Low Libido in Women
Not in the mood for sex most of the time? A low sex drive is very common, rarely talked about, and only a problem if it bothers you. Desire is shaped by your body, mind, relationship and sleep, so the fixes usually start there, not with a pill.
What’s normal: desire rises and falls through life, with age, stress, health, hormones and relationships. There’s no right amount: the right level is whatever suits you. For some women, desire shows up once things get going rather than out of the blue. That counts too.
When it’s a problem: only when it bothers you. Doctors call ongoing low desire that causes distress hypoactive sexual desire disorder (HSDD), also described as female sexual interest/arousal disorder. In a study of over 10,000 Australian women, low desire with distress affected about 1 in 8 women aged 18–24 and about 1 in 3 aged 40–64.
Common causes: tiredness, stress, relationship conflict, depression and anxiety, some medicines (including antidepressants and blood pressure tablets), hormonal contraception for some women, menopause and vaginal dryness, pain with sex, pregnancy and breastfeeding, an underactive thyroid, low iron, long-term illness and heavy drinking. Often it’s several at once.
The libido ladder
Desire is a whole-person thing, so the fixes are too. Treat pain, dryness, mood and medicines first; therapy has good evidence; hormones and medicines give modest gains for some.
- Step 1 · Self-careSleep, stress and talkingLook at what’s draining you: sleep, workload, stress or conflict. Talk with your partner about what helps you feel close. Some couples plan time for intimacy, with no pressure for it to go anywhere.
- Works
- Not tested as a package, but experts suggest it as the starting point; desire can follow once things begin, as long as sex is never painful or distressing
- Cost
- Free
- How long
- Weeks
- Watch for
- Planning intimacy only helps when you want it. Sex should never feel pressured.
Spontaneous desire gets the press. Responsive desire is just as real.
- Step 2 · PharmacyLubricants and vaginal moisturisersFor dryness or discomfort, which can happen around menopause, while breastfeeding or with some medicines. A water-based lubricant is a good default.
- Works
- Helps dryness quickly; treating dryness is one of the recommended fixes for low desire
- Cost
- About $10–20
- How long
- Use as needed
- Watch for
- If sex still hurts, see your GP. Pain needs its own check.
If it hurts, it isn’t a desire problem, it’s a pain problem.
- Step 3 · GPHealth and medicine checkYour GP asks about mood, sleep, pain, periods and menopause symptoms, reviews your medicines and contraception, and may check thyroid and iron levels.
- Works
- Treating the cause should help. On the pill: in a large review, about 85 in 100 users reported the same or higher desire and about 15 in 100 reported lower desire
- Cost
- Medicare rebates for the visit; blood tests usually Medicare-covered
- How long
- A few months after any change
- Watch for
- Don’t stop antidepressants or contraception suddenly. Plan any switch with your GP.
Sometimes the culprit lives in the bathroom cabinet.
- Step 4 · Allied healthSex therapy, CBT or mindfulnessTalking therapy with a psychologist or sex therapist, alone or as a couple. Covers stress, body image, relationship patterns and what helps desire build.
- Works
- Good evidence for low desire: psychological therapies gave a moderate improvement in symptoms in trials
- Cost
- About $150–250 a session; Medicare rebates with a GP mental health treatment plan
- How long
- Several sessions
- Watch for
- Look for a therapist trained in sexual health.
The brain is the main sex organ, and it usually has 37 tabs open.
- Step 5 · PrescriptionVaginal oestrogenA low-dose cream, pessary or ring for dryness and painful sex after menopause. If hot flushes and poor sleep are part of the picture, ask about menopausal hormone therapy too.
- Works
- Very effective for vaginal dryness, with little hormone absorbed into the body
- Cost
- Under the $25 PBS co-payment for many products
- How long
- Long term, as long as symptoms need it
- Watch for
- Ask your specialist first if you’ve had breast cancer.
Fixing the plumbing often fixes the mood for it.
- Step 6 · PrescriptionTestosterone (after menopause)A small daily dose of cream on the skin for postmenopausal women with distressing low desire, once other causes have been looked at. The aim is levels in the normal female range.
- Works
- Modest: about 1 extra satisfying sexual event a month compared with placebo, with gains in desire, arousal and pleasure. Stop if there’s no benefit by 6 months
- Cost
- In Australia there is a TGA-registered testosterone cream made for women. It’s not PBS-listed (the PBS advisory committee declined it in 2025), so it’s a private script
- How long
- Up to 6 months to judge; blood tests before starting, at 3–6 weeks, then every 6 months
- Watch for
- Acne and extra hair growth in some. Safety data only go to about 2 years, and trials excluded women with breast cancer or heart disease.
