Does it feel like you’ve lost your sexual spark? Has your libido become less predictable or intense than it used to be?

If you’re wondering “Why is my sex drive so low?”, you’re not alone. And you’re right to be concerned. Good sexual health is important as we move into older adulthood. It allows us to create and maintain emotional intimacy with our partner. It helps us manage stress. Having an active sex life and a healthy libido can even reduce our risk factors for chronic disease.

How do you define libido?

Libido refers to a person's overall sexual drive or desire for sexual activity. It’s influenced by a complex blend of internal and external factors, including biological, psychological, and social aspects.

Low libido, on the other hand, is when a person has a persistent or recurrent lack of interest in sexual activity or sexual intimacy.

Is it normal for libido to decrease with age?

Yes. It’s common for women to experience a drop in sexual desire and function beginning in their late 40s and early 50s. For older men, this shift may not happen until their 60s and 70s. Loss of libido is very individual. Some people may notice a dramatic change, while others notice no difference at all.

When sex drive is low or absent for six months or more—and it causes significant personal distress or relationship issues—it is sometimes referred to as Hypoactive Sexual Desire Disorder (HSDD), or Male Hypoactive Sexual Desire Disorder (MHSDD) in men. People with this condition lack sexual thoughts and fantasies and have little or no interest in sexual activity, alone or with a partner. They are unresponsive to their partner's sexual signals and may even avoid sex entirely.

What causes a loss of libido in older men?

When libido declines significantly in older men, low testosterone may be the culprit. During a process called andropause—a transition similar to menopause for women—testosterone levels start dropping naturally. While many men may not feel any difference in their sexual desire, some may notice a reduction in their libido or problems achieving and maintaining an erection (erectile dysfunction). A doctor can suggest if a medication for ED could work for you.

Additional symptoms of low testosterone include loss of body and facial hair, depression, loss of muscle tone, and fatigue. Low testosterone is diagnosed through simple blood tests. If a man’s testosterone level is low, this condition can be treated with a testosterone patch, injections, gel, or a pellet inserted under the skin.

Certain medical conditions (obstructive sleep apnea, for example) can cause a loss of testosterone as well. In some cases, it’s the treatments for these conditions that affect testosterone. For instance, prostate cancer often requires chemotherapy, which may lower testosterone levels during the treatment period.

What causes a loss of libido in older women?

Menopause-related changes can cause women’s interest in sex to decline or disappear entirely. In fact, in her book Managing Your Menopause Naturally, author Maryon Stewart cites studies showing that up to 75% of women feel their sex drive has decreased since menopause.

This loss of libido can take an emotional toll on older women, impacting not just their self-esteem but also their relationships. Research shows that the link between low libido among women and personal distress is highest during the midlife period.

What affect women's sex drive after 40? Declining testosterone levels during this time are thought to contribute to reduced sexual desire.¹ In addition, falling estrogen levels can cause the lining of the vagina to become dry and uncomfortable. “When this happens, penetration can become painful and, in extreme cases, the tissue may tear and bleed,” Stewart explained. Engaging in penetration when vaginal tissues are fragile is not only painful; it can lead to urinary tract infections (UTIs).

The hot flashes that often accompany lower estrogen levels can interfere with sexual motivation as well. Says Stewart: “If you are also suffering from night sweats, it’s not surprising that you don’t feel very sexy.”

For some women, the physical changes that aging brings—such as weight gain, sagging skin, and thinning hair—can make them feel less desirable. This diminished self-image may make them feel more inhibited with their partner.

Talk to your doctor before starting any herbal supplements to make sure they don’t interfere with any medications you’re currently taking.

What else causes a loss of libido in men and women?

Aside from gender-specific factors, there are other, more universal factors affecting sex drive.

