What to Do If Your Partner Has No Sexual Desire – Causes & Practical Solutions

Begin the conversation with a specific observation and a permission request: name one recent behavioral change (for example, intimate encounters per month dropped from 8 to 2), ask if you can discuss it, and set a single, small goal for the week – a 5-minute non-sexual touch at bedtime three times. Being patient during that check-in is a gift to both of you; thats a concrete move that reduces immediate defensiveness.

Collect objective data for 6 weeks: each day log a simple 0–10 rating of interest, sleep hours, alcohol units, major stressors and any medications started or changed. If the 6-week average interest score remains <=3/10 and there is no clear psychosocial trigger, arrange a medical review. Tests to request: TSH, fasting glucose or HbA1c, serum total testosterone (men), estradiol (when clinically indicated), and medication list review for SSRIs or other agents linked to low libido. Lifestyle targets that measurably enhance baseline drive: 150 minutes/week moderate exercise, 7–9 hours sleep nightly, limit alcohol to ≤14 units/week, and eliminate heavy weekend bingeing.

Address relational factors with specific practices: schedule two date-nights per month, commit to three affectionate but non-sexual contacts per day, and create a “no-problem” ritual where you both share one positive thing about the relationship weekly. Shame and low self-esteem drive avoidance; if they report feeling ashamed or uncomfortable, validate that the situation isnt rejection of you and offer to seek couples work together. A sex-focused clinician or a trained therapist can help translate small behavioral shifts into increased responsiveness.

Communication tactics that produce results: use concise “I” statements tied to behaviors (“I noticed we hugged less this month and I miss that”) and avoid global labels. People report faster improvements when they combine behavioral prescriptions (schedules, touch rituals) with targeted medical review and short-term therapy. If medication side effects are suspected, ask the prescriber about alternatives such as bupropion or dose timing changes rather than stopping abruptly.

If progress stalls after three months of consistent logs, agreed behavioral steps and medical evaluation, move towards more specialized help: an accredited psychosexual therapist or endocrinologist depending on the test results. Keep tracking so decisions are evidence-based; thats how small, steady changes build back intimacy. Don’t blame yourself – help is available and seeking it is a practical act, not a failure. They can recover interest when the right medical, behavioral and relational pieces are present and attended to.

Identify Medical and Hormonal Contributors

Arrange a focused medical evaluation within two weeks: morning fasting labs including total and free testosterone, SHBG, estradiol, FSH, LH, TSH and free T4, prolactin, HbA1c, fasting glucose, lipid panel, CBC and CMP; add a sleep study if there is loud snoring, daytime somnolence or high BMI and refer to endocrinology, gynecology or urology based on abnormal results.

Perform a medication audit with the prescribing clinician: list current antidepressants (SSRIs/SNRIs), antipsychotics, beta blockers, hormonal contraceptives and antihypertensives; never stop medications without clinician approval, but discuss timed switches, dose reductions or alternatives (bupropion, mirtazapine, or different antihypertensive classes) that evidence shows often reduce adverse effects on interest in intimacy and helps restore baseline function over 6–12 weeks.

Use natural, nonpharmacologic options alongside medical care: pelvic floor physical therapy for pain, structured exercise for 12–16 weeks to improve testosterone sensitivity and mood, and topical vaginal estrogen for genitourinary symptoms. Practice non-demand touching exercises (sensate focus) for short, daily intervals so little, mutual physical contact rebuilds positive somatic messages instead of pressure; this helps reduce performance anxiety and creates more fulfilling encounters over time.

Gather medical information and bring it into conversations with empathy: encourage spouses to talk openly about test results, symptoms and medication effects, and avoid language that makes they feel attacked. Brief, regular conversations focused on specific factors (fatigue, pain, mood, sleep) are more helpful than one long discussion. Identify what labs show, what treatments can change, and set a joint plan so everything is addressed clinically and in the shared relationship conversation.

Check for common medical conditions linked to low libido

Arrange targeted medical evaluation immediately: obtain morning labs (total testosterone twice on separate mornings, calculated free testosterone, TSH, prolactin, CBC, fasting glucose or HbA1c, lipid panel) and complete a medication review within two weeks.

