Loss of Libido | Information & Treatment for Low Libido

A loss of libido describes a decreased sexual desire or the loss of libido—that is, a waning interest in sex that can persist over an extended period of time. Medical professionals often refer to this as a sexual desire disorder when the sex drive or the need for sex is significantly reduced. This condition can encompass both a lack of sexual pleasure and a lack of sexual desire, and it affects both women and men at various stages of life—often between the ages of 18 and 59. A loss of libido can be persistent or described as a recurring deficiency and often becomes medically relevant only when it lasts for at least six months and places a strain on the couple’s relationship or overall well-being. 

The causes of a low libido are diverse and can be both physical and psychosocial in nature. Physical causes include, among others, low testosterone, fluctuations in testosterone levels, hormonal imbalances, or conditions such as diabetes, which can impair sexual experience. Medications such as antidepressants can also negatively affect libido. Factors such as stress, work-related stress, or general health issues often play a significant role as well. Psychological triggers such as anxiety disorders can also lead to a sexual desire disorder and reduce interest in sexual activity.

From a therapeutic perspective, psychosocial causes can be divided into three categories:

• Relatively superficial reasons such as a lack of sexual experience, limited sexual skills, or irrational beliefs can contribute to sexual dysfunction—in such cases, sex therapy is recommended as a first step
• Intrapsychic factors such as unconscious fears or internal conflict: individual psychotherapy is advisable
• If the symptoms are an expression of a relationship conflict—such as a lack of sexual fantasies or sexual aversion—couples therapy may be helpful

Symptomatically, a disturbed libido often manifests as reduced sexual desire, persistent avoidance of sexual activity, lack of sexual desire, or complaints such as pain related to sex or pain during sex. A detailed medical history and, if necessary, urological or gynecological evaluation are advisable to narrow down the possible causes and find an appropriate treatment.

Trust-based communication is key: Professional sex therapy or couples therapy provides a safe space to explore psychological causes of loss of libido and to work together to find ways back to intimacy.

Non-organic sexual dysfunction in men and women is classified as follows:

• F 52.0: Lack or loss of sexual desire
• F 52.1: Sexual aversion and lack of sexual satisfaction (F 52.10 sexual aversion, F 52.11 lack of sexual satisfaction)
• F 52.2: Failure of genital responses
• F 52.3: Orgasmic disorders
• F 52.4: Ejaculatio praecox (premature ejaculation)
• F 52.5: Nonorganic vaginismus (spasms of the vaginal muscles that allow penile penetration only with pain)
• F 52.6: Nonorganic dyspareunia (pain during sexual intercourse)
• F 52.7: Increased sexual desire
• F 52.8: Other nonorganic sexual dysfunction
• F 52.9: unspecified nonorganic sexual dysfunction

Treatment for sexual dysfunction depends on the various underlying causes of the disorder. Many complaints are primarily treated with sex therapy, especially when individual psychological factors or relationship-related stressors play a role. If the problem stems from a desire disorder or involves a loss of libido, both behavioral therapy methods and techniques to promote arousal are used. Only in cases of more common comorbidities—such as personality disorders, anxiety disorders, and mood disorders—is more in-depth psychotherapy indicated. Depending on the findings, physical aspects are supplemented by laboratory tests, physical examinations, or urological or gynecological interventions. Medications such as antidepressants, as well as other medications, can also negatively affect sexual function and must therefore be taken into account in treatment. Overall, treatment is individualized and depends on the severity of the symptoms.