Medication

Medications can cause side effects that dampen desire or make it harder to get aroused. Some medications known to cause sexual difficulties include:

• Selective serotonin reuptake inhibitors (SSRIs)
• Blood pressure medications
• Antipsychotics
• Opioids
• Statins
• Histamine-2 antagonists (H2 blockers)
• Chemotherapy drugs

If you're on one or more medications and have noticed a drop in your sexual interest, ask your doctor if your medicine may be the cause. They might suggest stopping your medication, lowering the dose, or switching to another type.

Mental health issues

Mental health challenges that impact your happiness and well-being can leave you feeling disinterested in sexual activity. These include:

• Depression
• Anxiety
• Relationship issues
• Past traumatic experiences
• Grief

If your low libido is due to psychological factors, addressing that issue may help you get back on track. This might involve talking to a mental health professional, for example, or practicing yoga to combat your anxiety.

Maintaining a positive outlook can go a long way, too, Stewart said. “What matters most is how you feel about yourself. If you have lost your sparkle, it’s possible to reframe your attitudes and habits and get back to being your old self, or even better.”

Chronic disease

Chronic diseases such as obesity, arthritis, diabetes, and heart disease can have a major impact on sexual function. Part of this can be attributed to physical symptoms of the condition itself, such as pain or fatigue. Medications used to treat the illness can also cause sexual side effects.

Lifestyle habits

Sexual arousal and performance depend on having good overall health. That’s why it’s important to limit or avoid lifestyle behaviors that can impair your body’s natural functions, such as smoking, alcohol overuse, or illicit drug use.

Leading a healthy lifestyle can help you feel better, boost your confidence, and give you more energy to enjoy sexual activity. This means exercising regularly, eating nutritious foods, getting plenty of sleep, and limiting alcohol.

What should I do if I’ve lost my libido, but my partner hasn't?

Since changes in your sex drive can strain your relationship with your partner, the issue shouldn't be swept under the rug. Communication is key. Be honest with them about how you're feeling, and listen carefully to their needs, too.

"When your libido is low, expecting your partner to understand what is going on, without explaining, is an easy trap to fall into," Stewart said.

The most important thing is that you both continue to communicate physically and emotionally. Take some time to explain what you are going through and ask for support."

Keep in mind that being intimate doesn't necessarily mean intercourse. Other acts of intimacy—such as massage, foreplay, or even holding hands and cuddling with your partner—can spark passion and bring you closer together.

Take action and talk to your doctor

If you’re happy with your life and the way you feel, lack of libido is not a problem. But if you want to stay sexually active and you’re concerned about your dwindling sex drive, it’s important to confront the issue head-on.

Should you notice a sudden or significant drop in your libido, arrange a visit with your primary care provider for a complete physical check-up. This will allow them to rule out any health or medication-related causes and explore other potential root causes for your fluctuating drive.

Embarrassed about talking to your doctor? Starting the sex conversation can feel awkward at first. But keep in mind sexual health is an essential part of your overall health, and it’s important to advocate for yourself. You can initiate a dialogue simply by asking questions. Remember you’re not alone; libido issues are extremely common among both men and women. Your provider likely sees patients every day who have symptoms just like yours.

An active sex life is possible at any age

Stewart wants older adults to know a dwindling sex drive is not an inevitable part of aging and menopause.

"There are no standards for a normal level of libido, and there is no such thing as a normal sex drive," she says. "What is normal for one couple may be abnormal for another. You can judge your libido only by your own standards. If you are concerned that your sexual desire has diminished, the good news is you can take action to restore it.

Includes excerpts from the book Manage Your Menopause Naturally. Copyright ©2020 by Maryon Stewart. Printed with permission from New World Library—www.newworldlibrary.com.

Sources

National Council on Aging, Aging Mastery Program (AMP), Sexual Health: An Overview.

1. Alice Scott and Louise Newson. Should we be prescribing testosterone to perimenopausal and menopausal women? A guide to prescribing testosterone to women in primary care. British Journal of General Practice. April 2020. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098532