First clinical thresholds to act on: total testosterone consistently <300 ngdl on two samples supports androgen deficiency in males; tsh>4.0 mIU/L suggests hypothyroidism (treat with levothyroxine and reassess energy/libido after dose optimization); prolactin >25–30 ng/mL is abnormal–values >100 ng/mL warrant pituitary MRI to exclude macroadenoma.

Medication culprits: SSRIs/SNRIs, opioids, certain antihypertensives, 5-alpha-reductase inhibitors, antipsychotics and metoclopramide. Discussing alternatives with the prescriber can reduce impact–examples: switch to bupropion when clinically appropriate, lower opioid exposure, or change beta-blocker class. Check black-box warnings and monitor closely; informed discussion with a psychiatrist or prescribing clinician is critical.

Chronic disease management improves outcomes: aim for HbA1c <7% where safe, optimize blood pressure and lipids, correct anemia (target Hgb >13 g/dL in males, >12 g/dL in females), and screen for obstructive sleep apnea (STOP‑Bang) with timely CPAP initiation. Doing this reduces fatigue, improves mood and often restores interest.

Mental health screening: use a validated tool (PHQ‑9, GAD‑7) and refer for psychotherapy if scores are elevated. If antidepressant side effects are suspected, a joint discussion with a psychiatrist about dose, timing (morning dosing, drug holidays only under guidance), or alternative agents is warranted; never stop medications abruptly.

When initial lab abnormalities havent been identified and symptoms persist through optimized medical management for 3 months, refer to endocrinology or a relevant specialist for advanced testing (morning cortisol, DHEA, pituitary imaging). If they show significant psychiatric contributors, seek a sex therapist or couples counsellor.

Practical bedside and relationship measures while medical workup proceeds: provide support without pressure, create comfortable non‑sexual intimacy (non-genital massages using slow, mindful technique and brief sensate exercises), introduce novelty gradually, and focus on positive, satisfying aspects of physical contact to reduce performance anxiety and help them feel well.

Documentation and follow-up plan: record baseline labs, medication adjustments, and target dates for reassessment (4–12 weeks after treatment changes). If no improvement then escalate care, coordinate multidisciplinary discussion, and consider referral pathways so the individual feels heard and willing to continue the process of recovery.

Recognize medication side effects that lower desire

Ask the prescribing clinician to review the full medication list and consider alternative agents, dose reduction, or timing changes immediately when libido drops; begin by recording exact start dates and symptom onset, and use a brief daily log or ASEX score to focus assessment within 2–4 weeks.

Common culprits and approximate incidence: SSRIs (reported reduced libido in roughly 30–60% of users), SNRIs (10–30%), antipsychotics with hyperprolactinemia risk (variable but notable), long‑term opioids (testosterone suppression in up to 20–50%), benzodiazepines (sedation-related interest decline), and some antihypertensives (beta‑blockers and older agents with lower single‑digit to low‑teens percent effects). Laboratory checks from baseline should include total testosterone, TSH and prolactin when endocrine effects are suspected; repeat within 4–6 weeks if values were not previously obtained.

Management options to discuss with the prescriber or pharmacist: switch to bupropion or mirtazapine where appropriate, add low‑dose buspirone for SSRI‑related problems, consider topical testosterone for postmenopausal hypoactive cases (after endocrine confirmation), and reserve PDE5 inhibitors for erectile response issues. Avoid abrupt discontinuation; short “drug holidays” for SSRIs carry relapse risk and require close medical supervision. Pointing clinicians to the documented timeline and ASEX/daily log makes benefit–risk tradeoffs clearer.

Behavioral and relationship tactics that help: schedule intimacy into the routine, plan shared activities that rebuild desire (dates, exercise, nonsexual touch), spend time on relaxation and erotica exposure to retrain arousal pathways, and keep conversations free of shame by communicating specific observations and requests. Start small goals this week (10–20 minutes of nonpressured connection) and grow frequency as comfort returns; learning new ways to enjoy physical closeness often helps medication changes work better.

