The Biology of Low Libido: The Science Behind Why Desire Can Change and How You Can Reclaim Your Spark

Here’s the scene: You’re enjoying brunch with your girlfriends, talking candidly about your relationships, when one brave woman at the table admits that her libido has vanished. “I miss having a sex life, but I guess this is just part of getting older,” she says. That’s the moment when you can be a stellar friend and tell her she doesn’t have to accept this change if she’s not ready—no woman does. The key is understanding our libido so we know how to fix it when it starts to dip, as is the case for around 50 percent of us over the age of 50. Get ready to be the most knowledgeable sexual health expert in your friend group. Keep reading about the biology behind low libido and an exciting treatment option to ensure you enjoy the satisfying sex you deserve!

What really is low libido in women?

According to the International Society for the Study of Women’s Sexual Health, libido or sex drive is your interest in sexual activity—simple as that. This includes everything from enjoying sexual fantasies to wanting intimacy (whether alone or with a partner) to responding to sexual cues when intimacy begins.

But there is no simple formula or mental math that calculates low libido. It’s not about having a certain number of sexual thoughts per week or sexual experiences per year. Instead, doctors gauge low libido as a change from your personal norm—specifically, an unwanted, persistent reduction of sexual desire.

Did you know that low mojo feeling has a name and a fix? Head to our Desire Hub for real answers.

Distressing low libido is a medical condition—not a personal failing

If you’ve felt a lack of interest in sex lately, don’t panic. This isn’t your fault or any personal failing. It is clinical. Many women experience a low-libido medical condition called hypoactive sexual desire disorder (HSDD). That means a persistently noticeable decline in sexual desire that’s causing distress. But here’s the good news: It’s treatable and you’re not alone.

Are patients ever surprised to learn low libido is a real clinical diagnosis? “Yes, 100 percent,” says Sameena Rahman, MD, founder of GYN & Sexual Medicine Collective. “I tell them that low libido is a bio-psycho-social condition.” She adds, “The key is understanding that it’s really multifactorial, that there are completely biological reasons for this happening and that you’re not broken.”

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The 3 main factors affecting women’s libido

Understanding HSDD is important, but it’s also worth knowing that a number of overlapping factors may be contributing to your libido changes. Here are the three biggest driving forces that can affect your desire for sex:

Biology shifts

Your body is incredibly complex, and fluctuating hormones play a starring role in libido. “Your testosterone starts to trend downward after age 30,” Dr. Rahman says. “And our neurotransmitters in the brain are responsive to what’s happening with our hormones.”

Think of the brain as having sexual “accelerators” and “brakes.” The accelerators are natural brain chemicals like dopamine and norepinephrine that fuel desire, anticipation and excitement. And the brake is serotonin, which, when too high, can dampen our libido and sexual responsiveness. HSDD happens when these chemicals slip out of balance.

Menopause brings additional biological changes that can affect libido as estrogen levels drop. Physical factors—including hot flashes, night sweats and increased urinary tract infections from a common condition called genitourinary syndrome of menopause (GSM)—might make sex less appealing or more painful. Dr. Rahman says, “We always want to treat sexual pain because nobody wants to have sex when they’re in pain.”

Psychological changes

Our mental health is a big piece of our libido puzzle. Dr. Rahman explains the connection: “Anxiety, depression and mood disruptions come in midlife to a lot of women, and so working with those patients to understand that if you have an inability to experience pleasure or joy from activities you once enjoyed, you can’t get motivated to do anything, including sex.”

Social and relationship factors

Social stressors are another overwhelming factor here. Many women are taking care of children and aging parents, plus their careers and their homes. It’s hard to find the energy for sex when we already have a mile-long to-do list. “There’s a lot of things happening all at once in midlife. Giving ourselves grace when it comes to dealing with low libido is really important,” says Dr. Rahman.

Plus, some women are going through divorces and relationship turbulence. “We joke that if you’re married to a man who is not treating you well, you don’t need hormone replacement therapy; you need husband replacement therapy,” Dr. Rahman quips.

Why some women’s libido actually goes up after midlife

If you’re longing for that vitality again, rest assured, it is within reach. And it’s never too late to get help. Some women happily report that their libidos rebounded or even soared in midlife. Why? Meena Malhotra, MD, founder of Heal N Cure Medical Wellness Center, explains, “You’re not afraid of pregnancy anymore. You finally know what you’re doing in life, maybe you’re more settled at work or you know your partner better. You know what you want or don’t want. These are all the reasons why the libido will go up.” Some women are even revealing having a delightfully “horny menopause.” If this doesn’t feel like you yet, rest assured it can be! Keep reading for real solutions that can get you one step closer to having the best sex of your life.

Real solutions to reclaim your desire

If you’ve noticed your libido waning and you miss it, there’s good news. Medicines are now here to help that were never available to women in past generations. The once-daily Addyi pill is designed to help restore the balance of brain chemicals involved in strengthening libido over a matter of weeks. It is FDA-approved for both pre and postmenopausal women under 65 with HSDD. And the on-demand, occasional-use injection Vyleesi is FDA-approved for premenopausal women. This shot works on the brain and central nervous system, helping to lift libido for 12 to 16 hours.

Success stories and testimonials from women featured in the documentary The Pink Pill show women get relief after suffering from low libido for years or even decades. Cindy Eckert, who brought the historic Addyi pill to market, says her goal was to help women. “We want to be vital, healthy, happy, in charge of our own pleasure our whole life.”

Talk to your doctor to see if prescription medication, developed to treat HSDD, might be right for you. The good news? You can book a telehealth appointment with an expert today by clicking this link and, if it’s right for you, get a prescription.

The bottom line on the biology of low libido

You don’t have to live without the fulfilling sex life—whether with a partner or solo—that you deserve. Your desire matters and your pleasure matters. We’re here to support you with helpful information during this time.