Low Sex Drive: Common Causes and Treatment
What is low libido? – Low libido describes a decreased interest in sexual activity. It is common to lose interest in sex from time to time, and libido levels vary through life. It is also normal for interest not to match your partner’s at times. However, low libido for a long period of time may cause concern as it can sometimes be an indicator of an underlying health condition.
Here are a few potential causes of low libido in men.
Low testosterone – Testosterone is an important male hormone, mostly produced in the testicles. Testosterone is responsible for building muscles and bone mass, stimulating sperm production and stimulating sex drive. It is normal for testosterone levels to vary, but adult men are considered to have low testosterone, or low T, when levels fall below 240 nanograms per deciliter (ng/dL) and low testosterone levels will decrease the desire for sex.
Medications – Taking certain medications can lower testosterone levels, which in turn may lead to low libido. For example, blood pressure medications such as ACE inhibitors and beta-blockers may prevent ejaculation and erections. Other medications that can lower testosterone levels include:
- chemotherapy or radiation treatments for cancer
- hormones used to treat prostate cancer
- corticosteroids (steroids)
- opioid pain relievers, such as morphine (MorphaBond, MS Contin) and oxycodone (OxyContin, Percocet)
- an antifungal medication called ketoconazole
- cimetidine (Tagamet), which is used for heartburn and gastroesophageal reflux disease (GERD)
- anabolic steroids, which may be used by athletes to increase muscle mass
- certain antidepressants
Restless legs syndrome (RLS) – Restless legs syndrome (RLS) is the uncontrollable urge to move the legs. A study found that men with RLS are at higher risk for developing erectile dysfunction (difficulty in getting or maintaining an erection) than those without RLS. The researchers discovered that men who had RLS occurrences at least five times per month were about 50% more likely to develop erectile dysfunction than men without RLS.
Depression – Depression changes all parts of a person’s life and people with depression experience a reduced or complete lack of interest in activities they once found pleasurable, including sex. Low libido is also a side effect of some antidepressants, including: serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and selective serotonin reuptake inhibitors (SSRIs), like fluoxetine (Prozac) and sertraline (Zoloft). However, the norepinephrine and dopamine reuptake inhibitor (NRDI) bupropion (Wellbutrin SR, Wellbutrin XL) has been shown not to reduce libido. If you’re taking antidepressants and you have a low libido, then consider adjusting the dose or switching to another medication.
Chronic illness – Not feeling well due to the effects of a chronic health condition, such as chronic pain, means that sex is likely low on the list of priorities. Certain illnesses, such as cancer, can also reduce sperm production counts as well. Other chronic illnesses that can take a toll on libido include:
- type 2 diabetes
- high blood pressure
- high cholesterol
- chronic lung, heart, kidney, and liver failure
If you’re experiencing a chronic illness, talk with your partner about ways to be intimate during this time. You may also consider seeing a marriage counselor or sex therapist about your issues.
Sleep problems – A study in the Journal of Clinical Sleep Medicine found that non obese men with obstructive sleep apnea (OSA) experience lower testosterone levels which in turn leads to decreased sexual activity and libido. In the study, researchers found that nearly one-third of the men who had severe sleep apnea also had reduced levels of testosterone. In another recent study in young, healthy men, testosterone levels were decreased by 10 to 15 percent after a week of sleep restriction to five hours per night. The researchers found that the effects of restricting sleep on testosterone levels were especially evident between 2:00 pm and 10:00 pm the next day – which might be crucial if trying for a baby.
Stress – Situations or periods of high pressure can cause sexual desire to decrease. This is because stress can disrupt hormone levels. Arteries also become narrower when stressed which restricts blood flow and potentially causes erectile dysfunction. A study of veterans with post-traumatic stress disorder (PTSD) found that their stress disorder increased the risk of sexual dysfunction more than three times. Stress management techniques, such as breathing exercises, meditation, and talking to a therapist, may help.
Low self-esteem – Self-esteem is defined as the general opinion a person has about their own self. Low self-esteem, low confidence, and poor body image can take a toll on emotional health and well-being. Feeling unattractive, or undesirable, is likely to put a damper on sexual encounters and not liking what you see in the mirror can even make someone want to avoid having sex altogether. Low self-esteem can also cause anxiety about sexual performance, which can lead to issues with erectile dysfunction and reduced sexual desire.
Too little (or too much) exercise – Too little or too much exercise can also be responsible for low sex drive in men. Getting regular exercise may reduce the risk for chronic conditions such as obesity, high blood pressure, and type 2 diabetes, all of which are associated with low libido and moderate exercise is known to lower cortisol levels at night and reduce stress, which can help increase sex drive. However, over-exercising has also been shown to affect sexual health. In one study, higher levels of chronic intense and lengthy endurance training on a regular basis were strongly associated with decreased libido scores in men.
Alcohol – Heavy alcohol drinking, or more than 14 units in a week, has also been linked to a decrease in testosterone production and over a long period of time, excessive amounts of alcohol can reduce sex drive.
Drug use – In addition to alcohol, the use of tobacco, marijuana, and illicit drugs such as opiates has also been connected to a decrease in testosterone production. This can result in a lack of sexual desire. Smoking in particular has also been found to have a negative impact on sperm production and sperm movement – important for trying to conceive.
Physical and emotional side effects of low libido
A decreased sex drive can be very unsettling for men and how they perceive themselves. Low libido can lead to a vicious cycle of physical and emotional side effects, including erectile dysfunction. This can lead to tension and conflicts with a partner, which may in turn lead to fewer sexual encounters and more relationship issues. Treating low libido often depends on treating the underlying issue and although it’s difficult to raise the subject, often the thought of talking about it is worse than the reality, and simple changes could make all the difference. You’re not alone.
If you feel comfortable, join or start the conversation below. Talking to other who have experienced/are experiencing the same thing can be extremely comforting.