When to escalate: if libido drop follows a major medication change, if lab abnormalities appear, or if mood and function worsen, request rapid reassessment. Include источник (prescriber or clinical pharmacist) in notes, document everything, and prioritize sharing medication lists when communicating with specialists; case examples (e.g., when Jordan began documenting onset and dosing, clinicians found a clear reversible cause) point to faster resolution when teams collaborate.

Spot hormonal signs and simple tests to request

Request a targeted hormonal panel now: morning total and free testosterone (men: draw 08:00–10:00), estradiol, FSH/LH (day 3 for menstruating people), anti‑Müllerian hormone (AMH), prolactin, TSH and free T4, SHBG, DHEA‑S, AM cortisol (08:00), 24‑hour urinary cortisol if Cushing suspected, fasting glucose, HbA1c, vitamin D, CBC and lipid profile.

Interpretation guidance with concrete cutoffs: total testosterone in cis men <300 ngdl is considered low; repeat on two separate mornings before diagnosing; amh <1.0 mlindicates diminished ovarian reserve risk; day‑3 fsh>10–12 IU/L suggests reduced ovarian reserve; prolactin >25 ng/mL warrants pituitary imaging when persistent; TSH reference 0.4–4.0 mIU/L (values above that often require levothyroxine); vitamin D <20 ng/mL is deficient; HbA1c ≥6.5% diagnostic for diabetes. If estradiol/FSH testing is done for cycle timing, document cycle day and use mid‑luteal progesterone to confirm ovulation.

Clinical signals that point to endocrine evaluation: unexplained fatigue, noticeable weight change, fragmented sleep, reduced genital lubrication or erectile difficulty, new or worsening anxiety and mood swings, acne or hair thinning. Even a little hormonal shift can make someone feel caught between needing change and being attacked by symptoms; testing allows targeted treatment rather than guessing.

Actionable next steps after abnormal results: sometimes consider endocrine or reproductive specialist referral; for hypothyroidism start replacement per guidelines; for hyperprolactinemia evaluate meds and pituitary imaging; testosterone replacement for confirmed male hypogonadism under monitoring; topical estrogen for significant vulvovaginal atrophy. Combine medical treatment with stress reduction (sleep hygiene, limit alcohol, weight loss, resistance exercise) because cortisol and metabolic dysfunction often amplify sexual and relationship effects.

Communication and care plan: present results together with partners or support people, avoid forcing intimacy while adjusting therapy, be patient – hormonal optimization can take weeks to months to change libido and energy. Learning basic endocrine numbers empowers shared decisions; there is no single cure, but addressing physiology often restores enough novelty and spice to help couples reconnect and work together on the psychological and relational factors that also influence desire.

How chronic pain or fatigue reduces sexual interest

Time intimate activity to coincide with peak analgesia: take short-acting analgesic 60–90 minutes before planned closeness and trial the timing on non-critical days to confirm pain reduction and side-effect profile.

Chronic pain affects about 20% of adults; studies of pain clinic populations reported 30–60% with reduced interest in intimacy. Fatigue syndromes lower available energy and increase perceived effort, so pleasure-related hormones and motivation decline even when mood scores were stable. Track morning-evening pain scores and simple energy ratings for two weeks to identify windows when people feel well enough to engage.

Medical steps: review medications with a clinician–NSAIDs, topical analgesics, and short-acting opioid strategies may help; anticonvulsants and some antidepressants can blunt libido and should be reconsidered with a professional. Screen for sleep apnea and iron deficiency; correcting those often raises energy and interest within 4–8 weeks.

Behavioral steps: use pacing and graded activity to rebuild stamina; schedule 10–20 minute sessions focused on loving touching and low-exertion stimulation rather than performance. Introduce novelty in small ways (audio erotica, scented massage oil, different positions that avoid pressure points). Pelvic-floor physiotherapy and desensitization techniques reduce hurt during intimacy and restore confidence over 6–12 sessions.

Psychological steps: brief CBT for pain reduces catastrophizing and anxiety, which otherwise amplify pain signals and shut down interest. Encourage open discussion about limits and mutual needs; avoid being caught in blame cycles or assuming things are intentional. Conversations that use neutral language and scripted lines help both people hear each other without escalating conflicts.

