PCOS Hormone Panel
A targeted nine-marker hormonal and metabolic screen designed to assess the key features of polycystic ovary syndrome — including androgens.
£109.00
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Overview
What Is Low Libido?
Low libido — clinically described as hypoactive sexual desire disorder (HSDD) — is a persistent reduction in sexual interest that causes personal distress. It is among the most under-investigated symptoms in primary care, frequently attributed to relationship factors, stress, or psychological causes without any physical assessment. Yet hormonal imbalances, nutritional deficiencies, and thyroid disorders are responsible for a substantial proportion of cases, and are often entirely correctable once identified.
In both men and women, testosterone is the primary hormonal driver of sexual desire. In men, testosterone levels decline from the mid-thirties onwards, with clinically significant deficiency affecting up to 40% of men over 45. Sex hormone-binding globulin (SHBG) determines how much testosterone is biologically active — high SHBG renders much of the total testosterone measurement irrelevant. In women, testosterone works in concert with oestradiol; both fall during perimenopause and menopause, producing a marked decline in sexual interest, arousal, and genital sensation. Measuring SHBG alongside total testosterone is therefore essential to understanding the full hormonal picture.
Beyond sex hormones, several other factors commonly suppress libido. Hypothyroidism reduces metabolic rate and energy throughout the body, including sexual drive. Low ferritin causes fatigue and reduced physical vitality. Elevated cortisol from chronic stress directly suppresses testosterone production via the HPA axis — a mechanism known as cortisol steal. Elevated prolactin (assessed via DHEA-S as part of adrenal panel) and PCOS in women further complicate the hormonal picture. A targeted panel measuring all relevant markers transforms what feels like a vague, embarrassing symptom into a clinically addressable problem.
Low Libido vs. Relationship Factors
Relationship difficulties and psychological stress are genuine contributors to low libido — but physical causes are consistently overlooked. A blood test cannot rule out psychological factors, but it can confirm or exclude hormonal drivers including testosterone deficiency, thyroid dysfunction, and oestradiol decline. Ruling out a physical cause first is the logical and efficient first step, because correctable hormonal imbalances are far easier to address than long-standing relationship issues.
Related experience
Common Symptoms Associated With Low Libido
Low libido often presents alongside other symptoms that collectively point to a specific hormonal or metabolic imbalance.
Fatigue
Persistent low energy and vitality accompany hormonal drivers of low libido
Low Mood
Depression and low testosterone or oestradiol share common hormonal mechanisms
Poor Sleep
Testosterone is primarily produced during deep sleep; poor sleep compounds deficiency
Night Sweats
Oestradiol and testosterone decline commonly cause both low libido and night sweats
Erectile Dysfunction
Testosterone deficiency frequently underlies both low libido and erectile dysfunction in men
Weight Gain
Adipose tissue converts testosterone to oestrogen, worsening deficiency as weight increases
The big picture
What Causes Low Libido?
Low libido can stem from several distinct biological pathways — a targeted blood test identifies which is relevant to you.
What to measure
Biomarkers Associated With Low Libido
These are the key blood markers that reveal the hormonal, thyroid, and nutritional drivers of low libido.
Testosterone (Total)
The primary androgenic driver of sexual desire in both men and women; should be measured alongside SHBG
SHBG
High SHBG binds testosterone, reducing the biologically active 'free' fraction and suppressing libido
Oestradiol
Declining oestradiol during perimenopause impairs arousal, lubrication, and sexual interest in women
LH
Luteinising hormone; elevated LH in women indicates declining ovarian reserve and perimenopausal transition
FSH
Follicle-stimulating hormone; elevated FSH confirms reduced ovarian or testicular function
DHEA-S
Adrenal androgen precursor; low DHEA-S reflects adrenal underperformance and reduced androgen output
TSH
Thyroid-stimulating hormone; hypothyroidism is a frequently missed cause of low libido and fatigue
Ferritin
Low iron stores reduce vitality and energy, indirectly suppressing sexual drive
Vitamin D (25-OH)
Vitamin D receptors are expressed in gonadal tissue; deficiency is associated with reduced testosterone
Underlying causes
Conditions Associated With Low Libido
Several specific conditions are known to reduce libido as a primary or prominent symptom, and each is identifiable by blood test.
Low Testosterone
Testosterone deficiency is the leading hormonal cause of low libido in men, and a significant cause in women
Menopause
Oestradiol and testosterone decline during menopause produce a consistent reduction in sexual desire and arousal
Hypothyroidism
An underactive thyroid reduces metabolic energy, mood, and sexual drive through multiple mechanisms
Iron Deficiency
Ferritin depletion causes fatigue and physical lethargy, reducing motivation for sexual activity
PCOS
Hormonal imbalance in PCOS — including elevated androgens and insulin resistance — disrupts desire and arousal
Getting answers
How Low Libido Is Investigated
A structured approach to blood testing provides a clear biological explanation for low libido in the majority of cases.
1
Measure testosterone and SHBG together
Total testosterone alone is insufficient — SHBG must also be measured to determine free (biologically active) testosterone. High SHBG is common in women on the oral contraceptive pill and in older men, and can render total testosterone readings misleading.
