Loss of libido (low libido), also known as reduced sex drive, is a very common problem which is affecting many women and men at some point in their life. This condition is often linked to tiredness, stress or relationship issues but also this can be a sign of underlying problem such as reduced hormone levels. Everyone’s sex drive is different. There is a not such thing as normal libido. But if you find your lack of desire for sex distressing or it is affecting your relationship, then you need to get medical help.
Causes of low libido
Here are the most common causes of low libido:
Underlying health problems: Any long – term condition can affect your sex drive. This can be a result of emotional and physical strain which these conditions can cause but also it can be a side effect of treatment. A low libido can be associated with:
- Major surgery – for example, surgery to remove the ovaries and womb in women [1,2]
- Cancer 
- An underactive thyroid – where the thyroid gland does not produce enough hormones
- Diabetes 
- Heart disease 
You need to talk with your doctor if you think that your low libido can be a result of underlying condition or the treatment for underlying cause.
Pregnancy, giving birth and breastfeeding: Loss of interest in sex is common while breastfeeding, after giving birth and during pregnancy. This can be because of:
- Changed priorities, such as focusing on looking after baby
- Painful sex caused by an injury such as a cut or tear, during childbirth
- Changes to your body and issues with your body image
- Changes in hormone levels
These problems can improve over time. You need to speak with your doctor if your sex drive does not return and it is a problem for you.
- Relationship problems: You need to think if you are happy in your relationship. You need to think if you have any doubts or worries that could be behind your loss of sexual desire.  A low libido can be result of:
- Physical sexual problems
- Difficulty trusting each other
- Poor communication
- Unresolved conflict and frequent arguments
- Loss of sexual attraction
- Being in a long – term relationship becoming over-familiar with your partner
You should talk about sex with your partner or you should read keep the passion alive in your relationship. Your doctor may be able to refer you and your partner for your relationship counseling if you are having persistent problems.
Depression: This condition is very different from simple feeling fed up, miserable or unhappy for a short while. This is a serious illness which interferes with all aspects of our life in which is also included the sex life.  In addition to low libido, sign of depression can include:
- Losing interest or pleasure in doing things you used to enjoy
- Feeling low or hopeless
- Feelings of extreme sadness that do not go away
Stress, anxiety and exhaustion: These factors can have a major impact on your happiness, including the sex drive. If you feel you are constantly anxious, stressed or tired, then you need to speak with your doctor for advice or you should make some lifestyle changes.
Aging and the menopause: A reduced sex drive is not an inevitable part of aging but this is something many men and women experience as they get older.  There can be many reasons for this such as:
- Side effects of medication
- Age – related health problems, including mobility problems
- Falling levels of sex hormones (testosterone) in men
- Falling levels of sex hormones (oestrogen and testosterone) just before, during and after the menopause in women
Sexual problems: You should think if your problem is a result from a physical issue which makes your sex difficult or it is unfulfilling. A low sex drive can be result of:
- Involuntary tightening of the vagina (vaginismus)
- Inability to orgasm
- Painful sex
- Vaginal dryness
- Erectile dysfunction
- Ejaculation problems
Medication and contraception: There are some medicines which can reduce libido such as:
- Many types of antidepressant medication [7,9]
- Medication for high blood pressure
- Hormonal contraception, such as the combined hormonal contraception (pill, patch or ring), the progestogen – only pill, the contraceptive implant and the contraceptive injection
- Medications for enlarged prostate such as finasteride
- Medications for fits (seizures) such as haloperidol
- Medication for prostate cancer such as cyproterone
- Medications called antipsychotics such as haloperidol 
 Blackwell Publishing Ltd. Risk for low sexual desire increases in women after surgical menopause. EurekAlert! 2006. Retrieved from www.eurekalert.org/pub_releases/2006-02/bpl-rfl022706.php
 Pauls RN. Impact of gynecological surgery on female sexual function. International Journal of Impotence Research. 2010;22:105–14.
 Shankar A, Prasad N, Roy S, et al. Sexual dysfunction in females after cancer treatment: an unresolved issue. Asian Pacific Journal of Cancer Prevention. 2017;18(5):1177–82.
 Omidvar S, Niaki MT, Amiri FN, Kheyrkhah F. Sexual dysfunction among women with diabetes mellitus in a diabetic center in Amol. Journal of Natural Science, Biology, and Medicine. 2013;4(2):321–4.
 Nascimento ER, Maia ACO, Pereira V, et al. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence. Clinics (Sao Paulo). 2013;68(11):1462–8.
 Dewitte M, Mayer A. Exploring the link between daily relationship quality, sexual desire, and sexual activity in couples. Archives of Sexual Behavior. 2018;47:1675–86.
 Carcedo RJ, Fernández-Rouco N, Fernández-Fuertes AA, Martínez-Álvarez JL. Association between sexual satisfaction and depression and anxiety in adolescents and young adults. International Journal of Environmental Research and Public Health. 2020;17(3):841.
 Leventhal JL. Management of libido problems in menopause. The Permanente Journal. 2000;4(3):29–34.
 Lorenz T, Rullo J, Faubion S. Antidepressant-induced female sexual dysfunction. Mayo Clinic Proceedings. 2016;91(9):1280–6.
 Park YW, Kim Y, Lee JH. Antipsychotic-induced sexual dysfunction and its management. The World Journal of Mens Health. 2012;30(3):153–9.