What Are the Symptoms and Lab Tests Needed for Low Libido in Men and Women? A Complete Guide

Low libido—also known as reduced sexual desire—is one of the most common sexual health concerns affecting both men and women. Although often misunderstood as purely psychological, low libido is usually the result of multiple factors, including hormonal imbalance, metabolic issues, stress, emotional well-being, and underlying medical conditions.

This comprehensive 1500-word guide explores the causes, symptoms, and essential laboratory tests recommended for men and women experiencing low libido, along with practical insights for diagnosis and treatment.

Understanding Low Libido: What It Really Means

Low libido refers to a persistent decrease in sexual interest, desire, or motivation that creates distress or affects a person’s relationship or quality of life. Libido naturally varies from one individual to another; however, a significant shift from a person’s normal baseline is usually a sign that something physiological or emotional needs evaluation.

Low libido is not about sexual performance but rather the desire to engage in sexual activity. This distinction is important because many individuals with low libido still have normal physical sexual function but lack the interest or mental drive.

Symptoms of Low Libido in Men and Women

Although the core issue—reduced sexual desire—is shared across genders, men and women often present different secondary symptoms. Identifying these symptoms helps clinicians understand the potential underlying cause.

Common Symptoms in Both Genders

These symptoms often indicate hormonal imbalance, stress, or metabolic dysfunction:

• Reduced desire for intimacy

• Less frequent initiation of sexual activity

• Decreased sexual fantasies

• Difficulty feeling aroused

  Emotional disconnection during sexual interactions

• Low energy or persistent fatigue

• Reduced pleasure and sensitivity

• Decline in overall mood or emotional well-being

• Increased irritability or stress

Many individuals also report a decline in confidence or self-esteem related to their sexual performance or body image.

Symptoms of Low Libido in Men

In men, low libido is often connected to testosterone deficiency, metabolic disorders, or psychological stress. Common male-specific symptoms include:

• Weak or less frequent morning erections

• Erectile dysfunction

• Reduced ejaculatory force

• Loss of muscle mass or strength

• Increase in abdominal fat

• Low motivation or poor focus

• Decline in physical performance

• Irritability, anxiety, or depression

Men may also experience relationship strain due to perceived performance issues.

Symptoms of Low Libido in Women

Women experience a more complex interplay of hormones—estrogen, progesterone, testosterone—making libido changes more dynamic. Symptoms commonly seen in women include:

• Vaginal dryness or reduced lubrication

• Pain during intercourse (dyspareunia)

• Difficulty achieving orgasm

• Low sexual responsiveness

• Hot flashes or night sweats (perimenopause/menopause)

• Irregular menstrual cycles

• PMS-related mood swings

• Anxiety or emotional sensitivity

These symptoms may intensify during menopause, after childbirth, or during periods of high stress.

Common Causes of Low Libido

Low libido rarely has just one cause. Instead, it often results from a combination of physiological, psychological, and lifestyle factors.

1. Hormonal Imbalances

Hormones play a central role in regulating sexual desire. Disruptions in any of the following can lead to decreased libido:

• Low testosterone in men and women

• High SHBG, which reduces free (active) testosterone

• Low estrogen (particularly during menopause)

• Low progesterone (fatigue, anxiety, insomnia)

• High prolactin, which suppresses sexual desire

• Thyroid disorders (hypothyroidism and hyperthyroidism)

• Elevated cortisol from chronic stress

Hormonal imbalances are among the most common reversible causes.

2. Medical Conditions

Certain chronic health issues directly influence libido:

• Diabetes

• Obesity

• Metabolic syndrome

• High blood pressure

• Cardiovascular disease

• Chronic kidney disease

• Sleep apnea

• PCOS (in women)

• Endometriosis

These conditions can affect circulation, nerve signaling, hormone production, or overall vitality.

3. Psychological and Emotional Factors

Mental health plays a major role in sexual desire. Low libido may be associated with:

• Stress and burnout

• Anxiety or depression

• Relationship conflicts

• Low self-esteem

• Past trauma

• Poor body image

• Work-related fatigue

In many cases, emotional and physical factors overlap.

4. Lifestyle Influences

Lifestyle choices have a significant impact on hormonal health and libido:

• Poor sleep

• Alcohol overuse

• Smoking

• Sedentary lifestyle

• Nutrient deficiencies

• Poor diet

• Excessive caffeine

• Overtraining or under-recovery

Correcting these often significantly improves libido without medication.

Recommended Lab Tests for Low Libido in Men and Women

Accurate diagnosis requires proper laboratory evaluation. Below is the complete list of recommended labs for both men and women, along with explanations of what each test reveals.

These labs help clinicians identify whether low libido is caused by hormonal imbalance, metabolic dysfunction, nutrient deficiency, or underlying medical disease.

Lab Tests for Men With Low Libido

1. Total Testosterone

Measures the total amount of testosterone in the bloodstream.

