Why am I not interested in sex anymore?

Loss of sexual interest can stem from hormonal imbalances, stress, medications, relationship issues, or underlying health conditions. Testing key biomarkers like testosterone, thyroid hormones, and cortisol can help identify the root cause and guide effective treatment.

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Understanding the Complex Nature of Low Libido

Experiencing a decrease in sexual interest can be confusing and distressing, especially when it seems to happen without warning. Low libido, or reduced sexual desire, affects millions of people and can significantly impact quality of life and relationships. While it's normal for sexual interest to fluctuate throughout life, a persistent lack of desire often signals an underlying issue that deserves attention.

The good news is that low libido is rarely permanent and often responds well to treatment once the root cause is identified. Understanding your body's unique biochemistry through comprehensive biomarker testing can provide crucial insights into what's affecting your sexual health.

Hormonal Imbalances: The Primary Culprit

Testosterone in Men and Women

Testosterone plays a crucial role in sexual desire for both men and women. In men, low testosterone (hypogonadism) is one of the most common causes of reduced libido. Normal total testosterone levels typically range from 300-1000 ng/dL in men, with levels below 300 ng/dL often associated with decreased sexual interest. Women also need testosterone for healthy libido, though in much smaller amounts (15-70 ng/dL).

Beyond total testosterone, free testosterone and sex hormone-binding globulin (SHBG) levels provide a more complete picture. High SHBG can bind to testosterone, making it unavailable for use by the body, effectively lowering libido even when total testosterone appears normal.

Estrogen and Progesterone Fluctuations

In women, estrogen and progesterone imbalances significantly impact sexual desire. During perimenopause and menopause, declining estrogen levels can cause vaginal dryness, painful intercourse, and reduced libido. Similarly, hormonal changes during pregnancy, breastfeeding, or while using hormonal contraceptives can affect sexual interest.

The delicate balance between estrogen and progesterone throughout the menstrual cycle also influences libido. Many women notice increased sexual desire during ovulation when estrogen peaks, and decreased interest during the luteal phase when progesterone dominates.

Thyroid Dysfunction

Thyroid hormones regulate metabolism and energy production throughout the body, including sexual function. Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can cause low libido. Common thyroid-related symptoms that accompany sexual dysfunction include fatigue, weight changes, mood swings, and temperature sensitivity.

TSH levels above 4.5 mIU/L may indicate hypothyroidism, while levels below 0.4 mIU/L suggest hyperthyroidism. However, optimal thyroid function often requires looking beyond TSH to include Free T3 and Free T4 levels for a complete assessment.

Stress, Mental Health, and Lifestyle Factors

The Cortisol Connection

Chronic stress elevates cortisol levels, which can suppress sex hormone production and reduce libido. High cortisol interferes with the hypothalamic-pituitary-gonadal axis, disrupting the delicate balance of hormones necessary for healthy sexual function. Additionally, stress activates the sympathetic nervous system, making it difficult to relax and become aroused.

Monitoring your cortisol rhythm throughout the day can reveal stress-related patterns affecting your sexual health. Ideally, cortisol should be highest in the morning (10-20 mcg/dL) and lowest at night (2-5 mcg/dL).

Depression and Anxiety

Mental health conditions profoundly impact sexual desire. Depression often manifests as anhedonia - the inability to feel pleasure in activities once enjoyed, including sex. Anxiety can create performance pressure and body image concerns that inhibit sexual interest. The relationship between mental health and libido is bidirectional: poor mental health reduces libido, while sexual dysfunction can worsen psychological distress.

Sleep Quality and Fatigue

Poor sleep quality directly impacts hormone production and sexual function. During deep sleep, the body produces testosterone and growth hormone, both essential for healthy libido. Chronic sleep deprivation can reduce testosterone levels by up to 15% in just one week. Additionally, fatigue from poor sleep makes sexual activity seem more like a chore than a pleasure.

