Medications That Reduce Libido

Birth control, antidepressants, and more can impact sex drive. Here's why and how to manage.

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Libido, which is another word for sex drive, can vary from person to person. Several factors, such as lifestyle, health conditions, and psychological influences can impact someone's sexual desire.¹ Medications can also affect someone's libido, including by decreasing it.

When someone's libido decreases, they might have fewer sexual thoughts and fantasies as well as less of an interest in sexual activity.2,3 Medications can have this effect on libido. Here is what can be done to help.

Medications That Decrease Libido

A variety of medications can have decreased libido as a side effect.

Birth control

Birth control is typically used to reduce the chances of getting pregnant. It can also be used to ease heavier-than-usual periods, cramping, or premenstrual syndrome symptoms that interfere with daily life.

Some hormonal birth control methods, such as the pill, might have the side effect of decreased libido. The exact reasoning behind this is not yet completely understood. One main belief is that taking hormonal contraceptives decreases sex hormones like androgens, namely testosterone, and that this, in turn, reduces sex drive.4

But the relationship between sexual function and hormonal contraception still needs more research.5 The conclusions of the research that has been done vary on how often birth control affects people's libido and even in what way libido is affected. Some people have reported no change in their libido after starting their birth control methods while others actually report experiencing an increase in sexual desire.4

For those whose libido is negatively affected, stopping the current birth control and switching to an alternate method may be recommended.6

Antidepressants

While antidepressants can significantly help with improving depression or anxiety, they can also interfere with sex drive. A common side effect of antidepressants is a lack of desire to have sex.7

Sexual dysfunction is especially common with the the antidepressants known as selective serotonin reuptake inhibitors (SSRIs). These medications help with depression by increasing levels of serotonin, a chemical that regulates mood, in the brain. That increase in serotonin may affect hormones and neurotransmitters, such as testosterone and dopamine. Because testosterone can affect sexual arousal and dopamine has a part in achieving orgasm, SSRIs may lead to reduced sexual desire. Of the SSRIs, paroxetine in particular has been found to have the greatest potential of causing sexual dysfunction.8

A lower dose of antidepressants may be recommended if decreased libido is negatively affecting someone's life. Alternatively, some doctors might suggest switching antidepressants.8

Blood pressure medication

High blood pressure, or hypertension, is often managed with medication. While these medications help keep blood pressure at safe levels, they may come with the unwanted side effect of decreased sex drive.

Beta-blockers are a common type of medication used to treat high blood pressure, but they can cause sexual dysfunction, which includes a lack of desire for sex. It's believed that the hypertensive drug might affect libido because it hampers the release of testosterone.9

Metoprolol in particular has been found to negatively impact libido in women. Researchers are studying whether Bystolic (nebivolol), a newer beta-blocker, has less of an effect on sexual dysfunction, with results suggesting it might.9

Diuretics, which are sometimes referred to as water pills and can help treat hypertension, can also decrease libido. Research results on the effects that other hypertensive drugs—including angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists (ARBs)—have on sexual dysfunction have been mixed.9

Researchers suggest choosing a medicine for hypertension with the lowest possible potential for sexual side effects to help maintain a balance between managing heart health and sexual wellness.10

Antiepileptic drugs

Antiepileptic drugs are essential to preventing seizures. However, these drugs can affect reproductive hormones and lower libido in both men and women.

A change in the concentration of sex steroid hormones in women can cause decreased sexual interest and pleasure in sexual activity.11 Men taking antiepileptic drugs may experience lower testosterone levels, reducing sexual desire.12

A health care provider can help with finding an antiepileptic drug that is effective at preventing seizures but that has less of a sexual dysfunction effect.

Cancer treatment

As people undergo cancer treatment, they may feel a lessened desire for sex. The type of treatment, as well as its dose and duration, can play a role in how your libido is affected.13

Chemotherapy may lower men's testosterone levels and, in turn, libido during the treatment period.13 Chemotherapy can also lower estrogen levels and cause primary ovarian insufficiency in women, which is when ovaries stop working as they should before age 40. One of the symptoms of this insufficiency is decreased sex drive.14

Hormone therapy may also lead to a decrease in sexual desire. For men, it's because of a decrease in testosterone levels.13 For women, it's because the hormones that have a part in sexual desire are being blocked.15

Medications used to treat pain associated with cancer treatment, as well as medicines that affect the nerves and blood vessels, may also affect sex drive.13

Cancer treatment side effects might also impact libido. For example, the fatigue, nausea, pain, and anxiety associated with chemotherapy can make sex less desirable. A person's appearance can also change during cancer treatment, which might create hesitancy surrounding sex for the one going through those changes.16

Diabetes drugs

With its lowering effect on testosterone, diabetes itself can lead to lower libido.17 But a couple of small studies show that the diabetes medication metformin can cause a decrease in sexual desire as well.

A 2021 study of 80 participants found that, among men with type 2 diabetes, taking metformin for three months reduced testosterone levels.18 Another small study—with just 64 participants—found that metformin led to a significant reduction in testosterone levels and sex drive.19

But again, these studies are small, so more large studies would be needed to show what the true connection is between metformin and libido, if there is any.

When to Visit a Health Care Provider

If low libido is significantly affecting your life, happiness, or current relationship, you may want to consider visiting a health care provider. Sexual health is an important part of physical, mental, emotional, and social wellness. While low libido can be frustrating, it can often be managed.

A health care provider can work with you on reducing or changing the dose of a medication that's suspected of lowering your sex drive. They might recommend additional medications or products specifically designed for managing low libido. If the decreased libido is a psychological cause, like chemotherapy having changed your appearance, counseling might help.3

What if You Want to Decrease Your Libido?

Not all concerns about sex drive revolve around maintaining or increasing libido. Some people might want help in managing their libido, especially if compulsive sexual behavior disorder is a concern. Recognized by the World Health Organization's International Classification of Diseases, compulsive sexual behavior disorder is marked by the inability, over an extended period of time, to control strong sexual urges that lead to sexual behavior. The lack of control leads to distress and can impair someone's personal and social life.20

Medication might be helpful in treating compulsive sexual behavior disorder, but research on that is limited. Treatment with SSRIs has shown benefits in a handful of case studies and one small randomized trial, yet more research is needed to fully understand if and how SSRIs might be useful in managing sexual compulsions.21

Besides any possible medications, cognitive behavioral therapy can be used to understand and manage compulsions.21

Summary

If low libido is negatively impacting your life, consider making an appointment with a health care provider to discuss your current medications. Birth control, antidepressants, and cancer treatment, among other medications, may play a factor in decreased libido. Your health care provider can help determine whether your change in sexual desire is due to your medication. If it is your medication, your provider can discuss your options, which might include a change in medication.

If you're looking for ways to lower libido, talk to your health care provider about medication and mental health therapy options that may help.

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