2
Assess the female hormonal axis (women)
Oestradiol, LH, and FSH provide a picture of ovarian function and menopausal status. Women aged 35 and over experiencing libido changes alongside cycle irregularity, sleep disruption, or mood changes should include all three. DHEA-S reflects adrenal androgen output and is particularly relevant in women post-menopause.
3
Screen thyroid and iron
TSH and ferritin should be included in any libido investigation. Hypothyroidism and iron deficiency are among the most common and most treatable causes of reduced sexual vitality, yet they are rarely included in standard sexual health consultations.
4
Consider cortisol and vitamin D
Morning cortisol identifies whether chronic stress is actively suppressing testosterone via the HPA axis. Vitamin D is required for gonadal testosterone production and is deficient in a significant proportion of UK adults throughout the year.
Recommended testing
Recommended Blood Tests
Private blood tests analysed by UK-accredited laboratories.
Adrenal and Stress Hormone Panel
A five-marker adrenal and stress hormone panel measuring cortisol, DHEAS, DHEA, aldosterone, and ACTH — designed for those investigating HPA axis function.
£129.00
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Female Hormone Profile
A six-marker hormone panel measuring oestradiol, progesterone, LH, FSH, testosterone, and SHBG.
£79.00
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Growth Hormone and IGF-1 Panel
A specialist two-marker panel measuring IGF-1 (insulin-like growth factor 1) and IGFBP-3 as stable surrogate markers for growth hormone status.
£149.00
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Insulin Resistance and Metabolic Hormone Panel
A six-marker metabolic and hormone panel assessing fasting insulin, HbA1c, glucose, cortisol, DHEAS, and adiponectin.
£119.00
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Comprehensive Hormone and Wellbeing Panel
A 20-marker comprehensive hormone and wellbeing panel covering sex hormones, adrenal markers, thyroid function, metabolic indicators.
£249.00
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Everyday contributors
Lifestyle Factors That Can Contribute
Alongside blood testing, targeted lifestyle adjustments support testosterone levels and sexual vitality through evidence-based biological pathways.
Resistance Training
Heavy compound exercise acutely raises testosterone and growth hormone; two to three sessions per week produces measurable hormonal benefits
Prioritise Deep Sleep
The majority of daily testosterone is produced during REM and deep sleep; seven to nine hours maintains optimal hormone output
Dietary Fat and Cholesterol
Sex hormones are synthesised from cholesterol; very low-fat diets are consistently associated with reduced testosterone in men
Stress Management
Chronic stress elevates cortisol, which competes with and suppresses testosterone production in the adrenal pathway
Limit Alcohol
Regular alcohol consumption suppresses testosterone production and impairs liver clearance of excess oestrogen
Vitamin D Optimisation
Maintaining vitamin D above 75 nmol/L is associated with significantly higher testosterone levels in population studies
Safety first
When To Seek Medical Advice
Low libido is rarely a medical emergency, but certain accompanying symptoms indicate the need for prompt investigation.
Red flags — speak to a doctor
These can point to a more serious underlying cause and should not be ignored.
- Libido loss alongside unexplained significant weight loss — this combination warrants urgent investigation
- Sudden severe fatigue and loss of libido together, particularly with postural dizziness, may indicate adrenal insufficiency
- Chest pain, breathlessness, or palpitations alongside reduced sexual activity tolerance
- Loss of libido following a new medication — many prescribed drugs, including antidepressants, antihypertensives, and hormonal contraceptives, suppress sexual desire and should be reviewed with your prescriber
Common questions
Frequently Asked Questions
The most common hormonal causes of low libido in women are declining oestradiol and testosterone during perimenopause and menopause, elevated SHBG (which binds and inactivates testosterone), and hypothyroidism. PCOS and iron deficiency are also frequently implicated. A targeted hormone panel identifies which factors are present so treatment can be tailored accordingly.
In men, low libido is most commonly caused by low testosterone — which affects up to 40% of men over 45. High SHBG reduces the fraction of biologically active testosterone, compounding deficiency. Hypothyroidism, elevated cortisol from chronic stress, iron deficiency, and low vitamin D are all additional contributors that should be screened alongside total testosterone.
Yes — chronic psychological stress elevates cortisol, which directly suppresses testosterone production through competition in the adrenal steroid synthesis pathway. This is sometimes called ‘cortisol steal’. Blood testing for both cortisol and testosterone identifies the degree to which stress-driven hormonal suppression is contributing to your low libido, and distinguishes this from primary testosterone deficiency.
Yes — combined oral contraceptive pills raise SHBG substantially (sometimes threefold), which binds and inactivates both testosterone and oestradiol, directly reducing sexual desire. Elevated SHBG can persist for months after stopping the pill. Measuring SHBG and free testosterone before and after any contraceptive change provides clarity on whether this mechanism is relevant to you.
For men: total testosterone, SHBG, LH, FSH, TSH, and ferritin. For women: all of the above plus oestradiol and DHEA-S. In both sexes, cortisol and vitamin D add important context. Trupoint’s male and female hormone panels include all of these in one convenient private blood test.
Keep exploring
Related Symptoms
Related Biomarkers
Related Conditions
Sources
References
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Goldstat R et al. — View source
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Shores MM et al. — View source
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Pastuszak AW et al. — View source
This page is for general information only and does not replace personalised medical advice. If you are worried about your health, please speak to a qualified healthcare professional. Trupoint Health blood tests are analysed by UK-accredited laboratories.