Introduction

Sex drive, otherwise known as libido, is the natural desire to engage in sexual activity. It is common in people assigned male and those assigned female at birth. The brain (hypothalamus) is responsible for regulating the sex drive. The hormones oestrogen, progesterone, and testosterone influence sexual desire, arousal and satisfaction. Low levels of these hormones are closely associated with low libido.  

Sex is a vital part of your physical and emotional health. It differs among individuals, and even the same person may feel their desire fluctuating depending on circumstances. 

Various factors that can cause a decrease in sex drive include high stress levels, health problems like cancer, high alcohol consumption, infection, advanced age, and even medications. 

Some medications are quietly killing your sex drive without you knowing. This article aims to highlight some of them and what you can do if your libido decreases because of them. 

How medications affect sex drive

Medications, whether prescribed or not, are typically taken to help relieve or treat symptoms of health issues. But they can also affect your sex drive even without you realising that. Ways medications can affect your sex drive include:

• Imbalance in hormone levels: Essential hormones that influence sex drive are oestrogen, progesterone and testosterone, and some medications can lower hormone levels, affecting sex drive¹
• Brain chemical imbalance: Some medications, especially those used in the treatment of depression, affect brain chemicals, such as dopamine and serotonin; a decrease in dopamine and an increase in serotonin may lower sex drive 
• Blood flow changes: some medications, such as those used in the treatment of high blood pressure, lower your blood pressure and reduce the flow of blood to your sexual organs, therefore, affecting your sex drive
• Mood alterations: Some medications, such as those used in the treatment of mental health issues, can alter your mood and your interest in sex
• Reduced nerve function: your nervous system can be depressed by some medications, and this can reduce the nerve function of sensation, reducing your response and drive for sex

Common medications that may be quietly killing your sex drive

Your interest and desire for sex can be affected by some medications. It is important to report to your doctor if your medications begin to interfere with your sex life. Here is a list of medications that may lower your libido and how they work in your body:

Medications for the treatment of depression

This class of medication is called antidepressants. Main groups are:

• Tricyclic antidepressants (TCAs)
• Selective serotonin reuptake inhibitors (SSRIs) 
• Serotonin norepinephrine reuptake inhibitors (SNRIs) 
• Monoamine oxidase inhibitors (MAOIs) 
• Atypical antidepressants

Examples include fluoxetine, sertraline, amitriptyline, duloxetine, and phenelzine

These medications are primarily used to treat mental health issues such as depression. 

Antidepressants work by changing the balance of chemicals in the brain. They increase levels of serotonin and norepinephrine.²

Normal sex patterns include stages such as interest or attraction, excitement, climax and relaxation. These stages are regulated by hormones, chemical messengers and proteins. Antidepressants affect all the stages, thereby decreasing sex drive. 

Blood pressure medications

This class of medication is called antihypertensives. About five main classes exist: beta-blockers, diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, and calcium channel blockers.³ Most implicated in disrupting sex drive are:

• Beta-blockers
• Diuretics 

Examples include metoprolol and spironolactone.

These antihypertensives disrupt sexual drive by blocking your body's neurological system.⁴ This neurological system is essential in the coordination of nerve signals, sex hormones and behaviour. 

Birth control medications

Most people of childbearing age take birth control pills to prevent unplanned or unwanted pregnancies. Various methods and medications are available for this purpose. If you are currently on any hormonal birth control medication, you need to understand that it can diminish your sex drive. They include:

• Progestin-only birth control
• Combination birth control

These medications can lower hormone levels important in sex. 

Medications for the treatment of anxiety and anxiety disorders

These are called anti-anxiety medications. Examples include benzodiazepines and buspirone. 

These medications generally reduce the excitability of nerves, produce a calming effect and promote sedation. These effects are referred to as an increased GABA_A receptor function and can affect erection and libido in people assigned male at birth.⁵

Antipsychotic medications

This class of medication, also known as neuroleptics,⁶ are used in the treatment of mental health problems, such as schizophrenia and bipolar disorder. The aim is to reduce or eliminate symptoms, such as hallucinations and delusions. Examples include risperidone and olanzapine. They work by blocking dopamine, the feel-good hormone. Dopamine suppression caused by antipsychotics can decrease sex drive.⁷ 

Opioid painkillers

Medications in this group, such as morphine and oxycodone, are used in the treatment of pain. They provide effective relief for moderate or severe pain by binding to pain receptors in your brain and other body parts. They have been associated with serious side effects such as addiction, confusion, and nausea. 

Opioids also reduce hormone levels important for sex, such as testosterone.⁸ This causes low sex drive. 

Chemotherapy and cancer medications

These medications are aimed at destroying cancer cells.⁹ Examples include antiandrogens (bicalutamide, flutamide, nilutamide) and busulfan. Healthcare providers consider some factors before treating cancer. These are your current state of health, the extent of cancer and the type. 

Your provider may recommend treatment with only one drug or a combination of drugs. Chemotherapy can also be given alongside treatment with hormones, treatment with radiation or surgery. It is a serious form of treatment and is known to affect sex and fertility. Speak with your healthcare provider before you start cancer treatment if you intend to have children. 

What you can do

Most side effects of medications concerning your sex drive are temporary. This means they can subside over time or after you finish your treatment. But this does not mean it is unimportant. Low sex drive can cause low self-esteem and confidence. Here is what you should do if you are taking any of the above medications. 

• Consult your healthcare provider: do not stop taking your medications without advice from a professional because this can cause serious side effects and may worsen your health problems
• Explore other options: discuss with your healthcare provider about adjusting or changing your medication dosage, or switch to a different medication, or see if a non-pharmacological treatment is available
• Lifestyle adjustments: you may be required to change some of your habits, exercise, diet, therapy or stress reduction, to improve your sex life
• Sex therapy or counselling: this is especially important if psychological factors are involved; a therapist or counsellor can guide you through this process. Do not feel shy to open up, as hiding information can affect your recovery

FAQs about sex drive

How common is a low sex drive? 

Low sex drive is a regular occurrence. One out of every five people assigned male at birth experiences it. Anyone can be affected by a low sex drive, including people assigned female at birth. 

How do I identify a low sex drive? 

You can identify a low sex drive when:

• You no longer have an interest in any sexual activity
• You do not think about sex and the thought rarely comes to your mind
• The thoughts of your sex life trouble you or make you anxious 

Are there other causes of low sex drive? 

Yes. Other things that may be killing your sex drive include:

• Heart problems
• Diabetes
• Depression
• Hurtful and/or traumatic memories of sex
• Smoking and alcohol consumption
• Maternity period
• Infections

How can I improve my low sex drive? 

You can improve your sex drive by doing any of these:

• Find out more about what sex is and understand how your sex drive can be affected
• Have a conversation with your romantic partner
• Make lifestyle adjustments, where necessary
• Treat underlying health problems

Summary

The role of medications in your life is to either cure, prevent or relieve symptoms of health problems. Taking them sometimes comes with unwanted side effects such as diminishing sex drive. A decline in your sex drive should, however, not make you refuse to continue your treatment. Always talk to your healthcare provider if you have any sexual concerns associated with your treatment. Remember, your sex life is an essential aspect of life.