What’s actually happening in your gut when you get indigestion?

Indigestion is often described medically as functional dyspepsia — meaning there’s no single visible cause, but the way your stomach empties and moves food becomes disrupted. This can show up as postprandial distress (discomfort after eating), epigastric pain in the upper stomach area, bloating, early satiety (feeling full too quickly), or belching. Some people also regurgitate small amounts of food or acid, or notice their stomach distend and delay emptying — in rarer cases this can be caused by gastroparesis, a more lasting motility problem — while food that isn’t broken down properly can ferment in the gut.

How is indigestion linked to acid reflux and GORD?

Indigestion and heartburn are closely linked to acid reflux, and reflux-related symptoms can sometimes point to GORD (gastro-oesophageal reflux disease). This acid-induced irritation can range from acute, one-off episodes to more chronic or recurrent patterns. Some people have non-erosive reflux disease, where the lining looks normal despite symptoms, while others develop erosive or ulcerating changes — peptic damage that a clinician can identify. When symptoms don’t respond to standard treatment, this is known as refractory indigestion and may need further investigation.

What if indigestion doesn’t improve, or keeps coming back?

If tests show a Helicobacter pylori infection, your clinician may prescribe antibiotics to eradicate H. pylori, since this can otherwise exacerbate symptoms long-term. Sometimes no clear cause is found even after doctors diagnose and investigate further — this is described as idiopathic or functional indigestion. In these cases, treatment tends to be symptom-related, focusing on managing what you’re experiencing rather than a single underlying cause.

Low Libido: Causes, Symptoms & How to Treat It

A low sex drive is very common and rarely a sign of something serious. It is often caused by a combination of physical, emotional, and lifestyle factors, such as stress, relationship problems, hormonal changes, or certain medications. While it can be distressing, low libido is highly treatable. A GP can help you identify the underlying cause and recommend the most effective steps to improve your sexual desire.

Experiencing a dip in your sex drive is entirely natural. Libido fluctuates throughout your life, influenced by a complex mix of physical health, emotional wellbeing, and lifestyle factors. It is very common to worry when you notice a change in your desire for sex, but a reduced sex drive is rarely a sign of a serious underlying condition. For many people, it is a temporary response to stress or tiredness. When a low libido persists and causes distress, there are practical, evidence-based ways to address it. Our online GPs regularly speak to people about these concerns, offering a confidential space to understand the causes and find effective support.

What is low libido?

Low libido, or a low sex drive, is a persistent lack of interest in sexual activity that causes personal distress. There is no single baseline for a healthy libido, as sexual desire varies hugely. A medical issue arises only when an unwelcome change from your typical desire affects your wellbeing.

Clinical definition

A clinical definition focuses on the distress a low sex drive causes you. If you have always had a lower interest in sex and it does not bother you, it is not a medical problem. It becomes a concern when you feel frustrated, anxious, or unhappy about your lack of desire.

Temporary lulls vs long-term problems

It is helpful to distinguish between a temporary drop in desire and a persistent problem. A short-term lull is often an understandable reaction to tiredness, a stressful week at work, or a minor illness. These fluctuations usually resolve on their own once you feel rested.

However, if your lack of interest persists over several months and causes you significant distress, it may be diagnosed clinically as hypoactive sexual desire disorder. According to NHS inform, a persistent, recurring or distressing loss of libido can indicate an underlying medical, psychological or lifestyle problem and should be discussed with a GP.

Common causes of low libido

The NHS guidance explains that low libido can have psychological, relationship, medication-related, hormonal, lifestyle, or health-related causes.

Psychological and emotional factors

Psychological factors are some of the most common reasons for a reduced sex drive. Stress, anxiety, and depression can all significantly lower your desire for sex. When you are highly stressed, your body produces more cortisol. Cortisol is a stress hormone that can suppress your natural sex hormones. Low self-esteem, poor body image, or past negative sexual experiences can also make it difficult to feel interested in physical intimacy.

Relationship issues

Relationship issues play a central role in sexual desire. Unresolved conflict, poor communication, or a lack of emotional intimacy can directly impact your sex drive. If you feel disconnected from your partner, it is very common for your physical desire to wane.

Physical health conditions and medications

Physical health conditions can drain your energy and affect your hormones. NHS local services note that underlying health problems such as diabetes and an underactive thyroid can reduce your sex drive. Other conditions like heart disease, chronic pain, and general fatigue also make sexual activity less appealing.

