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Sometimes it happens…you’re just not in the mood for any kind of sex. There are so many factors that go into this, from dynamics with a partner to your physical and mental health. If you’re in the midst of what some people would call a “dry spell” and feeling less of a connection either to your partner or your own sexuality, your low libido might be associated with a bothersome medical condition called Hypoactive Sexual Desire Disorder or HSDD.
Or you may have wondered if you were on the spectrum of asexuality if you’re not feeling any sexual attraction to others at the moment or never have. Either way, there is nothing wrong with you. Both being asexual and having low libido may warrant a conversation with a mental health professional to express what you’re feeling and make sure you have enough support.
Mental and sexual health experts explain more about both asexuality and low libido.
What does it mean to be asexual?
Asexuality is a sexual orientation and refers to anyone who doesn’t identify with having any sexual attraction toward people of any gender identity. It’s not a choice to abstain from sexual acts, like celibacy, according to the LGBT Center at UNC Chapel Hill, nor is it a mental or sexual disorder, per the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). AASECT data estimates that about 1 to 1.7 percent of people identify as asexual.
Being asexual doesn’t mean there’s something wrong with your health. “A common misunderstanding about asexuality is that it’s distressing for the person who is asexual,” says Stevie Stanford, PhD, a licensed psychologist and sex therapist at Driftwood Recovery in Driftwood, Texas. “Some people just do not have an interest in being sexual, and it does not detract from their lives whatsoever.” This is not to say that they have never been or never will spontaneously decide to be sexually active, Dr. Stanford says. People who identify as “Ace” represent the ‘A’ in the LGBTQIA+ and are celebrated as part of the queer community.
The difference between asexuality and low libido
Asexuality is not a medical condition or an identity that someone “chooses,” according to the Trevor Project. It is also not the same as choosing abstinence or celibacy for religious reasons, or a fear of intimacy or inability to find a partner — in fact, asexual people might be in a relationship or have a family. It’s different from low libido, which is typically a sign of a medical condition or changes in your psychosocial environment.
If you’re experiencing an ongoing and frustrating lack of sexual desire, you’re not alone. 1 in 10 women experience HSDD (Hypoactive Sexual Desire Disorder). It’s the most common medical condition to cause sex-related distress for women — affecting self-esteem and putting a strain on relationships — but many women don’t discuss it with their doctors, and it often goes undiagnosed. HSDD can involve reduced interest in sexual activity, with or without a partner, fewer fantasies and sexual thoughts, and reduced arousal or sense of pleasure during sex with a partner.
“It might feel like your sex life is “not what it used to be,” and this is likely distressing to be considered low libido,” says Anna Cabeca, DO, an OB/GYN who specializes in hormones, menopause, vaginal, and sexual health.
Low libido can also be caused by certain medical conditions. It might be a recent surgery, vaginal dryness or pain with sex due to low estrogen levels in perimenopause or menopause, or low desire or arousal due to anxiety, depression, or certain medications, like antidepressants, Dr. Cabeca explains. “Some people with low libido can get great pleasure and orgasm once they ‘get into the mood,’ but they just have a hard time with the spontaneous desire part,” adds Dr. Stanford.
“Low libido might also signify a physiological change, like an imbalance of hormones (common during and after menopause),” says Dr. Cabeca. “Changes in libido could also result from an experience of sexual trauma, and this is totally normal. Sometimes, low libido arises from a spiritual or religious belief that can impact your decisions or from a disconnect or issues and strain in a relationship with a partner. And low libido, unlike asexuality, can be related to your environment: For example, you might get turned off by entering the bedroom and seeing your partner’s dirty socks,” Dr. Cabeca adds.
How to know if you might be asexual
Asexuality is on a spectrum, so you could experience sexual attraction once you’re romantically or emotionally involved with someone (known as demisexual), or you may choose to be romantic and not sexual with a person or multiple people, says Dr. Stanford. It doesn’t mean that the person is unhappy with their life or even in that relationship.
Here’s how to tell if this identity might fit for you: “A good way to determine if you are asexual is to ascertain if you have ever had a sexual attraction to another person. Those who identify as asexual have little or no sexual desire or attraction to others,” Dr. Stanford says. “For those with a low libido, there is attraction; it is clear who you are attracted to, but there is not a spontaneous arousal to want to have sex.”
One thing that might feel unclear for you is averseness to sex if you’ve experienced trauma. This is where a sex therapist or psychologist can come in to support you. “Working through the trauma and then re-evaluating the level of desire can help to determine if it’s asexuality orientation or if it’s a trauma that is affecting your ability to enjoy sex,” according to Dr. Stanford.
Ways to treat low libido
- Talk therapy or sex therapy. A psychologist or a specialist who is certified in sex therapy can be a great resource to have an unfiltered conversation about your feelings around low libido (or asexuality, for that matter, if that’s how you identify), and can guide you in working through how it affects your relationships.
- Hormone replacement therapy. With a patient with low libido or diagnosed female sexual arousal disorder, Dr. Cabeca tries to look at things holistically to ensure that hormones that influence libido, such as estrogen, progesterone, and testosterone, are healthy and working correctly. Sometimes, OB/GYNs prescribe an estrogen-based medication or suggest a topical hormonal replacement therapy cream to give you a boost of the hormones you may need to up your libido.
- Medication. There are also medication options for low libido associated with HSDD, including Vyleesi, an FDA-approved, as-needed, on-demand injection for HSDD in women who have not gone through menopause. It should be taken at least 45 minutes before you decide to initiate any sexual activity, and there are no alcohol restrictions.
- Lifestyle practices like initiating self-intimacy. A regular intimacy practice (yes, self-intimacy absolutely counts!) is getting into your body. Dr. Stanford recommends doing anything that involves movement and the body — it could be a Zumba class, a pole dance class, or even yoga or breathwork, which also helps you tune into your body. Pair that with some self-care: Do something for yourself, like getting your nails done or massaging lotion or body oil into your skin after a shower. “Take a little extra time to feel your skin as you are putting the lotion on and enjoy your own touch,” Stanford says. “When we pour into ourselves, we love ourselves more.”
Vyleesi is an FDA-approved prescription option. Visit Vyleesi.com for important safety information.
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Mara Santilli is a journalist reporting on health and wellness and how social and political systems influence the well-being of certain groups, including but not limited to Black and brown communities, women, and the LGBTQ+ community. Her editorial work has appeared in publications such as Shape, Marie Claire, Cosmopolitan, Women’s Health, InStyle, Glamour, and more. Outside of reading and writing, she enjoys traveling (especially to Italy), singing, dancing, musical theatre, and playing guitar and piano.