One extra good night a month. Modest is the honest word.
- Step 7 · OverseasFlibanserin or bremelanotideFlibanserin is a daily bedtime tablet; bremelanotide is an injection used at least 45 minutes before sex. Both act on the brain, not on hormones.
- Works
- Small. Flibanserin: about 0.6–1 extra satisfying sexual event a month over placebo. Bremelanotide: a small improvement in desire scores. Stop either after 8 weeks if there’s no benefit
- Cost
- Approved in the US. We found no Australian (TGA) approval for either
- How long
- Daily (flibanserin) or as needed (bremelanotide)
- Watch for
- Flibanserin: dizziness and sleepiness in about 1 in 10, and fainting risk with alcohol. Bremelanotide: nausea in about 4 in 10, flushing and a brief rise in blood pressure.
Headline-friendly, results-modest.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Herbal “libido boosters”Not shown to raise desire directly; at best they support general health. Be wary of online claims of natural cures.
- DHEA tabletsAny benefit for sexual function was small, trials were almost all in women after menopause, and acne was more common. Not recommended for low desire, and there’s no good evidence for younger women.
- Testosterone before menopause, or for energy, mood or brain fogThere isn’t enough evidence to recommend it before menopause, and it hasn’t been shown to help wellbeing, mood, fatigue, thinking or bones.
- Compounded testosterone, pellets, injections and male productsNot recommended: doses are hard to control and levels can end up far above the normal female range.
- A blood test to “diagnose” low libidoTestosterone levels can’t diagnose low desire. They’re only used to keep treatment in a safe range.
- Libido medicines or peptides bought onlineUnapproved products haven’t been checked for safety, quality or whether they work.
What you can do
- Ask yourself whether low desire bothers you. If it suits you, it isn’t a problem.
- Notice what dampens desire for you: tiredness, stress, pain or conflict. Start with the easiest fix.
- Talk with your partner outside the bedroom about what helps you feel close.
- Use a water-based lubricant if sex feels dry, and stop if it hurts.
- Write a list of your medicines and contraception to bring to your GP.
- If you feel low most days, read our depression fact sheet.
See your GP if
- Low desire is bothering you or straining your relationship
- Sex is painful, or you have dryness, bleeding after sex or unusual discharge
- It started after a new medicine or contraception
- You also feel low, anxious or unusually tired
- Desire hasn’t returned after having a baby
- Hot flushes, night sweats or changing periods suggest perimenopause
Your level is allowed to be your level. Low desire is only a problem if it bothers you. Sex should never hurt or feel pressured. If it does, raise it with your GP or a counsellor, whatever your desire.
Common questions
Is it normal to have a low sex drive?
Yes. Desire varies a lot between women and across life, and there is no right amount. It is only a problem if it bothers you. In a large Australian study, about 1 in 3 women aged 40 to 64 had low desire that caused them distress.
Can the contraceptive pill lower my libido?
It can for some women. In a large review of pill users, about 85 in 100 reported the same or higher desire and about 15 in 100 reported lower desire. If you think your contraception is affecting you, ask your GP about switching.
Does testosterone work for women with low libido?
For postmenopausal women with distressing low desire, it gives a modest benefit: about one extra satisfying sexual event a month compared with placebo. It should be stopped if there is no benefit by 6 months. There is not enough evidence to recommend it before menopause.
Is there a pill for low libido in women?
Flibanserin, a daily tablet, and bremelanotide, an injection, are approved in the US. Their effects are small and side effects such as dizziness or nausea are common. We found no Australian approval for either.
Helpful resources
- Jean Hailes: Expert tips to boost your libidoPractical advice from women’s health experts. Free, Australia.
- NHS: Low sex driveCauses, when to see a GP and treatment options. Free, UK.
- Menopause fact sheetHormone therapy, vaginal oestrogen and other options. Free, from us.
Evidence and more information
- NHS: Low sex drive (loss of libido)
- Jean Hailes: Expert tips to boost your libido
- Global Consensus Position Statement on the Use of Testosterone Therapy for Women (2019)
- Australasian Menopause Society: Testosterone use in women
- Zheng et al. 2020: Low sexual desire with distress across the adult life span (Australia)
- Frühauf et al. 2013: Psychological interventions for sexual dysfunction (meta-analysis)
- Käypä hoito evidence summary: Combined oral contraceptives and libido
- Cochrane 2015: DHEA for women in the peri- or postmenopausal phase
- PBAC November 2025: Testosterone 1% cream public summary document
- US FDA: Flibanserin prescribing information
- US FDA: Bremelanotide prescribing information
- Sexual Medicine Society of North America: Breastfeeding and sexuality
- TGA: Unapproved peptide products
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