be in both testicles as pressure from the enlarged area puts pressure against the unaffected area which can cause discomfort to the normal testicle. It has also been found to decrease a man's sex drive and makes him less active for fear of enlarging the mass.

Prostatitis

Prostatitis is an inflammation of the prostate which can be caused by bacteria. A man who suffers from prostatitis, can significantly reduce the amount of male hormones, which causes a decrease in libido.