Condition

Low Libido

Reviewed by Dr Abhishek Kumar on

Low libido means a persistently reduced interest in sex that the man himself finds unwelcome, distinct from a quiet week after a stressful stretch or a late night at work. It differs from erectile dysfunction, which is a difficulty with the physical response rather than the wish for sex, though the two often travel together. A single dull month is not a diagnosis; the pattern over time matters more than any one occasion.

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Desire naturally shifts with age, sleep, workload and the state of a relationship, so an occasional dip is ordinary rather than a disorder. In a large British population survey, 41.6% of men who had had sex in the past year reported at least one problem with sexual response, yet only 9.9% described real distress about their sex life, and 23.4% of men in a relationship said their level of interest in sex differed from their partner's[1]. Because reduced desire can also be an early sign of low testosterone, depression, thyroid disease, heavy drinking, or a side effect of a medicine such as an antidepressant, a first consultation asks about mood, sleep, alcohol, current prescriptions and the relationship before assuming the cause is only physical.

Some symptoms need prompt care: when to seek emergency or specialist care.

How each system of medicine approaches Low Libido

SystemApproachTypical review period
Modern medicineThe first appointment maps the pattern — how long it has lasted, whether it is situational or constant, and what else has changed — before anything is prescribed, because desire has physical, hormonal and psychological threads that need separating.Hormone tests and a medicine review are usually completed within the first two visits, and any treatment started is reviewed at 8-12 weeks against how the man rates his own desire, not against a number on a report. Evidence varies by cause

Testosterone treatment can improve sexual function in some men with confirmed testosterone deficiency, while low libido can also have medication, psychological, relationship, sleep, and other medical causes that require individual assessment.

AyurvedaVajikarana treats desire as tied to general vitality — sleep, digestion, stress and stamina — and a formulation is chosen for the individual rather than for 'low libido' as a single label.A course is typically followed for 6-8 weeks before the response is reviewed, since herbal regimens act gradually rather than on the first dose. Limited direct evidence

A placebo-controlled trial of an ashwagandha extract studied stress-related outcomes rather than low libido itself. No comparable trial establishes an effect of Ayurvedic treatment on low libido.

HomeopathyA remedy is chosen from the whole picture — when the change in desire began, sleep, mood, appetite and general constitution — rather than from the label 'low libido' alone.Response is assessed over several weeks, with the prescription revised at follow-up rather than several remedies combined. Insufficient evidence

A systematic review of individualised homeopathy found low-reliability evidence across several conditions, but did not establish effectiveness for low libido specifically.

Modern medicine for Low Libido

When a low testosterone level is confirmed on blood tests, testosterone treatment may be offered; when a medicine, a thyroid problem or a mood disorder is driving the pattern, treating that comes first, sometimes alongside couple-focused counselling.

  • Evidence for testosterone: in a year-long trial of 470 men aged 65 and over with low libido and a confirmed low testosterone level, testosterone treatment significantly improved 10 of 12 measures of sexual activity and desire compared with placebo[2].
  • Not always a testosterone problem: Low desire can occur even when testosterone levels are normal, so a normal blood test does not necessarily end the assessment; other possible contributors are considered.
  • Medicine review matters: Some commonly used medicines can affect sexual desire, so reviewing current medicines with the prescriber can be an important part of the assessment.
  • A hormone test is not always the answer: when poor sleep, low mood, or relationship strain may be contributing, addressing those factors may be an important part of treatment.

Doctors of this system: Sexologist in India

Ayurveda for Low Libido

Adaptogenic herbs such as Withania somnifera (ashwagandha) are commonly used, usually paired with advice on sleep, diet and daily routine, on the reasoning that lowering background stress supports desire indirectly.

  • What one trial found: In a 60-day placebo-controlled trial in stressed adults, ashwagandha affected measures including morning cortisol and DHEA-S compared with placebo. Testosterone increased in men taking the extract, but the between-group difference was not statistically significant[3]. These findings do not establish an effect on sexual desire.
  • Evidence is limited for desire itself: no large randomised trial has established that an Ayurvedic formulation improves low libido as its primary outcome, so the stress-related findings above should not be presented as evidence of improved sexual desire.
  • Interaction check: current medicines, supplements, and relevant medical conditions should be reviewed before an herbal or Ayurvedic preparation is used, because individual products may have contraindications or medicine interactions.

