What Low Desire Really Means For People Over 50

low desire

What does low desire really mean for people over 50? Is it low libido or something else? Learn more in this episode with Dr. Bat Sheva Marcus.

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Dr. Bat Sheva Marcus is a nationally recognized sex therapist, author, educator, and sexual health advocate. Formerly the Clinical Director of a leading sexual health center, she is the author of Satisfaction Guaranteed and was profiled in The New York Times Magazine as “The Orthodox Sex Guru.” She is known for her warm, candid, and practical approach.

In this episode:

  • The biggest myths people believe about low desire and low libido
  • Why low desire is rarely just psychological or physical
  • How hormones, medications, and medical conditions quietly affect someone’s sex life
  • Why therapy or medicine aren’t always enough on their own, and how combining the two helps
  • Practical, science-backed strategies that can help people reignite intimacy at any age or stage of a relationship


EP 734: Dr. Bat Sheva Marcus – The Libido Lie: What Low Desire Really Means

Highlights of this episode:

Understanding desire and libido

  • Bat Sheva explained that sexual desire evolves throughout life; it is not something people permanently “figure out.”
  • Desire reflects an ongoing interaction between psychological and physiological factors, including hormones, emotions, stress, and brain activity.
  • Low libido does not necessarily mean sexuality is permanently lost. Rebuilding desire requires intention and consistent effort.
  • People may choose not to pursue sex, but those who miss feeling sexual or connected to their bodies can often make meaningful changes.
  • A partner is not solely responsible for creating desire. Individuals can explore what stimulates their own minds and bodies.

Rebuilding the erotic mind

  • Bat Sheva compared erotic attention to a language or exercise program: it can become less accessible when unused but can be strengthened with practice.
  • Dance and other forms of movement can help people reconnect with their bodies, sensuality, and physical confidence.
  • To revive fantasies, people can read, watch, or listen to erotic material and remain curious about what interests them now.
  • Two key guidelines:
    • Stay open and curious.
    • Avoid judging or editing fantasies.
  • Fantasies do not necessarily reflect real-life desires or intentions. Fantasies involving power, being pursued, or taboo scenarios can provide emotional themes—such as feeling wanted or relieved of responsibility—without implying a wish to experience those situations literally.
  • Fantasizing about someone other than a partner is not automatically infidelity and may help restore sexual energy.

Physical health, treatment, and relationships

  • Vaginal and genital health can strongly affect sexual comfort and desire. Bat Sheva encouraged listeners to discuss symptoms such as dryness, discomfort, and recurrent UTIs with a qualified clinician.
  • Local vaginal estrogen may support vaginal health and reduce related problems; treatment decisions should be made with a doctor, especially for people with cancer risks or other medical considerations.
  • Systemic hormones, testosterone, and DHEA may be relevant for some people with low desire, but treatment requires individualized medical guidance and responsible monitoring.
  • Men experiencing erectile dysfunction or low libido should seek medical care rather than remain isolated by shame.
  • Partners can address sexual difficulties through repeated, compassionate conversations that avoid blame or threats.
  • If a partner refuses to seek help, solo sexual activity can still support bodily awareness, sexual vitality, and pleasure.
  • Bat Sheva shared resources including her book, Satisfaction Guaranteed: How to Have the Sex You Always Wanted, and courses on low libido and sex over 50.

Watch this episode on YouTube here:

Connect With Dr Bat Sheva

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