Medical Conditions and Medications

Chronic Health Conditions

Several chronic conditions can reduce sexual interest through various mechanisms:

  • Diabetes: High blood sugar damages blood vessels and nerves, affecting arousal and sensation
  • Cardiovascular disease: Poor circulation reduces blood flow to sexual organs
  • Obesity: Excess weight lowers testosterone and increases estrogen in men
  • PCOS: Hormonal imbalances in women with PCOS often include elevated androgens and insulin resistance
  • Chronic pain conditions: Pain and fatigue from conditions like fibromyalgia reduce sexual interest

Medication Side Effects

Many common medications can reduce libido as a side effect. Antidepressants, particularly SSRIs, are notorious for causing sexual dysfunction in up to 70% of users. Blood pressure medications, especially beta-blockers and diuretics, can interfere with arousal. Other culprits include antihistamines, opioid pain medications, anti-seizure drugs, and some prostate medications.

If you suspect medication is affecting your libido, don't stop taking it without consulting your healthcare provider. Often, adjusting the dose or switching to an alternative medication can help restore sexual function while maintaining treatment effectiveness.

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Relationship and Psychological Factors

Sexual desire doesn't exist in a vacuum - it's deeply influenced by relationship dynamics and psychological well-being. Unresolved conflicts, poor communication, lack of emotional intimacy, or feeling disconnected from your partner can significantly reduce sexual interest. Past trauma, body image issues, and cultural or religious beliefs about sexuality also play important roles.

Sometimes low libido reflects relationship issues rather than individual health problems. Couples therapy or sex therapy can help address communication barriers, rebuild intimacy, and develop strategies for rekindling desire.

While aging doesn't automatically mean loss of sexual interest, age-related hormonal changes do affect libido. Men experience a gradual decline in testosterone production starting around age 30, losing about 1% per year. Women face more dramatic hormonal shifts during perimenopause and menopause, with estrogen levels dropping by up to 80%.

However, many older adults maintain satisfying sex lives by adapting to these changes. Hormone replacement therapy, when appropriate, can help restore sexual function. Regular exercise, stress management, and maintaining overall health also support sexual vitality with age.

Diagnostic Approach: Key Biomarkers to Test

Identifying the cause of low libido requires comprehensive testing. Essential biomarkers to evaluate include:

  • Total and free testosterone
  • Sex hormone-binding globulin (SHBG)
  • Estradiol and progesterone (in women)
  • Thyroid panel: TSH, Free T3, Free T4
  • Cortisol (preferably multiple samples throughout the day)
  • Prolactin
  • DHEA-S
  • Fasting glucose and HbA1c
  • Vitamin D
  • Complete blood count to check for anemia

Understanding your unique biomarker profile helps identify specific imbalances contributing to low libido. Regular monitoring allows you to track improvements as you implement targeted interventions.

Treatment Strategies and Lifestyle Interventions

Hormone Optimization

When hormone imbalances are identified, targeted treatment can restore sexual function. Options include testosterone replacement therapy for men with clinically low levels, bioidentical hormone therapy for menopausal women, and thyroid medication for those with thyroid dysfunction. Working with a healthcare provider experienced in hormone optimization ensures safe, effective treatment.

Lifestyle Modifications

Simple lifestyle changes can significantly improve libido:

  • Exercise regularly: Strength training boosts testosterone, while cardio improves circulation
  • Prioritize sleep: Aim for 7-9 hours of quality sleep nightly
  • Manage stress: Practice meditation, yoga, or other relaxation techniques
  • Eat a balanced diet: Include healthy fats, lean proteins, and plenty of vegetables
  • Limit alcohol: Excessive drinking suppresses testosterone and impairs sexual function
  • Maintain a healthy weight: Even modest weight loss can improve hormone levels

Supplements and Natural Remedies

Several supplements show promise for supporting sexual health. Vitamin D supplementation can improve testosterone levels in deficient individuals. Zinc supports testosterone production, while magnesium helps reduce stress and improve sleep. Herbs like ashwagandha, maca root, and tribulus terrestris have traditional use for enhancing libido, though scientific evidence varies.

For those interested in understanding their current health status and tracking improvements, SiPhox Health's free blood test analysis service can provide personalized insights from your existing lab results.

Taking Action: Your Path to Renewed Sexual Vitality

Losing interest in sex doesn't have to be permanent. By understanding the multifaceted nature of libido and addressing underlying causes, most people can restore their sexual desire and enjoyment. Start by getting comprehensive biomarker testing to identify hormonal imbalances or health issues. Work with healthcare providers who take your concerns seriously and offer evidence-based treatments.

Remember that sexual health is an important component of overall well-being. Don't hesitate to seek help - whether through medical evaluation, therapy, or lifestyle changes. With the right approach, you can rediscover your sexual vitality and enhance your quality of life.

