Low libido is the most common sexual complaint among women. Here is why it happens — and what genuinely helps, from hormonal approaches to relationship interventions.
Hypoactive sexual desire disorder (HSDD) is defined as persistently low sexual desire that causes personal distress. Key word: distress. If a woman has low desire but is not distressed by it, it is not a disorder. Low libido is only a problem when the woman herself feels it is a problem — or when it significantly affects her marital relationship.
Women produce testosterone (in smaller amounts than men) in the ovaries and adrenal glands. Even small amounts are critical for libido. Causes of low female testosterone: oral contraceptive pills (reduce free testosterone significantly), oophorectomy (removal of ovaries), menopause, hypopituitarism, and ageing.
Low oestrogen (during breastfeeding, perimenopause, menopause, or after some hormonal contraceptives) reduces vaginal lubrication, causes pain with intercourse (dyspareunia), and reduces genital sensitivity — all of which reduce desire.
Both hypothyroidism (low thyroid) and hyperthyroidism commonly affect libido. The thyroid regulates metabolic rate — when it's off, everything is off. A basic thyroid panel (TSH, free T4) should be part of any workup for low libido.
Despite elevated androgens, PCOS often reduces libido due to fatigue, body image concerns, and the hormonal chaos of the condition. Treating underlying PCOS typically improves libido.
For most women in relationships, addressing the relationship dynamic is more effective than any pill. Gottman's research: women who feel emotionally connected and respected show significantly higher desire. If your husband does not make you feel desired as a person — not just as a body — your biology will reflect this.
A wife who consistently has very low desire and this is affecting the marital rights of the husband should: first investigate and treat any physical or psychological cause, second communicate openly with her husband about the challenge, and third seek help from a doctor or counsellor. Islam acknowledges that this affects the husband's rights and the wife has a responsibility to address it — but this is addressed through seeking treatment, not through suffering in silence or feeling ashamed.