What Is Libido? Women's Sex Drive, What Changes It and What Helps

Libido is sexual desire: how often, and how strongly, someone wants sex. It varies a great deal. In Britain's national survey, 34.2% of women with a partner had lacked interest in sex for three months or more in the past year. Low desire is a problem only when it bothers you, and the NHS says treating the cause should help.^{1, 2} This guide covers what is normal, what changes desire, the medicine question in NHS and regulator wording, and what the trials found: 20 randomised trials of talking therapies, 15 pooled exercise trials at low certainty, and small supplement trials in women, each linked with its size and funding.^{3, 4}

Evidence at a glance

• Rests on: the NHS low sex drive page (reviewed 26 May 2026), NICE's menopause guideline (updated 15 April 2026), Britain's national survey of sexual attitudes and lifestyles (15,162 people), and pooled analyses of 36 testosterone trials (8,480 women) and 20 talking-therapy trials.
• Largest single study: the third British national survey (Natsal-3), 15,162 people aged 16 to 74, interviewed between 2010 and 2012.
• Strongest measured outcome: across 36 trials, testosterone raised desire scores in women after the menopause against placebo or a comparator (standardised mean difference 0.36), with acne and hair growth more common.
• Not tested: the long-term safety of testosterone for women; the 2019 pooled analysis says it still needs study.

Sources checked on 14 October 2026.

What does libido mean?

Libido is sexual desire: wanting sex, and how often and how strongly that wanting arrives. In everyday speech it is the same thing as sex drive. It is not arousal, the body's response once something sexual is happening, and not satisfaction, how you feel about your sex life as a whole. Women and men both report desire, and both report losing it for a while.

A healthy libido has no number. In Britain's third national survey of sexual attitudes and lifestyles (Natsal-3), 51.2% of women who had had sex in the past year reported at least one problem with sexual response, but only 10.9% were distressed about their sex life.⁵ So the useful question is not whether your desire matches a chart or a partner's, but whether it bothers you or has changed in a way you did not expect. There is no checklist for a "good" libido; it is desire that suits you.

What is a normal sex drive for a woman?

There is no normal to measure yourself against, only a range. Natsal-3 interviewed 15,162 people aged 16 to 74 between 2010 and 2012; the table shows how common low interest, sexual difficulties and distress were among women and men. Low interest was common, distress about it was not.^{2, 5}

The frequency row is a description, not a target: among women aged 16 to 44 the median was three occasions a month in 2012.⁶ Desire shifts with age, health, mood, medicines and life stage. In a survey of 2,467 women aged 20 to 70 in four European countries including the UK, low desire became more common with age while the distress it caused became less common; Do libido supplements for women work? carries that figure and the age question.⁷ A low sex drive is not a red flag about you: in Natsal-3 it went with age, poorer health and depression in both sexes.^{2, 5} The only sign of it is noticing that you want sex less than you did, or than you would like, for a stretch of time.

What is the difference between desire and arousal, and what is responsive desire?

Desire is wanting sex; arousal is the body's and mind's response once something sexual is happening. Many women, especially in long relationships, notice desire after arousal has begun rather than before it. Researchers call that responsive desire, as opposed to spontaneous desire, and the model was proposed so that a different pattern is not mistaken for a disorder.⁸

The 2000 paper that set out the model describes desire in long-term relationships as following arousal and emotional closeness, triggered by motivation and context rather than arriving from nowhere.⁸ The diagnostic manuals disagree on the same point: the psychiatric manual folds low desire and low arousal into one diagnosis, while the sexual-medicine societies and the international disease classification keep them separate.^{9, 10} In the research, context sets responsive desire in motion. In Natsal-3, women who did not feel emotionally close to their partner during sex had nearly five times the odds of lacking interest (adjusted odds ratio 4.80), and finding it hard to talk about sex doubled the odds (2.06).² Those are survey findings, not instructions. The most-asked question here, what arouses a woman most, has no single answer in the data: closeness, ease and a setting that feels right are what the surveys describe; the rest is personal.

What lowers a woman's libido?

The NHS lists relationship problems; stress, anxiety or depression; vaginal dryness; pregnancy and having a baby; lower hormone levels as you get older, particularly around the menopause; some medicines, including some for high blood pressure and antidepressants; hormonal contraception such as the pill, patch or implant; drinking too much alcohol; and long-term conditions such as heart disease, diabetes, an underactive thyroid or cancer.¹

Two of these come with numbers. In Natsal-3, women with depression had about four times the odds of low sexual function (adjusted odds ratio 4.11).⁵ The NHS lists "problems with sex, such as low sex drive" among the side effects of SSRI antidepressants and says that for some people these "may carry on after stopping"; a prescribed medicine is never stopped or changed without the prescriber.¹¹ After a hysterectomy, the NHS says many women have "an initial loss of sexual desire", which usually returns with recovery.¹² Low iron is a cause to test for, not guess at: in 129 women aged 18 to 45, every domain of sexual function scored lower in the 52 with iron-deficiency anaemia, and heavy periods are the usual reason; iron and heavy periods covers the test.¹³ Vaginal dryness has its own page. The detail on each cause, and the botanical trials, sit on low sex drive in women: causes and the trials.