Practical aids: try positioning pillows to reduce strain, friction-reducing products to minimise pain, and short sensory exercises (handholding, forehead kisses) to reconnect when stamina is low. Keep a drawer with accessible products and a printed plan so decisions don’t require high energy.

Use a brief shared log so these data are objective rather than interpretive; note time, pain score, energy, and what worked. Avoid sending photos that make someone feel exposed on bad days; prefer in-person or voice conversation for sensitive topics. Jordan, a 42-year-old with chronic back pain, increased weekly intimacy from once monthly to twice weekly after adjusting meds, adding pelvic therapy, and scheduling short evening touching sessions when energy peaked.

Language matters: say “I notice I’m low on energy tonight; can we try five minutes of gentle touching?” instead of accusatory phrases. Learning to ask for what helps reduces anxiety and the tendency to withdraw. If progress stalls, consult a pain specialist or intimacy-focused therapist–combined medical and relational approaches produce the best outcomes.

Address Relationship and Psychological Factors

Schedule a weekly 30-minute check-in with a significant other to review emotional connection and small problems: allocate 10 minutes listening, 10 minutes naming one goal, 10 minutes making a concrete action plan to ensure steady progress.

Be sure to set measurable targets (examples: increase affectionate touch to three times per week; complete one intimacy exercise together every fourth day) and treat this plan as a living document, recording outcomes for 90 days to track progress towards improved closeness.

If lack of interest persists for 8–12 weeks or is paired with mood changes, seek a licensed therapist; clinical CBT for 6–12 sessions every 1–2 weeks can bring measurable change, and couples work every 2–4 weeks helps work through specific problems together. Seeking a psychiatrist to review medication and order basic labs (testosterone, thyroid, vitamin D) can still be necessary.

Support brain chemistry through 150 minutes per week of moderate aerobic exercise, two strength sessions, and a diet rich in protein and omega‑3s; prefer natural sources (fatty fish, nuts) over unregulated supplements, aim for 20–30 g of protein per meal, and use supplements only when labs indicate deficiency–these steps enhance neurotransmitter balance and overall well-being.

Practice intimacy techniques such as sensate focus or 10–20 minute non‑goal touch sessions twice weekly to ease performance pressure and improve connection; add a relaxation technique (box breathing 4‑4‑4‑4 or progressive muscle relaxation for 10 minutes) before close contact to reduce anxiety.

Address uncomfortable topics directly: use timed three-minute “I” statements, avoid blame, and list specific aspects that feel off; make incremental changes rather than everything at once so progress is measurable and emotionally safer for both people doing the work.

Use short check-ins after difficult conversations to assess mood, update the action plan, and set one micro-goal for the next 48 hours; these micro-wins build towards longer-term change and help counter persistent lack of desires.

How to ask about emotional distance without blame

Schedule a 20–30 minute, distraction-free check-in when both feel calm; a fixed time reduces caught-on-the-cusp reactions and prevents everyday distractions from derailing the conversation.

• Set environment: dim lights, neutral seating, no phones, light relaxation music if that helps the body and senses relax.
• Use a named technique: a 2-minute check-in + 10 minutes each for speaking and 3 minutes for reflection creates structure and ensures mutual understanding.
• Agree beforehand on ground rules: no interruptions, no blame, no problem-solving until both feel heard.

Verbal approach – practical lines and framing that avoid accusation:

1. Begin with a neutral observation: “Lately Ive noticed a little withdrawal in our routine; I want to understand what may be behind that.” (use youve below for balance)
2. Curiosity script: “I’m interested in hearing from you: what feels different to you about time together?”
3. Avoid black-or-white statements; instead acknowledge specifics: “I noticed fewer shared activities and more solo routines; that creates a sense of loss for me.”
4. Use youve to invite perspective: “If youve felt distracted lately, can you share what’s been filling your mind or pulling attention away?”

Listening technique and micro-skills:

• Reflect back: repeat one sentence of what they said, then ask, “Did I get that right?” This prevents misinterpretation and shows you listen.
• Label feelings before solutions: name the emotion you hear – tired, caught, uninterested – which helps move conversations out of blame and into understanding.
• Watch body language: open palms, uncrossed arms, and facing each other increase safety; note when one needs a break and offer time rather than pushing.

