Is persistently reduced libido always caused by low testosterone?
No. Sleep, mood, medications, relationship context, thyroid, prolactin, and vascular health all shape libido. Confirmed low testosterone is one driver among many. The assessment screens the full picture before any pathway begins.
Full answer
Libido is multifactorial. Causes include sleep deprivation, depression, SSRIs, opioids, finasteride, antihypertensives, hyperprolactinemia, thyroid disease, vascular disease, relational stress, and confirmed low testosterone. The oMeds assessment screens the full picture: total and free testosterone, SHBG, estradiol, prolactin, TSH, vitamin D, ferritin, mood and sleep screens, and medication review. Confirmed deficiency with matching symptoms routes to TRT or BHRT depending on physiology. Reversible drivers are addressed first because hormone optimization cannot substitute for sleep, mood care, or a medication change.
Educational. Not a substitute for individualized provider review.
- Testosterone Optimization pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03