Low Libido in Women: 6 Common Medical Causes and Effective Treatments

Low libido in women is common and often misunderstood. While stress and relationship factors can play a role, low sexual desire is frequently driven by medical and hormonal causes, especially during midlife. At some point in life, up to 1 in 5 women will experience a persistent decrease in sexual desire that causes distress or affects quality of life.

Understanding the underlying cause is essential, because effective treatment depends on why libido has changed, not just that it has.

1) Hormonal Imbalances (Perimenopause, Menopause, and Post-Menopause)

Hormonal imbalance is the most common medical cause of low libido in women, particularly during perimenopause, menopause, and post-menopause.

Declining estrogen, progesterone, and testosterone levels can reduce sexual desire, arousal, and comfort during intercourse. Estrogen loss contributes to vaginal dryness and pain, while low testosterone, often overlooked in women, directly affects libido, sensitivity, and orgasm.

Symptoms may begin years before menopause and progress gradually.

Treatment: Personalized hormone therapy, which can include a combination of estrogen, progesterone and carefully monitored low-dose testosterone when appropriate. The hormones used to treat an imbalance are typically determined by comprehensive lab testing and symptoms reviewed and discussed with your provider.

2) Thyroid Disorders

Thyroid dysfunction can significantly affect libido by altering metabolism, energy, and mood. Both hypothyroidism and hyperthyroidism are associated with fatigue, depression, and reduced sexual interest.

Because symptoms can be subtle, thyroid-related low libido often goes undiagnosed without proper testing.

Treatment: Focuses on restoring and maintaining healthy thyroid hormone levels.

3) Chronic Medical Conditions

Conditions such as diabetes, cardiovascular disease, autoimmune disorders, and chronic pain syndromes can impair libido by affecting circulation, nerve function, inflammation, and energy levels. Poor blood flow and fatigue directly interfere with sexual arousal and response.

Treatment: Involves managing the underlying condition while addressing contributing hormonal or metabolic factors. GLP-1 medications are often used to help treat some of the most common underlying conditions, including pre-diabetes, cardiovascular risks, and help with energy levels.

4) Medications That Affect Sexual Desire

Several commonly prescribed medications can lower libido, including antidepressants (especially SSRIs), hormonal birth control, blood pressure medications, and some anxiety treatments. These drugs may alter neurotransmitters or suppress natural testosterone production.

Treatment: Options include medication adjustments, alternatives, or supportive therapies under medical supervision. In select cases, FDA-approved treatments such as Addyi or Vylessi may be considered for premenopausal women.

5) Vaginal Atrophy and Genitourinary Syndrome of Menopause (GSM)

Low estrogen levels can cause thinning and dryness of vaginal tissue, leading to discomfort or pain during sex. When intercourse becomes painful, sexual desire naturally declines.

This condition affects up to 50% of postmenopausal women, yet is frequently underreported.

Treatment: Includes estrogen therapy, non-hormonal moisturizers or lubricants, pelvic floor therapy, such as V-Tone, and systemic hormone support when appropriate.

6) Depression, Anxiety, and Chronic Stress

Mental health conditions can significantly reduce libido by disrupting dopamine and serotonin, key neurotransmitters involved in sexual desire and pleasure. Chronic stress and poor sleep further suppress sexual interest.

Even mild or untreated symptoms can meaningfully affect libido.

Treatment: Focuses on addressing mental health concerns while reviewing medications and hormone balance.

When Should a Woman Seek Help for Low Libido?

If low libido is persistent, worsening, or affecting quality of life or relationships, a medical evaluation is appropriate. Assessment typically includes hormone testing, medication review, and evaluation of overall health.

Low libido is not something women are expected to “just live with.” When the underlying cause is identified, effective and individualized treatment options are available.

Addressing Low Libido In Women At Fountain of You MD

At Fountain of You MD we typically start with comprehensive lab testing to evaluate key hormones that directly affect sexual desire, including estrogen, progesterone, testosterone, thyroid markers, and other relevant metabolic indicators. This allows us to determine whether low libido is linked to hormonal shifts, perimenopause or menopause, thyroid dysfunction, or other underlying imbalances.

If hormonal changes are contributing, treatment may include personalized hormone optimization tailored to your body and symptoms, rather than a one-size-fits-all approach.

For women who continue to struggle with low desire despite addressing hormonal factors, or for those who need additional support, we also offer PT-141 (Bremelanotide). PT-141 works on the central nervous system rather than hormone levels, helping stimulate sexual desire and arousal by activating pathways in the brain involved in libido. It can be a valuable option for women experiencing low sexual desire that has not responded to traditional approaches.

Additionally, we offer advanced Vaginal Rejuvenation treatments designed to improve vaginal dryness, vaginal atrophy, and overall comfort during intimacy, factors that can significantly contribute to low libido. Options such as Morpheus V, V-Tone, and FormaV help restore tissue health, improve sensation, and enhance comfort, supporting a more positive and confident sexual experience.

Low libido is complex, but it is also treatable. With proper evaluation, targeted therapies, and medical guidance, many women are able to restore sexual desire, comfort, and confidence at any stage of life. Schedule your consultation at Fountain of You MD in Virginia Beach or Chesapeake to get started.