Causes and Treatments for Low Libido in Men

Learn about the causes and treatments for low sex drive in men

a disappointed man sitting in bed thinking about his low sex drive

What is low libido?

Low libido means that a man has a low sex drive or no sex drive whatsoever. Male hypoactive sexual desire disorder is a condition where men have a persistent lack of sexual fantasies and desire for sexual activity that also causes distress or relationship issues.

Low libido is relatively common in men, and may affect over 20% of men at any one time. For most men low libido is acquired, meaning that at some point in their past, they had a normal libido. When a drop in sexual desire makes a man struggle to get excited for sex or strains his relationship, it can be quite stressful. 

While there is no one size fits all answer to “what is a normal sex drive,” there  are normal ranges that vary from man to man and over time. It is quite normal for men to lose interest in sex occasionally, but their sex drive typically bounces back. On the other hand, male hypoactive sexual desire disorder lasts at least six months without getting better. Here, we will talk about common causes of low libido and what you can do to treat it.

Psychological causes of low libido

Stress

Stress is unavoidable and can affect all areas of life, including sex drive. In fact, research shows that one of the most common reason men give for low libido is work related stress and fatigue. Other life situations, like money worries, relationship issues or having a new-born can make sex seem like the farthest thing from your mind.

Once sex drive decreases it can stay low and become distressing for both you and your partner.

Life stressors can block the automatic erotic thoughts we usually experience before or during sex. These automatic thoughts are the key to feeling sexual desire. Stress may even play a bigger role than medical conditions or emotions in decreasing sexual desire.

While stress may be a part of life, we can find ways to minimize its impact on our daily life and sex drive. If life stressors are sucking the fun out of your love life, it’s time to find ways to manage stress. Techniques like mindful meditation, deep breathing exercises and guided imagery may all help to improve your sex drive and decrease your stress levels.

Relationship problems

Relationship problems are another stressor that can directly impact a man’s libido. When men are distracted by ruminations of relationship conflict, poor communication, feelings of rejection there is little space for spontaneously formed erotic thoughts.

Sexual boredom can also play a role and may be a factor in up to a quarter of men with low libido. Men who have been in a committed relationship for 5 or more years or are not sexually attracted to their partner are also more likely to have low libido.

Importantly, some studies have not shown such a clear cut relationship between libido and relationship status. That’s why it’s important to take a well-rounded look at all possible causes of low sex drive before coming to any hasty conclusions.

Depression

Both depression and anxiety can reduce sexual desire in men. This makes sense as these conditions- like stress- make it challenging to think about or respond to sexual thoughts or desires. In fact, over 40% of men with psychiatric mood disorders complain of a drop in sex drive.

Unfortunately, some medications that treat depression, like selective serotonin reuptake inhibitors (SSRI) can also cause a low libido and include Zoloft and Prozac. If you are on one of these medications and your depression is getting better, but your sex drive is worsening, it’s a good idea to check in with your doctor. Luckily, anti-depressants like Wellbutrin do not affect libido. Other psychological conditions like low self-esteem and a history of abuse or trauma can also interfere with our ability to develop sexual arousal or desire.

Sexual dysfunction

It’s not uncommon for men with low sex drive to have other kinds of sexual dysfunction. For example, men with erectile dysfunction (ED) or ejaculation disorders may ultimately develop low libido if they don’t get treated. As many as 30% of men with premature ejaculation, 40% of men with ED and 50% of men with delayed ejaculation complain of low libido.

Anxiety around sexual performance – including anxiety about the ability to achieve or maintain an erection- can decrease sex drive and distract the man from making or pursuing any erotic thoughts.

What can you do treat psychological causes of low libido?

Dealing with underlying psychological concerns is critical to treating low libido. Managing stress, fixing relationship issues or getting treatment for depression or anxiety may be required in order to boost your low libido.

