Low Libido / Low Desire
Low libido is a persistent drop in sexual desire, in men or women, with many possible causes ranging from hormones to medication to life circumstances, most of them addressable.
Symptoms
- Little or no interest in sex where interest used to exist
- Absence of sexual thoughts or fantasies
- Distress or relationship strain related to the change
- Sometimes paired with fatigue, low mood or other symptoms that point to a cause
Causes
Desire sits at the crossroads of biology and life, so the list of causes is long: low testosterone in men, hormonal shifts of perimenopause and after childbirth in women, thyroid problems, depression and, ironically, some antidepressants, certain contraceptives, painful sex, chronic illness, poor sleep, stress, and relationship dynamics. Usually more than one factor is in play.
How PVT tests for it
A PVT consult takes the story first, because the pattern narrows the cause quickly: when desire changed, whether anything else changed with it, and whether desire is low everywhere or only in one context. Hormone checks through Lancet, a medication review and mood screening follow where they add information.
Treatment
Treatment follows the cause. That can mean treating a hormone deficiency, adjusting a libido-suppressing medication, treating pain or dryness that has made sex unappealing, hormone treatment in perimenopause, low-dose testosterone for selected women within guidelines, and psychosexual or couples support where the driver is relational. A tailored plan usually combines more than one of these.
When to see a doctor
Come in when the change has lasted months and bothers you or your relationship. Low desire is one of the most common issues in sexual medicine for both sexes, and a structured assessment almost always finds something workable.
Medically reviewed by Dr D. Moodley [DOCTOR_NAME_PLACEHOLDER], HPCSA [HPCSA_NUMBER_PLACEHOLDER]. Last reviewed 1 July 2026.
Questions about Low Libido / Low Desire
Desire naturally rises and falls with stress, sleep, health and relationship season. What deserves assessment is a persistent change that bothers you. Roughly one in three women and one in five men report low desire at some point, so you are in wide company.
Possibly. SSRIs and some other antidepressants, certain blood pressure medicines and some hormonal contraceptives are all recognised libido suppressors. Never stop a medication on your own; your doctor can usually adjust the dose, switch agents or add a counter-strategy.
Not by itself. Biology is often the driver, and fixing a hormonal or medication cause frequently restores things. Where the relationship is part of the picture, naming that honestly is useful too, and a psychosexual referral can help both partners rather than assigning blame.
In selected cases, yes. International guidelines support a trial of low-dose testosterone for postmenopausal women with distressing low desire after other causes are addressed. It is prescribed carefully, at female-appropriate doses, with monitoring.
Book a private consult
Most patients are seen within the week at Milnerton or Table View. You can book by WhatsApp without saying why you are coming in.
R650 private doctor consult, paid upfront by cash or card. It covers the assessment, test selection, explanation of your first results, and a script where clinically appropriate. Lab tests are billed separately by the blood lab (Lancet). Medical aid is optional: you claim back yourself if you have it.