What is low sexual desire disorder (HSDD)?

Doctors use the term hypoactive sexual desire disorder only when low desire has lasted at least six months and causes distress; an expert consensus review puts it at about 10% of adult women.¹⁴ It is diagnosed from a conversation about history and symptoms, not from a test, and it describes a problem that troubles you, not a verdict on you.

The British figure is close. In the second national survey, 10.7% of 6,942 women aged 16 to 44 had lacked interest in sex for six months or longer in the past year, and 27.9% of them had sought help.¹⁵ NICE's menopause guideline lists "sexual difficulties (for example, low sexual desire)" among the symptoms a clinician should discuss (recommendation 1.2.2).¹⁶ The diagnostic manuals disagree on whether low desire and low arousal are one problem or two, so the count depends on who is counting.⁹ There is no self-test (see the FAQ).

Is there a medicine for low sex drive in women?

The NHS treats the cause: relationship counselling, lubricants for dryness, HRT for the menopause, antidepressants or cognitive behavioural therapy for depression, or a change of medicine or contraception.¹ Around the menopause a specialist can prescribe testosterone, in the NHS and NICE terms below. No medicine for low desire in women appears in the UK medicines regulator's product list; two are licensed in the United States.

The NHS says testosterone "is not currently licensed to treat symptoms of menopause" but "a specialist doctor may be able to prescribe it for you", usually only if you are post-menopause, have problems with low sex drive and HRT alone has not helped; acne, unwanted hair growth and weight gain are possible side effects, "but these are not common".¹⁷ NICE's recommendation 1.5.25 [2015] says to consider testosterone supplementation "for people with low sexual desire associated with menopause if HRT alone is not effective"; by supplementation NICE means the prescribed hormone, not a food supplement, and in November 2015 this was an off-label use.¹⁶ Behind both sits a publicly funded 2019 pooled analysis of 36 randomised trials in 8,480 women: after the menopause, testosterone raised desire scores against placebo or a comparator (standardised mean difference 0.36) and added about 0.85 satisfying sexual events a month; acne and hair growth were more likely, no serious adverse events were recorded, and long-term safety still needs study.¹⁸ Libido and the menopause has the HRT and testosterone sections in full.

The "female version" question has a short answer. Two medicines are licensed in the United States for low desire in women before the menopause, flibanserin and bremelanotide; neither appears in the UK medicines regulator's product index (checked 13 October 2026).^{14, 19} The NHS describes sildenafil as "mainly used to treat erection problems" and for pulmonary arterial hypertension; it lists no use for women's desire.²⁰ The MHRA warned in February 2026 that unauthorised pills sold online "may contain no active ingredient, the wrong dose, hidden drugs or toxic ingredients".²¹

What helps, and when should you see a GP?

Start with the cause, as the NHS does.¹ Of the treatments trialled, talking therapies have the longest record: across 20 randomised trials against a waiting list, psychological treatment reduced symptom severity (effect size d 0.58), with the clearest gains for women with low desire.³ Exercise is next: 15 controlled trials in women pooled in 2026 found programmes of four weeks or more raised sexual-function scores by 5.31 points against no exercise, at low certainty by GRADE.⁴

How to increase libido in women sets out exercise, sleep, alcohol and therapy trial by trial. The supplements trialled in women are small studies of four to seventeen weeks with questionnaire outcomes: the live page sets them out by size, and saffron supplements gives the three saffron trials with their funding. Foods with the reputation are on what is an aphrodisiac. One figure helps when reading any small trial: in eight placebo-controlled medicine trials in 3,959 women, placebo improved sexual-function scores by 3.62 points and treatment by 5.35, so about two thirds of the treatment effect was matched by placebo.²² That is a fact about expectation, not a verdict on any treatment.

See a GP if you are worried about your low sex drive, if you take a medicine or use hormonal contraception and think it may be affecting your sex drive, or if your sex drive does not return to normal after pregnancy.¹ For anxiety or depression, you can refer yourself to NHS talking therapies without speaking to a GP.²³

Every guide in this series

• How to increase libido in women: what the trials found for exercise, sleep and therapy.
• What is an aphrodisiac? Foods, chocolate and the evidence.
• Libido and the menopause: HRT, testosterone and what helps.
• Saffron supplements: the trials in women.
• Do libido supplements for women work? Causes, then the botanical trials.
• Ashwagandha for women: the trials and safety.
• What is ginseng good for? Species and trials.
• Vaginal dryness at any age.
• Vaginal health after the menopause.
• Iron and heavy periods: when to test.
• The Wellgard menopause guide.

What we don't know

• No British population figures for sexual function newer than Natsal-3 (2010 to 2012) had been published in PubMed by 14 October 2026.
• The long-term safety of testosterone for women: the 2019 pooled analysis of 36 trials says it still needs study.
• Whether any one lifestyle change or therapy works better than another: the trials compare each with a waiting list or usual care, not with each other.
• Most supplement trials in women have fewer than 100 participants and run for 12 weeks or less.