References

  1. Corona, G., Rastrelli, G., Ricca, V., Jannini, E. A., Vignozzi, L., Monami, M., ... & Maggi, M. (2013). Risk factors associated with primary and secondary reduced libido in male patients with sexual dysfunction. The Journal of Sexual Medicine, 10(4), 1074-1089.[PubMed][DOI]
  2. Leproult, R., & Van Cauter, E. (2011). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA, 305(21), 2173-2174.[PubMed][DOI]
  3. Davis, S. R., Davison, S. L., Donath, S., & Bell, R. J. (2005). Circulating androgen levels and self-reported sexual function in women. JAMA, 294(1), 91-96.[PubMed][DOI]
  4. Basson, R., & Gilks, T. (2018). Women's sexual dysfunction associated with psychiatric disorders and their treatment. Women's Health, 14, 1745506518762664.[PubMed][DOI]
  5. Gabrielson, A. T., Sartor, R. A., & Hellstrom, W. J. (2019). The impact of thyroid disease on sexual dysfunction in men and women. Sexual Medicine Reviews, 7(1), 57-70.[PubMed][DOI]
  6. Montejo, A. L., Montejo, L., & Baldwin, D. S. (2018). The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management. World Psychiatry, 17(1), 3-11.[PubMed][DOI]

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Frequently Asked Questions

How can I test my hormone levels at home?

You can test your hormone levels at home with SiPhox Health's Hormone Focus Program. This comprehensive program includes testing for testosterone, estradiol, DHEA-S, cortisol, and other key hormones that affect sexual health, providing lab-quality results from the comfort of your home.

How long does it take for libido to return after addressing the underlying cause?

Recovery time varies depending on the cause. Hormone replacement therapy may show improvements within 3-6 weeks, while lifestyle changes like better sleep and stress management might take 2-3 months. Medication adjustments can improve libido within weeks of switching to alternatives.

Is low libido a normal part of aging?

While hormone levels naturally decline with age, complete loss of sexual interest isn't inevitable. Many older adults maintain healthy sex lives by addressing hormone imbalances, staying physically active, and maintaining good overall health. Age-related changes are treatable.

Can birth control pills cause permanent loss of libido?

Birth control pills can reduce libido by suppressing testosterone production and increasing SHBG, but these effects are typically reversible. Most women see their libido return to baseline within 3-6 months after discontinuing hormonal contraceptives, though some may need hormone support during recovery.

What's the difference between low libido and erectile dysfunction?

Low libido refers to reduced sexual desire or interest, while erectile dysfunction is the inability to achieve or maintain an erection despite having sexual desire. They can occur together but are distinct conditions with different causes and treatments. Both warrant medical evaluation.

This article is licensed under CC BY 4.0. You are free to share and adapt this material with attribution.

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View Details
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Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
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Paul D. Thompson is Chief of Cardiology Emeritus of Hartford Hospital and Professor Emeritus at University of Connecticut Medical School. He has authored over 500 scientific articles on cardiovascular risk factors, the effects of exercise, and beyond. He received National Institutes of Health’s (NIH) Preventive Cardiology Academic Award, and has received NIH funding for multiple studies.

Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

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Health Programs Lead, Health Innovation

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View Details
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Pavel Korecky, MD

Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
Paul Thompson, MD

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Advisor

Paul D. Thompson is Chief of Cardiology Emeritus of Hartford Hospital and Professor Emeritus at University of Connecticut Medical School. He has authored over 500 scientific articles on cardiovascular risk factors, the effects of exercise, and beyond. He received National Institutes of Health’s (NIH) Preventive Cardiology Academic Award, and has received NIH funding for multiple studies.

Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

View Details
Robert Lufkin, MD

Robert Lufkin, MD

Advisor

Physician/medical school professor (UCLA and USC) and New York Times bestselling author empowering people to take back their metabolic health with lifestyle and other tools. A veteran of the Today Show, USA Today, and a regular contributor to FOX and other network news stations, his weekly video podcast reaches over 500,000 people. After reversing chronic disease and transforming his own life he is making it his mission to help others do the same.

His latest book, ‘Lies I Taught In Medical School’ is an instant New York Times bestseller and has re-framed how we think about metabolic health and longevity. In addition to being a practicing physician, he is author of over 200 peer reviewed scientific papers and 14 books that are available in fourteen languages.

