You’re getting enough sleep, meditating to reduce stress and your hormonal levels checked out fine at the doctor. So why is your libido still missing in action? Exhaustion, stress and hormonal problems are among the most common and well-known causes of low libido, but they are far from the only culprits. Whether you or your partner are struggling in the desire department, gaining awareness of the underlying cause is important. Read on to learn about 10 less obvious causes worth considering.

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1. Performance Anxiety

Worrying that sex is more about performing well in bed than pleasure and connection can fuel anxiety, which is a major libido killer. “Sexual desire, arousal and performance have a significantly large mental component that many individuals are not aware of,” says Natalie Stanish, an associate licensed marriage and family therapist in Chicago. Concern over ejaculating prematurely, she added, is a potential setup for performance anxiety and low sex drive. The same can happen if you or your partner experiences erectile dysfunction, takes a while to reach orgasm or tries to replicate sex as portrayed in porn.

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2. Too Much Exercise

A healthy lifestyle that includes regular exercise can enhance sexual function, including your arousal capabilities. Going overboard, however, can have the opposite effect. Hardcore training puts a lot of stress on the body, which can disrupt the endocrine system, according to recent research. As a result, chronic overexercise can lower testosterone levels, leading to less interest in sex. Overexercise can also inhibit libido by lowering estrogen levels and causing exhaustion, weakness and fatigue.

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3. Certain Medications

Certain medications can bring on libido loss as a side effect. “Desiring and engaging in sexual activity requires a range of neurological structures to work properly,” said Gabriella I. Farkas, M.D., Ph.D., a psychiatrist in the greater New York City area, noting in particular the cerebral cortex, limbic system, pituitary gland, medulla oblongata, cerebellum and peripheral nervous system. “If even one of these is damaged or underperforming, libido may be substantially compromised.”

In addition to disorders like depression, anxiety and Parkinson’s disease, medications known to interfere with these functions and sex drive include SSRIs like Prozac and Zoloft, Anafranil, which treats OCD, and antipsychotics. Antihistamines, opioids and some birth-control pills can also lower libido.

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4. An Underactive Thyroid

Your thyroid gland produces hormones that regulate your metabolism, which affects not only digestion and calories burned, but also your moods, energy levels and sex drive. While an overactive thyroid gland can cause increased sex drive, an underactive thyroid — also known as hypothyroidism — can tank it.

“With hypothyroidism, the metabolism is slowed down, which means the reproductive organs are slowed down as well,” says Kent Holdorf, M.D. “The adrenal glands that produce hormones that convert into the sex hormones are also slowed down. Both men and women can see decreased testosterone and estrogen levels.”

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5. Too Much Tech

Scrolling through your smartphone before sleep can be fun, but it can also take up time that could have been spent more intimately with your partner. This kind of distraction seems to fuel less interest in sex. A study published in the Archives of Sexual Behavior in February 2017 showed that young millennials are more than twice as likely to refrain from sex in their early 20s as compared with the previous generation. Some experts believe the shift is partly due to plentiful screen time and less focus on in-person interaction. This makes sense, given that millennials also spend more time online than older adults.

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6. Family Responsibilities

Speaking of distractions, family responsibilities and a relationship that’s gone on for some time can lower sex drive. “The stronger the relationship, the more a significant other is more than just a partner,” said psychiatrist Dr. Farkas. “This is especially true for married couples with children. It can be challenging to imagine having sex with one’s best friend or the parent of one’s child.”

While eroticism and domesticity don’t need to oppose each other, it’s common. In “Mating in Captivity,” sexologist and author Esther Perel illustrates that sex often grows blasé because it thrives on novelty and surprise and safety and security equally. If you and your partner haven’t prioritized new shared experiences or individual passions to maintain a sense of mystique, sex can fall off your radar.

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7. Too Much Alcohol

A few sips of wine may help set the mood, but going overboard on alcohol of any kind can interfere with sexual desire. Alcohol can make it more difficult to achieve or maintain an erection, reduce vaginal lubrication and make orgasms more difficult to experience or less intense. A study published in the Journal of Sexual Medicine in May of 2016 linked recreational drug use, including alcohol, with lower libido in infertile couples.

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8. Trust Issues

Everyone lies on occasion, but in some cases deception or insecurities around trust go deeper than the occasional white lie, fueling significant intimacy problems. And these issues don’t have to involve infidelity. Past betrayals, lying about money and feeling hurt or rejected can all play a role.

“The amount of trust, bonding and closeness a partner feels toward the other may subconsciously affect their libido levels,” said marriage and family therapist Natalie Stanish. “Sexual encounters are significantly emotional and vulnerable in an intimate relationship, and any type of rupture of trust or closeness to your partner may unknowingly affect your or their sexual desire or interest in being physically intimate.”

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9. Sleep Apnea

More than 18 million people have sleep apnea, a sleep disorder that causes snoring and repeated, brief interruptions in breathing as you snooze. In addition to other complications, such as an increased risk for heart disease and memory problems, sleep apnea can make sex a lot less appealing. In fact, a study published in the European Respiratory Journal in 2014 showed that obstructive sleep apnea lowered sex drive in men and women. That’s likely because not only does sleep apnea, which causes poor sleep, drive down levels of testosterone, but the lack of quality sleep can leave partners less in tune with the others’ needs and moods and put a drain on the relationship.

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10. All Work and No Play

Americans work more hours than any other population the world. If a 40-hour work week sounds like a vacation and your sex life could use one, you may want to scale back.

Overwork can lead to burnout, a condition marked by stress and feelings of inadequacy that can cause insomnia, dizziness, difficulty thinking clearly and chronic fatigue. All of this can interfere with your sex life, lowering sexual desire and your sense of closeness. Even if you don’t experience burnout, working excessive hours leaves little time for intimacy with your partner.

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What Do YOU Think?

Everyone experiences decreased sex drive on occasion. If your symptoms are severe or long-lasting, see your doctor to rule out or secure treatment for any medical causes. Working with a sex and relationship therapist and maintaining open communication with your partner can also help, no matter what the cause.

What factors have lowered your sex drive? What’s helped? Let us know in the comments!

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