Why your current medications might be destroying your drive

If you're on a combined oral contraceptive or an SSRI antidepressant and experiencing low libido, the medication may be the cause, not a separate condition. That's the first thing to investigate before looking for a treatment.

Low libido in women: what's actually going on

Low sexual desire in women (hypoactive sexual desire disorder, HSDD) is more common than most people discuss. It has multiple causes, hormonal, psychological, relational, and medication-related, and treatment depends on identifying the underlying driver.

This is not a condition to self-medicate. The right starting point is a clinical evaluation.

Medications that commonly cause low libido. Check these first

Before looking for treatments, check whether a current medication is the cause:

• Combined oral contraceptives (COCs): can reduce testosterone levels and libido in some women; switching formulation or method may help. A 2019 study in the *Journal of Sexual Medicine* found COC users had significantly lower free testosterone than non-users.
• Antidepressants (SSRIs): sexual side effects including reduced desire are among the most common reasons women discontinue antidepressants; affects approximately 30–40% of SSRI users
• Antihypertensives: beta-blockers in particular are associated with reduced libido
• Antihistamines: can cause dryness and reduced arousal

If you suspect a current medication is the cause, discuss switching or adjusting with your doctor before stopping anything.

Hormonal causes and treatment options

Perimenopause and menopause: Declining oestrogen and testosterone are the most common hormonal drivers of low libido in women over 40. Hormone replacement therapy (HRT), including low-dose testosterone in some cases, may be considered by a gynaecologist.

Thyroid dysfunction: Both hypothyroidism and hyperthyroidism can affect libido. A thyroid function test is a reasonable first step if libido decline is accompanied by fatigue, weight changes, or mood shifts.

Hormonal contraceptive adjustment: If you're on COCs and experiencing low libido, a gynaecologist may suggest switching to a progestin-only pill, IUD, or non-hormonal method.

What's available in Nigeria

Prescription options for low libido in women are limited in Nigeria compared to Western markets. Flibanserin (Addyi), approved in the US for premenopausal HSDD, is not widely available. HRT formulations are available through specialist gynaecology practices.

The most practical first step is a gynaecology consultation to identify the cause, followed by targeted treatment.

Managing ongoing prescriptions

If you're prescribed hormonal therapy or other long-term treatment for this condition, a care plan ensures consistent supply without monthly reordering friction. Famasi offers home delivery for women's health medications across Nigeria.

Low libido in women is underdiagnosed and undertreated. Partly because it's underdiscussed. The clinical conversation is worth having.

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