Certain medications are well known to affect libido. Some antidepressants, particularly selective serotonin reuptake inhibitors, and medicines used to treat high blood pressure can cause a noticeable drop in sexual desire.

Lifestyle impacts

Your daily habits have a strong influence on your sexual health. As highlighted by NHS local urology services, libido problems can be associated with obesity, smoking, alcohol, and recreational drug use. Drinking too much alcohol can numb your nerve endings and reduce physical sensation, while smoking can restrict blood flow. Being significantly overweight or underweight can also alter your hormone levels. Finally, a lack of regular exercise and poor sleep quality can leave you too exhausted to think about sex.

Libido changes in women

Women often experience changes in libido due to significant hormonal shifts and milestones throughout their lives.

Menopause and perimenopause

The transition through the menopause and perimenopause is a primary cause of reduced sexual desire. During this time, levels of oestrogen and testosterone naturally decline. A full NICE guideline notes that menopausal low libido can involve interacting physical and psychological factors, including hormonal changes, vaginal dryness, and painful intercourse. When sex becomes physically uncomfortable, it is entirely expected that your desire to have it will decrease.

Pregnancy, childbirth and breastfeeding

Pregnancy, childbirth, and breastfeeding also bring profound physical and hormonal changes. A sudden drop in oestrogen after giving birth, combined with the extreme fatigue of caring for a newborn, can leave many women with little to no interest in sex. The psychological adjustment to parenthood and changes in how you view your body also play a large part in postpartum libido.

Hormonal contraception

For some women, hormonal contraception can influence their sex drive. Certain types of contraception, such as the combined oral contraceptive pill, can lower the amount of natural testosterone available in the body. While testosterone is typically thought of as a male hormone, it is also essential for female sexual desire. If you notice a persistent drop in libido after starting a new contraceptive, it is worth discussing alternative options with a GP.

Libido changes in men

For men, physical conditions and hormonal factors typically sit at the root of a changing or diminished sex drive.

Low testosterone

Testosterone is the primary hormone responsible for male sexual desire. While testosterone levels naturally decline as men get older, a significant drop can have a noticeable impact on libido. Alongside a lack of interest in sex, men with low testosterone might also experience persistent fatigue, a depressed mood, and a gradual loss of muscle mass.

Sometimes, medical treatments are a factor. NICE guidance states that long-term androgen-deprivation therapy for prostate cancer can reduce libido and may cause a loss of sexual function.

Erectile dysfunction

Erectile dysfunction is another major factor. While a low sex drive and erectile dysfunction are different issues, they are heavily linked. Erectile dysfunction is the inability to get or keep an erection firm enough for sex. The anxiety, frustration, and stress caused by these erection problems can lead to a reduced interest in sex altogether.

The NHS explains that alongside erection problems, you might also have a low sex drive. Addressing the physical mechanics of erectile dysfunction often helps restore confidence and sexual desire.

How to increase your sex drive

You can increase your sex drive through a combination of actionable lifestyle changes and professional medical treatments tailored to your symptoms.

Actionable lifestyle changes

There are several actionable lifestyle changes you can start today to support a healthier sex drive.

Aim for 30 minutes of moderate exercise, such as brisk walking or swimming, five days a week. Exercise boosts blood flow, improves mood, and increases energy levels.
To manage daily stress, try a simple five-minute breathing exercise each evening to help lower cortisol levels.
Limit your alcohol intake to under 14 units a week, spread over at least three days. Alcohol is a known depressant that impairs sexual function.

Medical treatments and therapies

If lifestyle changes are not enough, a GP can discuss medical treatments and therapies with you. This might start with a review of your current prescriptions to see if any are affecting your sex drive. A doctor might also suggest a blood test to check your hormone levels and thyroid function.

For women experiencing the menopause, Hormone Replacement Therapy can ease symptoms like vaginal dryness. Furthermore, NHS guidelines note that testosterone gel or cream may improve low libido for some people experiencing menopause or perimenopause. NICE recommendations suggest considering testosterone supplementation for menopausal low sexual desire when hormone replacement therapy alone is ineffective.

For men with clinically low testosterone, testosterone replacement therapy might be an option. A GP can also refer you for talking therapies, such as psychosexual counselling or relationship therapy, which are highly effective for emotional blockages.