Low levels lead to:– reduced libido– erectile dysfunction– low energy– decreased muscle mass

2. Free Testosterone (Direct or Calculated)

Represents the biologically active testosterone.

Even if total testosterone is normal, low free testosterone can cause symptoms.

3. SHBG (Sex Hormone Binding Globulin)

High SHBG binds testosterone, reducing the free amount.

Common causes: aging, hyperthyroidism, liver disease.

4. LH and FSH

These pituitary hormones determine whether low testosterone is due to:

• Primary testicular failure

• Secondary hormonal suppression (stress, obesity, pituitary dysfunction)

5. Estradiol (E2)

Men require balanced estrogen levels for libido and erectile function.

Too high → low libido, breast tenderness, fat gainToo low → erectile issues, low nitric oxide

6. Prolactin

High prolactin suppresses testosterone and sexual function.

7. Thyroid Panel (TSH, Free T3, Free T4)

Hypothyroidism is a silent cause of low libido.

8. Cortisol (Morning Level)

Chronically elevated cortisol decreases testosterone production.

9. Metabolic Labs

• Fasting glucose

• Insulin

• HbA1c

• Lipid panel

Poor metabolic health impairs sexual performance and circulation.

Lab Tests for Women With Low Libido

1. Total and Free Testosterone

Women need small amounts of testosterone for optimal libido, energy, and vaginal lubrication.

Low levels lead to:

• low desire

• reduced orgasm intensity

• fatigue

• decreased motivation

2. SHBG

High SHBG reduces available testosterone.

Often elevated by birth control pills and thyroid disorders.

3. Estradiol (E2)

Estrogen affects vaginal moisture, sexual responsiveness, mood, and arousal.

Low estrogen → dryness, painful intercourse, low desireHigh estrogen → PMS, mood instability, libido changes

4. Progesterone

Important for emotional well-being, sleep, and hormonal balance.

Low progesterone → anxiety, restlessness, sleeplessness, low libido

5. LH and FSH

Helps diagnose:

• Menopause

• Perimenopause

• PCOS

• Ovarian dysfunction

6. Prolactin

Elevated levels significantly suppress libido.

7. Thyroid Function

Hypothyroidism is a leading cause of low libido in women.

8. Cortisol

Chronic stress disrupts female hormone cycles and reduces desire.

9. Nutrient Status

• Vitamin D

• Vitamin B12

• Ferritin

Deficiencies cause fatigue, mood changes, and hormonal imbalance.

When Should You Seek Medical Evaluation?

You should consult a doctor if low libido is accompanied by:

• Persistent symptoms lasting more than 3 months

• Pain during intercourse (women)

• Erectile dysfunction (men)

• Severe fatigue or mood swings

• Menstrual irregularities

• Hot flashes or night sweats

• Difficulty sleeping

• Relationship distress

A proper hormonal and metabolic evaluation can reveal treatable causes.

Treatment Strategies for Low Libido

Treatment is customized depending on lab results, medical history, and lifestyle factors. However, most patients improve with a combination of medical and lifestyle interventions.

1. Hormonal Optimization

For Men

• Testosterone Replacement Therapy (if clinically indicated)

• HCG or clomiphene citrate to stimulate natural testosterone

• Hormone-balancing supplements (zinc, vitamin D, magnesium)

For Women

• Estrogen therapy (perimenopause/menopause)

• Progesterone supplementation

• Low-dose testosterone therapy

• Hormone-cycle balancing

2. Lifestyle Modification

Lifestyle changes significantly improve sexual desire:

• Strength training

• Regular cardiovascular exercise

• Increasing protein intake

• Reducing sugar and processed foods

• Prioritizing sleep (7–9 hours)

• Reducing alcohol and nicotine

• Stress management techniques (breathing, meditation)

3. Nutritional Support

Key supplements for libido:

• Zinc

• Omega-3

• Vitamin D3

• Magnesium

• Ashwagandha

• Maca root

• L-arginine

These support hormone production, blood flow, and stress reduction.

4. IV Therapy (Clinic-Based Support)

Clinics such as Reset Room Bali may offer:

• Libido-boosting amino acids

• Energy IV drips

• Vitamin B complex

• B12 injections

• Antioxidant IVs

• Hydration therapy

These improve cellular energy, reduce fatigue, and support hormone regulation.

5. Psychological Support

Counseling or therapy may help if libido is affected by:

• Anxiety

• Depression

• Relationship issues

• Past trauma

Conclusion: Low Libido Is Treatable With the Right Evaluation

Low libido is a multidimensional issue involving hormones, metabolism, mental health, and lifestyle. The good news is that it is highly treatable once the root cause is identified.

A proper evaluation—including testosterone, estrogen, SHBG, thyroid hormones, prolactin, cortisol, and key metabolic markers—provides the foundation for a personalized treatment plan.

With targeted hormonal optimization, lifestyle adjustments, nutritional support, and stress management, most men and women can restore their sexual desire, emotional vitality, and overall quality of life.

Men's Bloodwork

Women's Bloodwork