Doctors of this system: Ayurvedic Sexologist in India

Homeopathy for Low Libido

The prescriber gives one remedy at a time, at a potency chosen for the case, and waits for the response before deciding whether to repeat it or move to another.

  • Evidence is insufficient: a meta-analysis of individualised homeopathic trials across various conditions reported small effects, but the evidence was considered low reliability[4]. It did not establish effectiveness for low libido specifically.
  • Referral is part of it: persistent low desire accompanied by other symptoms such as unexplained weight change, marked tiredness, or significant mood changes warrants medical assessment, regardless of the treatment system chosen.

Doctors of this system: Homeopathic Sexologist in India

What is known and what remains uncertain

  • Known: A dip in desire is common and not automatically a medical problem, according to a large national survey.
  • Known: Testosterone treatment improved desire and sexual activity in older men with confirmed low testosterone and low libido in a year-long trial.
  • Uncertain: Whether ashwagandha has any direct effect on desire itself remains unproven.
  • Uncertain: Why some men with reduced desire feel distressed by it while others do not is not established.

Questions to ask your doctor

  • Could a medicine I am taking be lowering my desire?
  • Should I have a testosterone blood test?
  • Could my mood or sleep be contributing to this?
  • What treatment options are available if a cause is found?
  • How long should treatment take before I notice a difference?

Doctors who consult for Low Libido

  • Dr Abhishek Kumar

    Qualification
    M.B.B.S
    System of medicine
    Modern medicine
    Registration
    Reg. No. 73512, West Bengal Medical Council

  • Dr Ravindra Sharma

    Qualification
    B.H.M.S
    System of medicine
    Homeopathy
    Registration
    Reg. No. H018423, Homoeopathic Medicine Board, Lucknow, UP

Frequently Asked Questions

Is it normal for interest in sex to come and go?

Yes. Desire moves with sleep, stress, workload and the relationship, and a quiet patch on its own is not a medical problem. In a large British survey, most men who reported a sexual-response problem were not distressed by it — only 9.9% said their sex life truly troubled them[1]. See a doctor when the change lasts months or bothers you.

Could this be a testosterone problem?

It can be, and a blood test settles the question rather than guessing. In men aged 65 and over with confirmed low testosterone and low libido, a year of testosterone treatment improved most measures of sexual activity and desire compared with placebo[2]; most men with low desire, though, turn out to have a normal level, so other causes are checked too.

Can antidepressants be the reason?

Yes, several common ones reduce desire as a side effect. Tell your doctor which medicines you take — a dose change or a switch is often tried, and a prescribed medicine should never be stopped on your own.

Do herbal supplements for libido actually work?

The trial evidence is thin. One placebo-controlled study found ashwagandha lowered stress hormones more than placebo, with a testosterone rise in men that did not reach statistical significance[3] — encouraging for general stress, not proof of an effect on desire.

How do I decide between the three systems of medicine on offer?

That is your choice, and it is discussed at the consultation. Modern medicine has the most direct trial evidence when a hormonal or medicine-related cause is found[2]; Ayurveda and homeopathy address the person more broadly and have less trial evidence behind them[3][4]. An underlying cause is checked whichever you pick.

References

  1. Mitchell KR, Mercer CH, Ploubidis GB, et al. Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet. 2013;382(9907):1817-1829. https://doi.org/10.1016/S0140-6736(13)62366-1
  2. Cunningham GR, Stephens-Shields AJ, Rosen RC, et al. Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels. J Clin Endocrinol Metab. 2016;101(8):3096-3104. https://doi.org/10.1210/jc.2016-1645
  3. Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: a randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186. https://doi.org/10.1097/MD.0000000000017186
  4. Mathie RT, Lloyd SM, Legg LA, et al. Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis. Syst Rev. 2014;3:142. https://doi.org/10.1186/2046-4053-3-142

This information is general and educational. It is not a diagnosis; please discuss your situation with the doctor during your consultation.

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