(Allure) Most of us experience low libido at some point in our lives. Unfortunately, there’s plenty of confusion and even controversy around what causes low sex drive, as well as how to treat it — not least because what “low” means is subjective.

You may have heard of HSDD, or hypoactive sexual desire disorder, which refers to the lack or absence of sexual desire. Some researchers claim the disorder was “invented” to sell the medication flibanserin, name brand Addyi, also referred to as “female Viagra.” Others say HSDD is a real problem that causes sufferers distress.

While Addyi remains controversial, it’s clear that many people’s libidos aren’t as high as they’d like. A lowered libido could be a sign of a diagnosable condition, or it could be due to a lifestyle factor. Sex therapist Holly Richmond points out that often, changes in sex drive are nothing to stress about (in fact, stress may only exacerbate the problem). Read on for nine possible reasons your drive is dipping.

1. You’re under a lot of stress.

Given the headlines about sexual assault and harassment flooding our social media accounts, a correlating dip in sex drive is totally understandable. If you’re experiencing high levels of stress, Richmond suggests seeking therapy to talk it out and learn stress management techniques. And before you jump to self-diagnosing any medical conditions, if you’re experiencing an unusually low libido, remember our national state of affairs — and cut yourself slack for feeling deeply affected by them. That includes in the bedroom.

2. You’re dealing with depression.

Everyone has down days, especially in times as stressful as this. But depression is even more serious: “Depression affects every aspect of your life, physically, mentally, and can cause libido issues,” says Jessica Shepherd, an OB/GYN at the University of Illinois at Chicago. For more information on depression, see the National Institute of Mental Health’s  site. Depression is brutal and yet treatable. Don’t hesitate to see your doctor if you’ve been feeling bluer than normal for longer than usual.

3. You’re on antidepressants.

While depression can affect libido, so can SSRI medications used to treat it, including Lexapro, Zoloft, and Prozac. Yes, it’s a cruel world when the treatment shares a side effect with the condition. However, Shepherd stresses that fear of sexual side effects isn’t a reason not to seek treatment for depression. If you’re on antidepressants that you feel are affecting your sex drive, abruptly stopping your medication can be dangerous. Instead, speak with your psychiatrist about changing treatment. Non-SSRI antidepressants such as Wellbutrin, for example, may be a good option for you (and your sex life).

4. You take hormonal birth control.

SSRIs are not the only medication that can lower libido. Oral contraceptives that have estrogen and progestin can affect libido, Shepherd says. The birth control pill decreases testosterone in the body, a hormone connected to sex drive; less testosterone can mean a lower libido. Some women report increased sex drive when on birth control, which may be for psychological reasons: It can be a huge turn-on when pregnancy becomes less of a concern. If you suspect that your birth control is killing your sex drive, though, speak to your OB/GYN about other contraception options. From low-hormone pills to IUDs, there are too many contraceptive methods out there not to look for the best one for you.

5. You have young kids in the house.

Pretty much any parent can speak to the libido-killing effect of having young children around at all times. Richmond says this comes down to lifestyle changes: Once you become a parent, you’re likely going to have less time for sex and be more focused on your kids. “When you have kids in the house especially under the age of five, you’re just going to have sex differently for a little while,” Richmond says. If you’re a happy parent but worried about the changes in your sex drive, Richmond says not to stress. Your libido should bounce back when you get a little more time, relaxation, and sleep — which can lead to a sex life even better than before you became a parent.

6. You’re suffering from a vaginal condition.

Sometimes libido is affected by lifestyle. Other times, however, there’s a medical reason yours is low. Vaginismus, for example, is a painful condition that causes vaginal spasms that make penetration difficult. “Sex becomes painful, so, therefore, vaginismus affects you mentally, and your libido is affected,” Shepherd says. Scientists remain unsure of the casuses of the condition, but it has been linked to past sexual trauma. One thing is certain: if you have a vagina, it’s understandably very difficult to become excited about penetrative sex if it’s painful and the thought of anything near your genitals causes you to cringe. While still mysterious in terms of causes, vaginismus is treatable through vaginal dilators, relaxation techniques, and therapy.

Another painful condition for vagina owners is vulvodynia, which is characterized by pain on the vulva, says Shepherd. The diagnosis is made after more obvious causes, such as a yeast infection or an STI like herpes, are ruled out. Another condition of mysterious origin (perhaps we should invest more money into women’s sexual health research?), vulvodynia is usually treated on an individual basis: Treatment can include everything from tricyclic antidepressants  to acupuncture.

7. You just ovulated.

A lower libido may be temporary and simply due to changes in your period. People who menstruate often feel horniest around ovulation, which occurs in the middle of the cycle. Libido may drop directly after ovulation thanks to higher levels of the hormone progesterone, which some studies have shown correlates negatively with libido. Keeping a journal that tracks changes in your cycle can help you predict libido dips and not stress when they occur.

8. You’ve started menopause.

With the start of menopause comes the end of periods, which many people welcome, but the accompanying hormonal changes can cause a dip in libido, Shepherd says. Thankfully, modern medicine has lots of responses to nature. Talk to your doctor about the treatment options available to menopausal people looking to regain their sex drives.

9. Your relationship isn’t putting you in the mood.

Our intimate relationships are often where we notice changes in our sex drives. Sometimes, they’re also the reason for these changes. Richmond says that in newer relationships, we may stress over what our partners think of our bodies, which can affect libido and ability to orgasm. In long-term relationships, meanwhile, lulls in sex drive aren’t uncommon. There’s a lot of research stressing cisgender men’s desire for sexual diversity, but all of us stand to benefit from varied sexual experiences. 

If you’re in a monogamous relationship, this doesn’t (necessarily) mean it’s time to start sleeping with other people. Instead, maybe it’s time to explore a new fantasy with your partner or introduce a new accessory into your relationship. Frequency of sex and levels of desire ebb and flow in all relationships, and “dry spells” are normal. (However, if you’re worried that your lack of sexual interest stems from any form of abuse by your partner, please reach out to talk to someone straight awaySafe, confidential resources are available to you.) 

And remember: As long as the sex you’re having is safe and consensual, you get to define for yourself what a satisfying sex life looks like. One person’s definition of a “high sex drive” may not be someone else’s, and the “right” frequency of sex is the one that you — and your partner — choose.

By Sophie Saint Thomas

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