If Your Libido is Low, This Sex Therapist Has a Message For You

02.13.2023 — The Frenshe Editors

In our sex-soaked culture, it can be easy to think that “everyone” wants to have sex all the time—and that if you don’t have much of a sex drive, something’s wrong with you. But plenty of people have low levels of desire, says Dr. Kate Balestrieri, PsyD, a licensed psychologist, certified sex therapist, and the founder of Modern Intimacy. Here, in a Frenshe Q&A, she sheds light on why low libido isn’t always the problem people think it is—and how couples can best communicate about their personal levels of desire, whatever they may be.

Why don’t we hear about low libido very often?

I think we don’t hear about low libido as frequently as it occurs because a lot of folks are confused about how much sex they should be wanting or having. When they feel like there’s a discrepancy between their desire and the amount of desire they think they should feel, that can often evoke a lot of shame and fear around relational security if they’re partnered. A lot of people will internalize a lower libido, or a drop in their libido, to indicate that there’s something wrong with them. 

And low libido has many causes. Sometimes they’re medical, sometimes psychological, sometimes relational. Sometimes it’s good old-fashioned stress! We don’t normalize and talk about the variables that contribute to low libido enough. I think we don’t hear about it very often because people are scared about what it means and what it will mean if [stronger libido] doesn’t come back. 

We don’t normalize and talk about the variables that contribute to low libido enough.

—Kate Balestrieri

How do you help clients identify whether low sex drive is an issue that needs to be addressed?

One of the things that I talk about with people straight away when they’re coming in for low libido is a conversation about how our libido will change over our lifespan. There will probably be many ebbs and flows—many instances where you experience more desire, and some instances across life when you’re just not that interested in sex because other things are a bigger priority. It’s really normal to have some oscillation or some waxing and waning in your libido. 

Often where it does become a quote-unquote “problem” is not in the low libido itself, but in the fact that there is a higher-desire partner who would like to be more sexual, and there’s a mismatch in libido. When that happens, the libido is not the problem; it’s the mismatch that is the problem. Couples have an opportunity to get a little bit more creative when they don’t make either of them the problem. They can look more acutely at problem-solving or troubleshooting as opposed to finding blame or letting all of the work that needs to be done to find a solution fall on one partner or the other. Often couples will get into a quiet power struggle about whose job it is to concede or compromise. Usually, the lower-desire partner ends up being blamed, shamed, or burdened with having to go to therapy to fix themselves. So there’s a lot of unnecessary shaming, blaming, and deflecting that happens in partnerships. And again, that’s not a desire or libido problem. That’s a relational issue.

How can people in partnerships talk about what’s going on in a way that fosters collaboration?

A lot depends on the couple and what kind of underlying personality traits curate their communication style. But when a higher-desire partner feels more entitled to sex, the first thing that I think needs to happen is an assessment of safety. Because when entitled partners are blaming and shaming and getting angry, there can be real safety concerns for the lower-desire partner—and not just physical safety or sexual safety, but also emotional safety and financial safety. There can be a lot of ways in which entitled higher-desire partners can begin to weaponize the conversation around sex, so it can be dicey for some folks to go into that conversation. 

For partners who are less entitled and who really do want to find a solution, I think the conversation is about refraining from judgment and really starting from a place of curiosity. Learn about what’s going on for your partner and how you can together create a more sustainable path into something that feels workable for you both. 

For a lot of partners, that can look like reexamining your share of domestic labor and looking at, “Does my partner have enough time to feel like themselves, let alone tap into their sexual energy? Or are they feeling so depleted in life because of all the tasks that they have to do? Is there something I can take off their plate so they can reconnect with their own body without an expectation for sex?” With an understanding that when we show up together, that gives partners a lot more permission to relax. For a lot of lower-libido partners, if that’s not their baseline, and it’s been a dip for them, that lower libido is usually an indication that they’re exhausted or that they don’t feel safe enough to relax into their sexual energy. 

There’s a really low level of understanding, frankly, amongst many physicians about sexual health and sexual wellness to begin with.

—Kate Balestrieri

You mentioned that low libido can have various causes. If someone is unhappy about experiencing low desire, what should that person do? What kind of professional should they see? 

When low libido is something that somebody wants to tackle, one of the first places to start is to have a hormonal workup. See a physician who understands sexual health and/or endocrine health and can look at doing a really important hormone assessment. Sometimes it looks like a hormone therapist, or it might look like a naturopathic doctor or somebody who’s a little bit more integrated in their approach to medicine. There are some physicians that are amazing, and there are some who have not been trained on these things, so they write it off as a lack of lingerie or something like that.  

I think there’s a really low level of understanding, frankly, amongst many physicians about sexual health and sexual wellness to begin with. So if you bump into a medical practitioner who’s not well-versed in this or doesn’t take your issue seriously, that’s not about you. That’s about their lack of training and lack of understanding of the holistic person that you are. So find somebody who does have that expertise.

