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My teen says she has no libido. Should I be concerned?

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The question

My 18-year-old daughter says she's not sexually aroused, ever. She's worried about having "low lobido'" but I'm not (for obvious selfish reasons) overly concerned. Could there be a physical problem?

The answer

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A physical problem causing a lack of sexual arousal is possible at the age of 18, but psychological reasons are more likely to be the root cause.

You mention that for obvious, selfish reasons you are not concerned as much.

In our culture there may be other parents or teens who will judge you for your comments and explain that it's a teenager's right to enjoy a healthy sex life. This will always be an extremely controversial topic and medical causes must be ruled out.

I would suggest that you prepare your daughter for a visit with a family doctor by going over some medical possibilities.

Ask her if she is taking any medications intermittently. For example, antihistamines may be associated with a loss of desire.

An underactive thyroid in a teen must be ruled out: Look for a history of a loss of energy, together with constipation, weight gain, a slow pulse or dry skin. In the end, a blood test for hypothyroidism is a definitive way to proceed.

If your teen is under stress due to school work, finances or relationships, get her to talk about that; or at least acknowledge how that may bother her and impact the rest of her wellbeing. I assume you will know if she is taking antidepressants, smokes, abuses alcohol or if she has a low self-esteem. A past history of sexual abuse must be ruled out too. All of these issues may cause a loss of libido.

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When she sees a doctor her blood pressure will be checked (high blood pressure may be a cause of a low libido); her thyroid and endocrine system will be carefully examined and blood tests may be run to look at her pituitary function and hormonal levels such as estrogen, testosterone and luteinizing hormone. Undiagnosed diabetes will also be ruled out.

Be thankful that your daughter is comfortable enough with your relationship to approach you on such an often sensitive issue. It is very well caused by an underlying issue, so you should seek medical advice from a family doctor.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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