Mindfulness based techniques have been shown to be effective in treating low libido in both men and women, as well as other issues such as psychological erectile dysfunction, premature ejaculation, stress, relationship issues and depression.

For men or couples who want more help, seeking out a sexual therapist, couples therapist or enrolling in cognitive behavioral therapy may be very useful.

Physical causes of low libido

Low testosterone

While checking your testosterone levels is a common step in evaluating low libido, it is not a common cause of a low sexual drive. Many studies that look at men with and without low libido have not found a difference in testosterone levels. One study found that while 11 % of men had low testosterone levels, only about half had symptoms. Of men with low testosterone and symptoms, only 28% complained about low libido. While replacing testosterone in men with low testosterone levels can help improve sex drive, testosterone has not been shown to be helpful for the majority of men with normal levels and low libido.

Health conditions and medications

Several health conditions can decrease your sex drive. Both kidney and thyroid disease can cause hormone imbalances that lead to low libido. Common medications can also cause a low libido. In addition to SSRIs, blood pressure medicines like metoprolol, prostate medicines like Proscar® and seizure medicines like Tegretol® can all cause a drop in sexual desire.

Importantly, using pain medications like opiates long term can also lead to a decrease in libido. If you notice low sex drive after starting a new medication, talk to your doctor about changing medicines. It could be an effective way to bring back excitement into the bedroom.

Aging

Some men may go through “male menopause” or andropause as they age and testosterone levels decrease. While some men experience no symptoms, others may notice fatigue, erectile dysfunction or low libido. Since these conditions often occur together, an older man with erectile dysfunction is also more likely to also have low libido.

Low sex drive is more common as men age, with one study showing a prevalence of 6% in men under 29 years old but 27% of men over 60 years, which is in line with decreasing testosterone levels in older men. Of course, many men of all age with normal testosterone levels can have low libido- just as some men with lower testosterone levels may have a normal sex drive.  

What can you do treat physical causes of low libido?

Men will need to get to the underlying physical cause of low libido to effectively treat it.

If you are concerned that you have low testosterone, you will need to get checked by your doctor to figure out if testosterone replacement is right for you.

The same goes for checking to make sure that you do not have a health problem that can affect sex drive or that one of the medicines your doctor prescribed.

Lifestyle factors affecting low libido

There are everyday habits that increased a man’s chances of having a low libido. For example, chronic overuse or abuse of alcohol or marijuana can have a negative impact on sexual desire. Additionally, sexual desire and drive is best when your health is optimized- that means getting good sleep, eating well and keeping active.

Many are looking for specific foods to increase libido. While certain foods and supplements are considered aphrodisiacs, like maca and gingko biloba, the data is conflicting and there is too little evidence to support supplement for men with low libido. While these foods are usually well tolerated, eating a well-balanced diet and maintaining a healthy lifestyle is likely more important for boosting your sex drive.

Are there medications or pills that can increase sex drive in men?

There is a lot of interest in a pill to improve sex drive in men, but currently there are no medicines or supplements that are specifically approved to increase libido in men.

Testosterone supplements are not effective in men with normal testosterone levels and should only be prescribed by a doctor since it can cause significant side effects. While several supplements are available online or over the counter that purport to increase libido or improve testosterone levels, there is little quality control and most are likely ineffective or may even be dangerous due to potential side effects or interactions with other medicines.  

Summary

If you feel like you have a low sex drive, there are several things to consider. Rather than looking to testosterone or a pill, take a step back to look for possible causes for the change. While there is no quick fix to a drop in libido, getting to the root cause can lead to rewards both in and outside of the bedroom.

About Oreoluwa Ogunyemi, MD

Urologist and Health and Wellness Coach

Dr. Ogunyemi is a medical doctor, trained urologist and a health and wellness coach. She received her medical degree from the David Geffen School of Medicine at UCLA. Her professional background and love of writing, allow her to efficiently synthesize complex and detailed research, making it accessible to a broader audience.

She serves as a medical writer for the Between Us Clinic.