How is low sex drive diagnosed?

Jan L. Shifren, MD
Reproductive Endocrinology
When evaluating a loss of sexual desire, your healthcare provider will first look for physical causes. Any of a number of chronic medical conditions can impinge on desire. So, too, can a variety of treatments and dozens of prescription medications. The emotional effects of almost any chronic disease -- such as frustration, depression, anger, fear of death, and altered body image -- can indirectly lead to the loss of desire. In women, low libido may stem from dyspareunia, or pain with intercourse, especially in postmenopausal women with vaginal dryness secondary to low estrogen levels.

If there are no obvious physical reasons for low libido, your healthcare provider will explore your attitudes and feelings about sex and about your partner. One important distinction to be made is whether the problem is a lifelong lack of desire, a more recent loss of interest, or a problem that occurs only with a particular partner or in a certain situation. Sometimes, a history of physical or sexual abuse can manifest as low libido (or an aversion to sex) that may not show up until after the person has married or had children.

If your libido has dropped, your healthcare provider will focus on the point when the change occurred and explore potential causes. He or she will ask about symptoms from menopause or aging and ask about your relationship with your partner. The healthcare provider will also ask about your levels of stress and fatigue, self-image, and whether depression may be a factor.

Diagnosing low sex drive may be complicated because there's really no "normal" level of sex drive. If you're bothered by your lack of interest in sex, doctors may start by asking you questions about your symptoms and medical history. In some cases, doctors may then perform a blood test or other screening tests to look for low levels of sex hormones like testosterone, which may be the cause of low libido. For women, doctors may perform pelvic exams to check for physical problems that may cause a decrease in sexual desire. You may be referred to a counselor or therapist to find any psychological or relationship issues that may lead to low sex drive.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.