Causes and Treatment of Low Libido in Men

Low libido is a decrease in sex drive that can interfere with sexual activity. While it can cause tension in a relationship, fostering doubt and guilt in both partners, it can often be treated if the underlying cause is identified. 

Low libido should not be confused with erectile dysfunction (ED), although the two conditions can co-exist. Communication and honesty are needed for a couple to cope while identifying the possible causes. Treatments can vary and may involve psychotherapy, hormone replacement, lifestyle changes, or the adjustment of medications.

Low libido can sometimes be caused by a single factor but is more often related to multiple factors that each contribute in their own way. Among some of the more common causes are low testosterone, medications, depression, chronic illness, and stress.

causes of low libido in men

Verywell / Brianna Gilmartin

Low Testosterone

Testosterone is an important sex hormone in men. It’s responsible for typical male characteristics, such as facial hair and body muscle. This hormone also helps maintain sex drive and sperm production. 

Testosterone levels peak during adolescence and early adulthood, and drop as you age—declining about 1% to 2% a year beginning in your 30s. If your levels drop below a certain point, you may have low testosterone (hypogonadism). 

The American Urology Association (AUA) defines low testosterone as less than 300 nanograms (ng) of the hormone per deciliter (dl) of blood.

Low testerone is common in older men, but it can occur in younger men as well. For younger men, a drop in testosterone levels can be caused by chronic diseases such as high blood pressure, type 2 diabetes, and heart disease.

Contrary to popular belief, low testosterone levels rarely lead to erectile dysfunction. But low testosterone can interfere with sex in other ways. Some men with low testosterone experience a drop in libido while others lose interest in sex completely. Additional symptoms of this condition include:

  • Body and facial hair loss
  • Depression
  • Fatigue
  • Reduced muscle tone

The most common treatment for low testosterone is testosterone replacement therapy (TRT). Though effective, TRT can come with potential risks. Some of these include acne, blood clots, prostate growth, and worsening sleep apnea. Additionally, TRT may put some older men at an increased risk for heart problems.

If you suspect your testosterone levels are low, then a conversation with your doctor is in order. A diagnosis of hypogonadism will only be made after checking your testosterone levels on two separate occasions.

Side Effect of Medication

Certain medications may cause low libido in men. These may include entire classes of drugs that can affect a man's sex drive to varying degrees. Common culprits include:

  • Anticonvulsants
  • Antidepressants
  • Antipsychotics
  • Beta-blockers
  • Benzodiazepines
  • Statins

Even over-the-counter drugs like Tagamet (cimetidine) can cause problems if taken for long periods of time.

Stopping or changing the suspected drug may reverse the condition, although this is not always possible with certain chronic medications. A dose adjustment may also help. As always, do not change medication or dosage without first talking to your physician.

Depression

Depression and low libido may go hand-in-hand. Depression can not only cause a lower sex drive, but it may also be the consequence, making a tough situation worse. Furthermore, while antidepressants can effectively treat depression, they can exacerbate problems with sexual desire.

If you are currently taking an antidepressant and experiencing a lower sex drive, you may want to talk to your doctor about lowering your dose. Switching to a different medication, including Wellbutrin (bupropion) or Remeron (mirtazapine) may also help. Just keep in mind that it can take time for this side effect to go away.

If you are depressed, it is important to discuss your libido with your doctor and to talk about how medications may impact your sex drive.

Chronic Illness

The high levels of pain and fatigue caused by chronic illness can take a toll on your sex drive. This can be especially true for the following chronic diseases and conditions:

  • Arthritis
  • Cancer
  • Chronic fatigue syndrome
  • Diabetes
  • Fibromyalgia
  • Heart disease
  • Kidney failure

When it comes to chronic illness and the loss of sexual function, there is rarely a straight line between cause and treatment. On the one hand, chronic illness is associated with an increased risk of depression. On the other, it can directly interfere with hormonal, neurological, or vascular functions central to the male sex drive.

Moreover, the medications used to treat the chronic condition (such as chemotherapy or cardiovascular drugs) may directly impair the male libido. As such, it can be difficult to pinpoint the cause of the loss of sex drive—and to find a solution. In some cases, multiple doctors may be needed.

Stress and Sleep Disorders

While stress can impair sexual interest by literally driving you to distraction, its effect on the sex drive is more insidious. Stress triggers the production of cortisol, a hormone that functions rather like a body's built-in alarm system. Cortisol not only causes the constriction of blood vessels, contributing to ED, it can also cause a precipitous drop in testosterone.

Stress is also linked to insomnia and other sleep abnormalities, which can increase the risk of fatigue and leave you less interested in sex.

There is evidence that elevated cortisol levels may increase the risk of obstructive sleep apnea (OSA), a condition associated with the reduction of daytime testosterone by anywhere from 10% to 15%.

Treatments depend on the specific sleep issue and may involve stress management techniques and improved sleep hygiene for insomnia and the use of positive airway pressure to treat OSA.

If the stress is associated with an anxiety disorder, medications may be needed. But be careful, because some anti-anxiety medications (the SSRIs) can lower your libido even more.

Lifestyle Factors

There are lifestyle factors that may contribute significantly to low libido in men. These tend to be more readily remedied by changing or stopping the behavior.

  • Alcohol and drug use: Excessive or chronic drinking can result in reduced testosterone levels.
  • Too much (or too little) exercise: Frequent and high intensity exercise is linked to a lower libido. Too little exercise can also lead to decreased libido in a variety of ways.
  • Obesity: Extra weight directly impairs metabolism and hormone function, resulting in significantly reduced total and free testosterone. By contrast, exercise and weight loss not only enhance mood and energy levels but also improve sexual function and self-image.
  • Smoking: This directly increases the risk of ED and indirectly impairs sexual arousal, according to a 2012 study from the University of Texas Austin.

While the detrimental effects of these behaviors are clear, it is never wise to pin low libido on a single lifestyle factor without first conferring with a doctor to explore all other possible causes.

A Word From Verywell

Low libido can be caused by a variety of physical, emotional, or psychological reasons. If low libido is affecting your relationship, avoid directly blaming yourself or your partner. Instead, have an open and honest conversation with your partner about how you're feeling.

If you're concerned by your low libido, talk to your doctor. There are lifestyle changes that may put you in the mood more often. The solution may even be as simple as changing a medication you are taking.

In the meantime, try to remind yourself that the loss of sexual desire is not the same thing as the loss of a desire for intimacy. Even when struggling with sexual dysfunction, make every effort to connect emotionally and physically. By doing so, you can forge a closer bond and may even end up strengthening your relationship.

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