View Details
Ben Bikman, PhD

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Advisor

Benjamin Bikman earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and professor (Brigham Young University) is to better understand the role of elevated insulin and nutrient metabolism in regulating obesity, diabetes, and dementia.

In addition to his academic pursuits, Dr. Bikman is the author of Why We Get Sick and How Not To Get Sick.

View Details
Tash Milinkovic, MD

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Health Programs Lead, Heart & Metabolic

Dr. Natasha Milinkovic is part of the clinical product team at SiPhox Health, having graduated from the University of Bristol Medical School. Her medical career includes rotations across medical and surgical specialties, with specialized research in vascular surgery, focusing on recovery and post-operative pain outcomes. Dr. Milinkovic built her expertise in emergency medicine as a clinical fellow at a major trauma center before practicing at a central London teaching hospital throughout the pandemic.

She has contributed to global health initiatives, implementing surgical safety standards and protocols across rural Uganda. Dr. Milinkovic initially joined SiPhox Health to spearhead the health coaching initiative and has been a key contributor in the development and launch of the Heart and Metabolic program. She is passionate about addressing health disparities by building scalable healthcare solutions.

View Details
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Health Programs Lead, Health Innovation

Dr. Tsogbayar leverages her clinical expertise to develop innovative health solutions and evidence-based coaching. Dr. Tsogbayar previously practiced as a physician with a comprehensive training background, developing specialized expertise in cardiology and emergency medicine after gaining experience in primary care, allergy & immunology, internal medicine, and general surgery.

She earned her medical degree from Imperial College London, where she also completed her MSc in Human Molecular Genetics after obtaining a BSc in Biochemistry from Queen Mary University of London. Her academic research includes significant work in developmental cardiovascular genetics, with her thesis publication contributing to the understanding of genetic modifications on embryonic cardiovascular development.

View Details
Pavel Korecky, MD

Pavel Korecky, MD

Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
Paul Thompson, MD

Paul Thompson, MD

Advisor

Paul D. Thompson is Chief of Cardiology Emeritus of Hartford Hospital and Professor Emeritus at University of Connecticut Medical School. He has authored over 500 scientific articles on cardiovascular risk factors, the effects of exercise, and beyond. He received National Institutes of Health’s (NIH) Preventive Cardiology Academic Award, and has received NIH funding for multiple studies.

Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

View Details
Robert Lufkin, MD

Robert Lufkin, MD

Advisor

Physician/medical school professor (UCLA and USC) and New York Times bestselling author empowering people to take back their metabolic health with lifestyle and other tools. A veteran of the Today Show, USA Today, and a regular contributor to FOX and other network news stations, his weekly video podcast reaches over 500,000 people. After reversing chronic disease and transforming his own life he is making it his mission to help others do the same.

His latest book, ‘Lies I Taught In Medical School’ is an instant New York Times bestseller and has re-framed how we think about metabolic health and longevity. In addition to being a practicing physician, he is author of over 200 peer reviewed scientific papers and 14 books that are available in fourteen languages.

View Details
Ben Bikman, PhD

Ben Bikman, PhD

Advisor

Benjamin Bikman earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and professor (Brigham Young University) is to better understand the role of elevated insulin and nutrient metabolism in regulating obesity, diabetes, and dementia.

In addition to his academic pursuits, Dr. Bikman is the author of Why We Get Sick and How Not To Get Sick.

View Details
Tash Milinkovic, MD

Tash Milinkovic, MD

Health Programs Lead, Heart & Metabolic

Dr. Natasha Milinkovic is part of the clinical product team at SiPhox Health, having graduated from the University of Bristol Medical School. Her medical career includes rotations across medical and surgical specialties, with specialized research in vascular surgery, focusing on recovery and post-operative pain outcomes. Dr. Milinkovic built her expertise in emergency medicine as a clinical fellow at a major trauma center before practicing at a central London teaching hospital throughout the pandemic.

She has contributed to global health initiatives, implementing surgical safety standards and protocols across rural Uganda. Dr. Milinkovic initially joined SiPhox Health to spearhead the health coaching initiative and has been a key contributor in the development and launch of the Heart and Metabolic program. She is passionate about addressing health disparities by building scalable healthcare solutions.

View Details