A drop in desire is common, and it is rarely explained by one thing. It can be hard to bring up, and it is worth looking into properly.
We look at hormones, but also at sleep, mood, iron, thyroid and the medications you take.
These are the causes we consider.
Perimenopause, menopause, or low testosterone in men.
Both underactive and overactive thyroid can lower desire.
Low iron stores cause fatigue that affects libido.
Chronic short sleep lowers energy and desire.
Low mood and low desire often travel together.
Stress, conflict and life circumstances matter.
Very common. SSRI antidepressants in particular, as well as some blood pressure medications and hormonal contraceptives.
This is what we check.
In men and women, interpreted against sex-specific ranges.
The main estrogen.
Interpreted with cycle timing or menopausal status.
High levels can lower desire in both sexes.
TSH, free T4, free T3 and antibodies.
Your iron stores.
Kidney function, electrolytes and fasting glucose.
Every prescription and supplement, since side effects are a common cause.
The only indication for testosterone in women supported by international consensus is hypoactive sexual desire disorder in postmenopausal women. It is prescribed off-label.
Pellets and injections are not recommended for women because they produce supraphysiologic levels, meaning above the normal female range. Testosterone is not a general solution for women, and we will tell you if it isn't appropriate for you.
We review results and medications together. Depending on what we find, options may include adjusting a medication with your prescriber, treating a thyroid or iron problem, hormone therapy where it is indicated, or a referral for counseling.
Initial evaluation
$250
Self-pay
Follow-up visit
$150
Self-pay
We accept PPO plans from Aetna, AmeriHealth, Horizon and UnitedHealthcare, plus Medicare. HMO plans are not accepted. Lab and treatment costs depend on what is ordered.
See full pricing →Yes. Medication side effects are a very common cause of low libido, and SSRIs in particular. We review every medication you take. Please don't stop a medication on your own; we can discuss options with you and your prescriber.
Only in a narrow case. The one indication supported by international consensus is hypoactive sexual desire disorder in postmenopausal women. It is prescribed off-label, and pellets and injections are not recommended for women because they produce levels well above the normal female range.
For men, low libido can be one sign of low testosterone, but not the only cause. Our low testosterone page explains how we test and when treatment is appropriate.
Yes. Depression, stress and relationship context all affect desire, and we talk about them without judgment.
We order a focused panel: sex hormones, prolactin, thyroid, ferritin and a metabolic panel, based on your history.
Follow-up visits can often be done by telehealth. The first visit and labs are usually in person in Atlantic City.
Book online or call us. Telehealth visits are available across New Jersey — learn more.