Rarely one cause. Usually hormones, medication, sleep and mood interacting.
Assessed by a GMC-registered GP, not a symptom checker
Honest about what needs to be seen in person
Tests and referrals arranged where they are needed
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Low libido is not a medical emergency.
Seek prompt assessment where it comes with:
Contact Samaritans on 116 123 if low libido comes alongside low mood and thoughts of self-harm.
Libido varies enormously between people and across a lifetime, and there is no correct amount. It becomes worth addressing when it has changed and that change bothers you or your relationship.
It is also almost never one thing. Hormones, sleep, mood, medication and relationship context all feed into it, and treating only the hormonal component while ignoring the rest is why a lot of treatment disappoints.
Hormonal — low testosterone in men; menopause and perimenopause in women, where falling oestrogen and testosterone both contribute; thyroid disease in either; raised prolactin, which is uncommon but important because it can indicate a pituitary tumour.
Medication — frequently the answer, and frequently missed
Physical and situational — erectile dysfunction, where anticipating difficulty reduces desire; vaginal dryness making sex uncomfortable; poor sleep; depression; stress; alcohol; and relationship factors, which are often the largest component and the least investigated.
Desire does not always come first. For a great many people — particularly women, and particularly in longer relationships — desire arrives after arousal has begun, not before it.
This is called responsive desire, and it is entirely normal. The problem is that almost everyone is taught the other model: that you should spontaneously want sex, and that if you do not, something is wrong. Waiting to feel like it before starting anything then means never starting anything, and the conclusion drawn is "I have lost my libido" when in fact the sequence has simply been misunderstood.
What helps: being open to beginning — touch, closeness, unhurried time — without any obligation for it to lead anywhere, and seeing whether desire follows. For a substantial number of people, it does, and the discovery is a considerable relief.
Do not stop an antidepressant abruptly to test this. Raise it — dose adjustment, timing, switching to a different class, or adding something are all realistic options, and being told to simply live with it is not the only answer.
If sex has become painful, desire will fall — and people frequently present with "low libido" without ever mentioning the pain. The body sensibly stops wanting something that hurts.
This is common after childbirth, around the menopause, and with skin or gynaecological conditions, and it is treatable. If this applies, say so directly — it changes the whole approach.
Thyroid function, ferritin, HbA1c, and — in men — a morning testosterone. Add prolactin, and in women a hormone panel where perimenopause is likely. These are cheap, and they occasionally find something entirely correctable.
Testosterone must be taken as a fasting morning sample, ideally before 11am, and a single low result should always be repeated before anyone treats it. Levels fluctuate substantially through the day, and a mid-afternoon sample can look falsely low.
Two things worth knowing. A mismatch in desire between partners is one of the most common relationship difficulties there is, and it is not the same as one person having a disorder. And psychosexual therapy works — it is evidence-based, practical, and not simply talking about your childhood. Look for a therapist accredited by COSRT.
This is a conversation people find difficult to start, and a twenty-minute appointment from your own home is a considerably easier setting for it than a surgery.
The consultation covers when it changed, whether desire is absent entirely or situational, sleep, mood, medication and any physical difficulty. Situational rather than global loss of desire points away from a hormonal cause, and that distinction saves a lot of unnecessary testing.
Where testing is warranted: testosterone in men — two fasting morning samples before 10am, or the result is unreliable — with SHBG, LH, FSH and prolactin; hormone testing in women where the picture suggests it; and thyroid function in either.
Treatment depends entirely on the cause. Where medication is responsible, switching often resolves it. Where it is hormonal, that is treatable. Where it is relational or psychological, we will say so and can refer for psychosexual therapy — which is frequently the more effective route.
No, and that is genuinely the answer rather than a diplomatic one. Desire varies enormously between people and across a lifetime, and there is no target frequency.
What makes low desire a problem worth addressing is distress — either your own, or a mismatch causing difficulty in a relationship. Someone with little interest in sex who is entirely content has nothing to treat. Someone whose desire has clearly dropped from their own baseline, and who minds, has something worth looking into.
It is the pattern where desire follows arousal rather than preceding it — you do not particularly want sex beforehand, but once things begin in an unpressured way, interest arrives. It is common, entirely normal, and more usual in women and in longer-established relationships.
It matters because the standard model — wait until you feel like it — fails completely for anyone who works this way, and leads them to conclude their libido has gone. Understanding this alone resolves the problem for a meaningful number of people, without any treatment at all.
Very likely, if you take an SSRI. Reduced desire, difficulty with arousal and delayed or absent orgasm affect a large proportion of people on them, and it is one of the main reasons people stop taking medication that is otherwise helping.
It is worth raising rather than tolerating or abandoning treatment. Options include adjusting the dose, switching to an antidepressant with a lower rate of sexual side effects, or adding a second medicine. Do not stop abruptly — that causes discontinuation symptoms and risks relapse.
Worth doing in men with genuinely reduced desire, particularly alongside fatigue, low mood, reduced morning erections or loss of muscle mass. But two important caveats.
First, the test must be done properly: a fasting sample before 11am, and any low result repeated on a second morning before treatment is considered, alongside LH, FSH, prolactin and SHBG to work out why.
Second, be cautious about clinics that test late in the day, treat a single borderline result, and prescribe testosterone indefinitely. Testosterone therapy is genuinely valuable in properly diagnosed deficiency; it is not a general tonic, it suppresses fertility, and it usually commits you to lifelong treatment. Low desire has many commoner causes that should be excluded first.
Frequently, and through more than one route. Falling oestrogen causes vaginal dryness and thinning, which makes sex uncomfortable, which reduces desire — and that chain is the most common and most treatable version.
Vaginal oestrogen treats the dryness directly, is very poorly absorbed into the bloodstream, and can be used long term. It is markedly under-prescribed. Systemic HRT helps the wider symptom picture, and testosterone is used off-label for persistently low desire in postmenopausal women where HRT alone has not been enough — with specialist guidance and monitoring.
Sometimes, and it deserves considering honestly rather than defensively. Desire responds to unresolved conflict, resentment, unequal domestic load, and simply never being alone together. None of that is a medical problem, and none of it improves with a blood test.
Equally, low desire is often not about the relationship at all — exhaustion, medication, pain and depression are all common causes in perfectly happy couples. Both possibilities are worth holding open.
The evidence is much less settled than the confident claims online suggest. What is reasonably clear is that heavy, escalating use can shape arousal patterns and, for some people, reduce responsiveness to a real partner — and that people who are worried about their own use often find that reducing it helps.
What is not established is the strong "porn-induced dysfunction" narrative presented as settled science by sites selling recovery programmes. If your use concerns you, cutting back is a reasonable experiment. It is rarely the whole story.
In rough order of how often it helps:
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
On this page
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
Patient reviews