Frequently asked questions

Do men and women have different sex drives?

In Natsal-3, 34.2% of women and 15.0% of men with a partner had lacked interest in sex for three months or more in the past year, and in both sexes it was more common with age, poorer health and depression.² It measures reported interest, not what anyone "should" want.

Can low libido be a sign of something serious?

Usually it has an everyday cause, but the NHS lists heart disease, diabetes, an underactive thyroid and cancer among the long-term conditions that can affect sex drive, and says to see a GP if you are worried.¹

Does the pill lower your sex drive?

The NHS low sex drive page lists hormonal contraception among the causes, while its combined-pill page says there is "no evidence" that the pill changes your sex drive.^{1, 24} A review of 36 studies in 13,673 women found 85% of users reported no change or an increase in libido and 15% a decrease, the fall concentrated in the lowest-oestrogen pills.²⁵

Is there a test for low libido?

No blood test measures desire. Doctors diagnose a desire problem from a conversation about how long it has lasted and whether it causes distress, and may test for causes such as anaemia or a thyroid problem.^{1, 14} Trial questionnaires such as the Female Sexual Function Index are research tools, not self-tests.

Sources

1. NHS. Low sex drive (loss of libido). Page last reviewed 26 May 2026. nhs.uk/symptoms/loss-of-libido
2. Graham CA et al. BMJ Open 2017. Survey, 11,508 people aged 16 to 74 with a partner in the past year (4,839 men, 6,669 women), Natsal-3; Medical Research Council, Wellcome Trust and Chief Scientist Office funding. PubMed 28903968
3. Frühauf S et al. Archives of Sexual Behavior 2013. Pooled analysis of 20 randomised trials against a waiting list. PubMed 23559141
4. Ruiz-Pérez I et al. Journal of Sexual Medicine 2026. Pooled analysis of 15 controlled trials in women; low certainty (GRADE). PubMed 42114124
5. Mitchell KR et al. Lancet 2013. Survey, 15,162 people aged 16 to 74, Natsal-3; Medical Research Council and Wellcome Trust funding. PubMed 24286787
6. Wellings K et al. BMJ 2019. Three surveys, 45,199 people (Natsal-1 to Natsal-3); Medical Research Council and Wellcome Trust funding. PubMed 31064762
7. Graziottin A. Journal of Sexual Medicine 2007. Survey, 2,467 women aged 20 to 70 in the UK, France, Germany and Italy. PubMed 17394593
8. Basson R. Journal of Sex and Marital Therapy 2000. Model paper. PubMed 10693116
9. Parish SJ et al. Sexual Medicine Reviews 2021. Review of diagnostic classifications. PubMed 32800563
10. Witherow-Párkányi M. Psychiatria Hungarica 2022. Review. PubMed 35582867
11. NHS. Side effects of SSRI antidepressants. Page last reviewed 12 June 2025. nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/side-effects
12. NHS. Hysterectomy: recovery. Page last reviewed 11 October 2022 (review overdue). nhs.uk/conditions/hysterectomy/recovery
13. Nikzad Z et al. PLoS One 2018. Observational, 129 women aged 18 to 45, 52 of them with iron-deficiency anaemia. PubMed 30521614
14. Goldstein I et al. Mayo Clinic Proceedings 2017. Expert consensus review. PubMed 27916394
15. Mitchell KR et al. Journal of Sexual Medicine 2009. Survey, 6,942 women aged 16 to 44, Natsal-2; funded by the Department of Health and the Medical Research Council. PubMed 19549088
16. NICE. NG23 Menopause: identification and management. Published 12 November 2015, last updated 15 April 2026; recommendations 1.2.2 and 1.5.25. nice.org.uk/guidance/ng23
17. NHS. Types of hormone replacement therapy (HRT). Page last reviewed 9 March 2023 (review overdue). nhs.uk/medicines/hormone-replacement-therapy-hrt/types-of-hormone-replacement-therapy-hrt
18. Islam RM et al. Lancet Diabetes and Endocrinology 2019. Pooled analysis of 36 randomised trials, 8,480 women, 12 weeks or longer; funded by the Australian National Health and Medical Research Council. PubMed 31353194
19. Dhillon S, Keam SJ. Drugs 2019. Review of a United States approval. PubMed 31429064
20. NHS. Sildenafil. Page last reviewed 29 July 2026. nhs.uk/medicines/sildenafil
21. MHRA. News release on illegal erectile dysfunction medicines. Published 13 February 2026. gov.uk/government/news
22. Weinberger JM et al. Obstetrics and Gynecology 2018. Pooled analysis of 8 placebo-controlled trials, 3,959 women. PubMed 29995725
23. NHS. NHS talking therapies for anxiety and depression. Page last reviewed 5 November 2025. nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies
24. NHS. Side effects and risks of the combined pill. Page last reviewed 15 February 2024. nhs.uk/contraception/methods-of-contraception/combined-pill/side-effects
25. Pastor Z et al. European Journal of Contraception and Reproductive Health Care 2013. Systematic review, 36 studies, 13,673 women. PubMed 23320933

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