Seven causes of low female libido: what the science supports

What did @drdiegodimarco actually say?

Honestly? It's hard to tell. The transcript for this video is largely incoherent, which is almost certainly a transcription error rather than what the creator actually said. The caption, however, is clear enough: @drdiegodimarco claims there are "at least 7 different reasons" for low libido in women, naming diseases, medications, hormones, and relationship dynamics as contributing factors. He invites followers to comment "SOLUTION" to receive a follow-up video on how to fix each case.

So we're fact-checking the premise he's selling, because that's what 66,700 viewers are actually consuming. The framework itself, that female low libido has multiple distinct etiological categories, is the claim worth examining.

Does the science back this up?

Yes, broadly. The categorization of female sexual interest/arousal disorder (FSIAD) into multiple contributing domains is well-supported by the literature, though "7 reasons" is a simplification.

The Diagnostic and Statistical Manual (DSM-5) recognizes hypoactive sexual desire disorder as a diagnosable condition requiring absence of desire lasting at least six months. Research consistently shows it's multifactorial. A landmark review by Clayton and Valladares Juarez (2022, Psychiatric Clinics of North America) identified biological, psychological, relational, and sociocultural contributors as overlapping, not neatly separable categories.

On the medication side, SSRIs and SNRIs are well-documented libido suppressors. A meta-analysis by Serretti and Chiesa (2009, Journal of Clinical Psychiatry) found sexual dysfunction rates ranging from 25% to 80% in patients on antidepressants. Hormonal causes, particularly low testosterone in women, are real but still contested in clinical guidelines. The Endocrine Society's 2019 position statement cautioned against routine testosterone prescribing for premenopausal women due to insufficient long-term safety data.

What did they get wrong (or right)?

The framing is mostly right at the surface level, but the engagement bait structure is where things get slippery. Promising that each "case" has a corresponding "solution" implies a one-to-one problem-to-fix map that doesn't exist in clinical practice.

Female sexual dysfunction is notoriously difficult to treat precisely because causes overlap. A woman experiencing low libido from relationship conflict AND hypothyroidism AND an SSRI doesn't have three separate solutions stacked neatly. She has a complex clinical picture that requires actual assessment, not a TikTok comment thread.

The hormone angle, given that this video is categorized under TRT, deserves scrutiny. Testosterone therapy for women is not FDA-approved for sexual dysfunction in the United States. It is used off-label, and a 2019 international consensus statement (Davis et al., Journal of Clinical Endocrinology and Metabolism) did support its short-term use for postmenopausal women with low desire, but with significant caveats about androgenic side effects and the lack of long-term safety data.

So if the follow-up video leans into testosterone as a primary solution without those caveats, that's where clinical responsibility starts to crack.

What should you actually know?

Low libido in women is real, common, and underdiagnosed. Roughly 1 in 3 premenopausal women and up to 40% of postmenopausal women report some degree of reduced sexual desire (West et al., 2008, Obstetrics and Gynecology). The fact that someone is talking about it on TikTok is not the problem.

The problem is the implicit promise that a comment gets you a personalized solution. These causes include:

• Hormonal shifts: menopause, perimenopause, thyroid dysfunction, prolactin excess
• Medications: SSRIs, oral contraceptives, antihistamines, antihypertensives
• Chronic illness: diabetes, cardiovascular disease, chronic pain conditions
• Psychological factors: depression, anxiety, trauma history
• Relationship and contextual factors: stress, communication breakdown, partner sexual dysfunction
• Genitopelvic issues: dyspareunia, vestibulodynia, pelvic floor disorders

A real clinical evaluation involves bloodwork, a detailed medication review, mental health screening, and often a referral to a pelvic health specialist or sex therapist. No TikTok video, however well-intentioned, replaces that.

The bottom line

The general premise here is defensible. Female libido is influenced by multiple interacting systems, and naming that publicly is useful. But the engagement mechanic, "comment for a solution," trades on that legitimacy to build an audience. If the follow-up videos include testosterone recommendations without proper risk disclosure, or imply that women can self-diagnose their libido category, that crosses from education into something more problematic. Watch the follow-up content carefully before trusting the framework.