I would also want to rule out any medical conditions. Cardiovascular issues, diabetes, cancer, some neurological conditions, and of course, hormone imbalances can all lead to pretty significant drops in libido and other sexual dysfunctions. You can start working with a sex therapist to start exploring the psychological, the emotional, and the relational components that can come with a shift in desire. And the identity components, too, because for a lot of people, they don’t realize that their desire is gone until it’s been gone for a while. Or it’s been really low for a while and then all of a sudden, they’re like, “Who am I? What do I want? What’s important to me? This feels different.” 

Some people really enjoy sex no longer being a huge focal point for them. Others really miss it, and they want it back and they crave it and they’re longing for something that feels really, really forgotten. That can bring up a lot of existential things for folks about who they are, their mortality, their vitality, the health and well-being of their relationship—and what happens if that is the problem. So a lot of folks are not motivated to address these questions that they have, because to address them might mean to take action that also feels scary. I think it’s okay to honor if you’re not ready to dive deeper into solving the problem if you’re not ready to make any of the changes that might be recommended with it. Not that I encourage people to stay stuck, but I do think there are things to consider.

You mentioned stress as a factor in libido, and our modern way of living is largely overscheduled and under-resourced—it feels like there just aren’t enough hours in the day. And statistically speaking, women, especially those in heterosexual partnerships, are doing the lion’s share of housekeeping, parenting, and so forth. How can people free up space to find room for sexual energy when we’re already stretched too thin?

When people are in partnerships and they feel like there’s a disproportionate amount of work that they’re doing in the relationship—whether it’s domestic engineering work or emotional labor—one of the first things that I think needs to happen is a redistribution of those tasks. That can be really tricky. I do think that beginning couples therapy can help you and your partner find a place of equity in the way that you run your home and your relationship. That’s a really important step for people who feel like they don’t have that time and space to take care of themselves. Because if that doesn’t happen, then they’re going to continue to be on this wheel of fatigue doing it all, and that’s not really a solution. It’s just going to create more stress if they have to substitute grocery shopping with stretching or doing some yoga for the day. I mean, there’s just only so much that we can do without having an honest conversation about what it means to be in a shared relationship with a partner. I really like Eve Rodsky’s book Fair Play for that; her Fair Play card deck is an accessible place to start for people who are defensive around this topic. 

What are you willing to let go of so that they can reprioritize little moments like being able to breathe, even if it’s just for a minute by yourself?

—Kate Balestrieri

I think a lot of partners don’t understand the invisible labor that goes into some of the things that just miraculously happen, like their laundry gets folded and put away for them. They don’t realize the buying of the laundry detergent and the planning, all the things that go around it. So having a more honest conversation is a good start. 

But whether or not that can happen, I think it’s important for people to think about what they are willing to let go of in terms of perfection in their lives. What are you willing to let go of so that they can reprioritize little moments like being able to breathe, even if it’s just for a minute by yourself? Can you breathe and set your timer on your phone and just be present with your breath and your body and reignite and awareness in your body? Most people have a minute throughout the day. Or an arousal serum could be an interesting way to invite sensation into your body, even if you don’t want to engage in solo sex. Just having a little extra cooling or tingling sensation can sometimes give people a bit of a reminder that their body does include a vulva, and that vulva does include pleasure sensors and receptors. Those are small things, that don’t require a ton of mental load, that can be both restorative and energizing erotically.

If there’s a high-desire person reading this story, and their partner has low desire, what’s the best way to be a good, supportive partner?  

The number-one thing is to not put pressure or guilt or shame on your lower-desire partner. Honor that they’re not doing this to you. I work with a lot of folks who struggle with that sexual entitlement piece, so often there’s this distortion that their partner is “withholding” sex from them. That’s just not a thing, because nobody’s entitled to sex with another person. 

So I think it’s really important for the higher-desire partner to have empathy for yourself, but also to consider how you can support your partner in other ways. Maybe they have a lower desire, or maybe their desire is more responsive and yours is more spontaneous, so it looks like lower desire, but it actually isn’t—they just need to be seduced or warmed up in a different way. Respond with curiosity. Working with a sex therapist can really help couples brainstorm and understand a little bit more about what sex means to each partner, because the higher-desire partner might want sex, but they might actually want cuddling or snuggling or some other kind of connection that they get access to through sex. Maybe there is an opportunity for them to be a bit more self-examining and curious about whether there are other needs that the sex is meeting for them. Can they try to get those needs met with their partner in other ways? 

Just because somebody has higher desire does not mean that the other partner is low desire.

—Kate Balestrieri

Any final thoughts? What else should we be thinking about with regard to levels of desire?

One thing that comes up a lot when I’m having this conversation with folks in heterosexual relationships is an assumption that women have lower libido than men. That’s really not true. But it does sometimes take different kinds of turn-ons and a different kind of invitation for women’s arousal to come out. The male partner may label the female partner as having low libido or low desire, but they’re comparing their partner’s desire to their own. So women’s desire is often labeled “low desire” because it’s in contrast to their male partner’s higher desire. But just because somebody has higher desire does not mean that the other partner is low desire. Neither partner’s libido level is a baseline that the other partner should conform to. We really have tremendous diversity in our libido and it’s unfair to partners when one of their libido is considered the standard. 

The Frenshe Editors