Practical follow-up actions to enhance connection:

• Create one small weekly activity that spices up routine–15 minutes of sensory connection (massage, slow dance, shared cooking with new spices) to enhance wanting and pleasure in the body without pressure.
• Schedule mini-checks: five minutes after dinner to say one thing that felt nice that day and one thing that caught your attention as a loss or negative so problems stay little and addressable.
• Rotate responsibilities for planning dates or relaxation activities so both spouses contribute and feel invested.

When negative emotions escalate:

• Pause rule: either person can call a 10-minute pause. Use that time for breathing, grounding, or sensory reset to avoid saying things that blacken the relationship.
• Return with a short recap of intent: “I want to understand, not accuse,” followed by one question focused on their experience.

Questions that help, not harm:

• “What usually distracts you lately?”
• “How does time together feel for you–exciting, routine, or neutral?”
• “Is there something small I can stop, start, or change to help you relax?”

Final reminders:

• Acknowledge small wins and thank them for sharing; positive reinforcement creates momentum and prevents retreat.
• If consistent distance persists, suggest a short series of guided conversations with a trained clinician to help translate conversations into improved relationships.

Source: The Gottman Institute

Steps to uncover past trauma safely

Begin with a one-week practice of daily 5-minute check-ins focused on body sensations and current feeling.

1. Set explicit consent and boundaries before any disclosure:

   • Agree on maximum time per session (10–20 minutes) and number of moments per week to spend on sensitive talk.
   • Create a safe-word or gesture for immediate pause; spouses or significant others should honor it without question.
   • Avoid leading questions; ask permission before probing and record whether the person does want follow-up.

2. Track triggers and patterns with a short journal:

   • Record date, setting, sensation in the body, exact feeling, and what underlying thought appeared.
   • Note any links to major loss, anniversaries, or recent stressors; five examples across two weeks reveal patterns more reliably than memory alone.

3. Use brief, repeatable grounding techniques when distress rises:

   • 5-4-3-2-1 sensory check (5 sights, 4 sounds, 3 touches, 2 smells, 1 taste) for immediate stabilization.
   • One-minute body scan focusing on breath and one tight area; stop if dissociation increases.

4. Structure conversations with clear goals and scripts:

   • Openers: “May I ask how a recent moment affected your body?” or “Would you like me to receive that memory or sit silently?”
   • Responses to disclosure: “I hear you,” “I believe you,” “Tell me how I can be helpful.” Avoid correcting details or minimizing.
   • Use planned check-ins every 24–48 hours after a heavy session to monitor aftereffects.

5. Create a simple safety plan and emergency list:

   • Include three trusted contacts, a professional hotline, and one grounding exercise that works for the person.
   • Decide ahead what does happen if flashbacks or suicidal thoughts emerge (who to call, which room to move to, which sensory items to use).

6. Know when to involve a therapist or other professional:

   • Refer if dissociation lasts more than a few minutes, if nightmares increase, or if daily functioning drops by 30% or more.
   • Recommend trauma-focused therapy options (trauma-focused CBT, EMDR) and offer to help schedule or accompany to the first appointment.

7. Limit exposure and pace recovery to promote growth:

   • Plan incremental exposure: two short discussions per week maximum for the first month, then reassess.
   • Encourage activities that help grow stronger connection and bond outside trauma talk: shared walks, neutral hobbies, brief laughter moments.

8. Practice specific communicating habits that support understanding:

   • Use reflective statements (“I hear that you felt…”) rather than why-questions.
   • Ask permission before physical touch; document what touch, if any, feels helpful.

9. Monitor progress with measurable check-ins:

   • Weekly 15-minute reviews: rate distress on a 0–10 scale, log changes in body responses, and note what was helpful this week.
   • Adjust frequency or refer to a specialist if ratings do not drop after four weeks of consistent practice.

If a disclosure does trigger severe symptoms or mentions self-harm, pause all private attempts to help and contact a professional immediately; do not attempt prolonged debriefing alone after major loss or acute crisis.