The One Fertility Issue No One Talks About: Low Libido

When supporting women on their fertility journey, we go through blood tests, hormone panels, stress levels, gut health, nutrient status — all the usual suspects. But there’s one topic that is often not mentioned; Low libido.

Very few people talk about low libido, so I do. Because low libido is not just a psychological issue — it’s a physiological signal. And when you’re trying to conceive, addressing it is not only valid but essential.

Let’s break the silence and uncover the real, addressable reasons behind low libido — so you can feel empowered, connected, and confident in your body.

Why Women Experience Low Libido

Low libido in women is more common than many realize. It affects millions — particularly during times of hormonal transition and chronic stress. Here are the key physiological causes that I often see in clinical practice:

Stress & cortisol overload

Chronic stress elevates cortisol levels, which can disrupt your body’s natural production of sex hormones like estrogen, progesterone, and testosterone. Cortisol competes with these hormones, creating a hormonal environment that suppresses desire. High cortisol can also disrupt ovulation and menstruation — both critical for fertility.

Support: Focus on stress-reduction techniques like breathwork, gentle movement, and adaptogenic herbs (like ashwagandha or rhodiola), as guided by a professional.

Low iron levels

Low iron — especially when ferritin (your iron storage marker) is depleted — can lead to fatigue, low mood, and low libido. If your body doesn’t have the resources to oxygenate tissue efficiently, your energy (and desire) can decrease.

Testing: Measure a full iron panel: ferritin, serum iron, transferrin saturation, and hsCRP (for credibility).

Support: Iron-rich foods like red meat, lentils and spinach can help — as can targeted supplementation.

Sex hormone imbalance

Yes, testosterone plays a major role in libido — even for women. Low levels can result in reduced desire, low energy and overall disinterest in intimacy. But libido can also be affected by estrogen dominance, low progesterone, or poor estrogen metabolism.

Testing Tip: Consider a comprehensive hormone panel (for example the DUTCH test)  that includes estradiol, progesterone, testosterone and DHEA.

Insulin Resistance & PCOS

High insulin levels and conditions like PCOS (Polycystic Ovary Syndrome) can not only affect ovulation and fertility but also reduce sex drive. Symptoms like weight gain, acne, and facial hair can impact self-confidence, making intimacy feel more emotionally complex.

Check: Fasting insulin, glucose, and HbA1c. A comprehensice approach can support insulin sensitivity through targeted nutrition and lifestyle changes.

Vitamin D Deficiency

Vitamin D plays a key role in hormone regulation, mood balance, and immune health — all of which impact libido.

Testing Tip: Get your 25(OH)D levels checked and supplement as needed, depending on your needs and under supervision.

Thyroid Dysfunction

Your thyroid sets the pace for every system in your body — including your libido. Hypothyroidism can cause fatigue, low mood, weight gain, and reduced desire.

Support: Ask for a full thyroid panel, not just TSH: Free T3, Free T4, reverse T3, and in some cases thyroid antibodies.

Gut Health

Your gut is deeply connected to your brain and hormone health. Imbalances like dysbiosis or leaky gut can impair nutrient absorption, neurotransmitter production, and hormone detox — all of which can quietly suppress libido.

Support: Nourish your gut with probiotic-rich foods, fiber, and anti-inflammatory meals. Consider comprehensive stool testing, like the GI-MAP, to assess your microbiome and see if a personalized protocol could help rebalance your system.

Poor Sleep Quality

Restorative sleep is when your body repairs and regulates hormones. Even minor disruptions in your sleep cycle can decrease libido and delay ovulation.

Tip: Aim for 7–9 hours of high-quality, uninterrupted sleep and get to bed before 10pm consistently. Prioritize sleep hygiene and manage nighttime blood sugar swings with balanced meals.

A Quick Note for Men: Over-Aromatization

While this article focuses on women, I also work with many couples — and it’s important to mention that low libido in men can have hormonal roots too. One common (but often missed) cause is something called over-aromatization — when the body converts too much testosterone into estrogen through an enzyme called aromatase.

This hormonal shift can lead to symptoms like low sex drive, fatigue, increased belly fat, and mood changes. It’s more common in men with insulin resistance, chronic stress, or excess body fat — and it can subtly interfere with fertility and overall vitality.

Support: Certain foods and herbs can help regulate aromatase activity naturally. These include:

• Turmeric
• Green and black tea
• Grapes (especially the skin, rich in resveratrol)
• Licorice root (used with guidance, as it can affect blood pressure)

Low libido isn’t just about desire — it’s about health, balance, and connection to your body. If you’re on a fertility journey and struggling with low libido, you are not alone, and there are real, supportive steps you can take to heal.

By understanding the why, you give yourself the gift of compassion — and the clarity to take empowered, evidence-based action.

Libido is a sign of health — let’s listen to it.

Warmly,