Common Cause	Potential Solutions to Discuss with a GP
Stress or anxiety	Mindfulness, talking therapy, lifestyle changes
Relationship problems	Relationship counselling, communication exercises
Menopausal symptoms	HRT, testosterone supplements, vaginal lubricants
Medication side effects	Reviewing your prescription for alternatives
Low testosterone	Blood tests followed by testosterone replacement therapy

Talking about low libido in a relationship

Talking about low libido in a relationship requires open, honest communication to prevent mismatched sex drives from creating a lasting rift.

Starting the conversation

If you are the partner experiencing low libido, starting the conversation can feel daunting. The key is to frame the discussion around your own physical and emotional experience, rather than making it about your partner's attractiveness.

Choose a calm, neutral time to talk, outside of the bedroom. You might start by expressing a desire to feel close, while explaining that your sex drive has been low recently and asking to talk about it together. Emphasise that your lack of desire is a personal symptom, not a rejection of them or the relationship.

Offering support

If you are the partner with the higher libido, how you respond is critical. Listen without blame and try not to take the situation personally. Avoid applying pressure, as guilt and stress will only suppress your partner's sex drive further. Instead, focus on their overall wellbeing and ask how you can support them in managing stress, tiredness, or any underlying health worries.

Rebuilding intimacy

While you work on the underlying causes of low libido, it is vital to rebuild intimacy beyond the bedroom. Physical affection does not always have to lead to sex. Try to increase non-sexual physical touch, such as holding hands, hugging, or giving a massage. Scheduling quality time together, like a regular date night or a shared hobby, can help foster a strong emotional connection, which is often the foundation for a healthy physical relationship.

When to get medical help for low libido

You should get medical help for low libido if your lack of sexual desire is persistent, causing you anxiety, or negatively affecting your relationship. You do not have to just accept a distressing drop in your sex drive. Our online GPs frequently consult with patients about sexual health, and you should never feel embarrassed to raise the topic.

Signs you should speak to a GP

You should book an appointment with a GP if your lack of sexual desire has persisted for several months, if it is causing you personal distress, or if it is creating significant strain in your relationship. You should also seek medical advice if you notice other symptoms, such as severe fatigue, unexplained weight changes, or pain during intercourse.

Preparing for your appointment

Preparing for your appointment can help you feel more in control. The doctor will need to understand the wider context of your health to find the root cause. Expect them to ask questions about your lifestyle, recent stressors, mood, relationship status, and any current medications you take. They may also ask about related physical symptoms, such as erectile function or painful intercourse.

Depending on your consultation, the GP might arrange a blood test to check your hormone levels, thyroid function, or blood sugar. They may also suggest a physical examination or refer you to a specialist, such as an endocrinologist or a psychosexual therapist. Booking a virtual GP consultation is often a comfortable first step, allowing you to discuss your concerns and explore the next steps from the privacy of your own home.

Getting expert help for your low libido

Getting expert help for your low libido starts with a simple, confidential conversation with a healthcare professional to identify the root cause. Experiencing a low libido is a very common issue that affects many men and women at different stages of life. It is important to remember that a reduced sex drive is highly treatable and is usually caused by an identifiable mix of physical, emotional, and lifestyle factors. Open communication with your partner and a willingness to explore the root causes are your strongest tools for improvement.

You do not have to manage this alone or wait for it to improve by itself. Our virtual GPs are highly experienced in supporting patients with sexual health concerns. Book an appointment with a Doctor Care Anywhere clinician today to discuss your symptoms in a private, convenient setting, and begin creating a tailored plan to help you feel like yourself again.

The most common reasons for a low libido include a combination of factors. The NHS groups these causes into psychological issues like stress and depression, physical health problems such as hormone imbalances or chronic illness, medication side effects, and relationship or lifestyle factors.

To explain low libido to your partner, it is best to choose a calm moment outside the bedroom to talk. Use personal statements to express your feelings without assigning blame, focusing on your experience of stress or tiredness. Reassure them of your commitment, making clear your low libido is not a reflection of your attraction.

You should worry about having a low sex drive when the issue becomes persistent, lasts for several months, causes you or your partner significant distress, or is accompanied by other worrying physical symptoms. A temporary dip in sexual desire is very common and usually nothing to worry about.

Your medication can be causing your low libido, as certain prescription medicines are known to lower sexual desire. The most common examples include specific types of antidepressants and medications for high blood pressure. Never stop taking a prescribed medication abruptly. Instead, speak to a GP to safely explore alternative options.

Low Libido (Men and Women): Causes and What Helps