Psychosomatics of low libido
Low libido is when your desire for intimacy is weaker than before or has gone. It is common, and the causes vary: stress, anxiety and depression, tiredness after a baby, menopause, vaginal dryness, relationships, some medicines and hormonal contraception, thyroid problems and diabetes. If it worries you, start with a doctor, who will help find the cause. The Ladder method adds questions about how much room is left for you yourself.
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When to see a doctor
Start with a gynaecologist or general practitioner: they will ask about medicines, contraception, sleep and mood, and order tests if needed, for example for your thyroid. The NHS advises seeing a doctor if a medicine or contraceptive may be the cause and if desire has not come back after pregnancy. A psychotherapist or sex therapist can help with relationships and anxiety.
In the Ladder method
In the Ladder method low libido is not explained as "you have shut yourself off from your husband", and you are not to blame for desire fading. The causes are often clear: tiredness, hormones, medicines, relationships, mood. The NHS names stress, anxiety and depression among the common causes, so questions to yourself belong alongside a visit to the doctor, not instead of it.
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In the method desire fits the image of room for yourself: how much strength and time is left in your day for your own pleasure. It is an image, not the cause, and it does not replace tests and a conversation with a doctor.
On the ladder this shows up as the steps "I'm not up to it" and "children, work and home come first". You can work through them at your own pace.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
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How it shows up
Book a doctor’s appointment if you notice:
- Less desire for intimacy than before
- Thoughts about sex rarely come
- Intimacy feels like a duty
- Dryness or pain during intimacy
- Tiredness, low mood, anxiety
- Desire has not come back after giving birth
What medicine knows
Libido is sexual desire. The NHS says that losing it is common. Desire changes over a lifetime, and there is no norm for "how much is right". It is a reason to get help if it worries you or affects your relationship.
Causes according to the NHS: relationship problems, stress, anxiety and depression, vaginal dryness, pregnancy and caring for a baby, menopause, medicines (for blood pressure, antidepressants), hormonal contraception, alcohol, illnesses such as diabetes, an underactive thyroid and heart disease. MedlinePlus adds tiredness from work and a difficult sexual experience in the past.
What doctors offer according to the NHS: counselling for couples, lubricants for dryness, hormone replacement therapy in menopause, cognitive behavioural therapy or antidepressants for depression, changing a medicine or contraceptive if it is the cause. Do not stop medicines on your own, talk to a doctor first.
MedlinePlus advises seeing a doctor if the problem lasts more than a few months or causes you distress. Desire does not have to appear "on schedule", and you do not owe anyone intimacy you do not want.
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Frequently asked questions
Can low libido be caused by nerves?
Yes, stress, anxiety and depression are among the common causes (NHS). But there are physical causes too: menopause, vaginal dryness, medicines, hormonal contraception, thyroid problems and diabetes. That is why it is worth seeing a doctor.
What does low libido mean in psychosomatics?
It has no proven "meaning". In the Ladder method desire that has faded becomes a reason to ask yourself how much room is left in your life for you yourself. It is a question to yourself, not a diagnosis.
When should you see a doctor about low libido?
If it has worried you for more than a few months, if you have started a new medicine or contraceptive, if desire has not come back after giving birth or if intimacy is painful. Start with a gynaecologist or general practitioner.
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Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.