Reproductive · Sexual health
Low libido
Libido has a signal-to-noise problem - relationships, stress, sleep, medications all contribute. But persistent, unexplained low libido almost always has a biomarker contribution worth investigating.
Feels like
Does this sound like you?
- Absence of spontaneous desire
- Arousal requires more effort
- Genital dryness or discomfort
- Emotional intimacy fine, physical drive absent
What to measure
The biomarkers that explain this symptom.
Grouped by the panel that tests them. We usually recommend running the top two panels together - patterns only show when you can see biomarkers next to each other.
Panel
hormones
- Testosterone (Free & Total)Women have testosterone too - free T in the lower quartile correlates with reduced desire.
- EstradiolBelow 50 pg/mL commonly drives dryness and discomfort.
- SHBGHigh SHBG (often from oral contraceptives) binds free T, reducing bioavailable testosterone.
- DHEA-SPrecursor to sex hormones. Declines with age and stress.
- ProlactinElevated prolactin suppresses libido.
Patterns we see
Three common clusters.
Your specific pattern will be unique, but most people land in one of these.
01
Low free T
Free testosterone bottom quartile, often with high SHBG.
02
OCP-related
On oral contraceptives, SHBG >100, free T suppressed.
03
Perimenopausal
Estradiol and testosterone both trending down.
Ready to look?
Order the hormones panels.
Running the top two panels together is what lets us see patterns. Add a third if you want a fuller picture - most people benefit from the trio.
Further reading