Low libido describes a decreased interest in sexual activity. Low libido may be pervasive or only occur with a single partner. It may be episodic or persistent and may indicate an underlying medical or psychological condition. Most men experience a decreased libido at some point in their lives.
Testosterone is involved in every aspect of the male sexual response. However, low testosterone is not usually the reason for a low libido. Instead, relationship, psychological, and environmental factors are more likely the underlying cause.1 Low libido may be because of a single underlying cause, but more likely, it is due to a combination of factors.
Low libido and erectile dysfunction are frequently thought to be the same disorder. These two conditions may coexist but have different underlying causes. Erectile dysfunction is the inability to get and sustain an erection suitable for penetrative sex. A man can have a healthy libido and erectile dysfunction. However, a low libido can also be an underlying cause of erectile dysfunction.
Up to five million men in the United States have low testosterone. After the age of 30, testosterone drops by about 1% per year.2 Hypogonadism is defined by testosterone levels below 300 nanograms per deciliter (ng/dl) in a man with symptoms consistent with low testosterone. The prevalence of hypogonadism increases with age, obesity, diabetes, and other chronic diseases.
Sexual symptoms associated with low testosterone include:
If you suspect low testosterone is the cause of your symptoms, contact your healthcare provider. As part of a comprehensive workup, your doctor will check your testosterone levels on two separate occasions in the morning. If your levels are low and you have symptoms associated with low testosterone levels, they may recommend testosterone replacement therapy.
Read More: What Happens When a Man’s Testosterone is Low?
Some medications can affect testosterone levels, mood, and libido.
Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that frequently cause sexual side effects. Monoamine oxidase inhibitors (MAOs) and tricyclic antidepressants can also cause decreased sex drive, impotence, orgasmic delay, and delayed ejaculation.
Long-acting antihistamines can affect libido, and short-acting ones can cause drowsiness, which may also negatively affect sex drive.
Common antipsychotics like haloperidol, risperidone, clozapine, olanzapine, quetiapine, amisulpride, and aripiprazole can affect sexual function, including libido.
Antiepileptics such as carbamazepine, phenobarbital, phenytoin, primidone, and valproic acid can cause decreased sex drive.
Blood pressure medications
Diuretics (commonly called water pills) and beta blockers are used to treat high blood pressure and may cause erectile dysfunction, which can affect libido.
Medications and hormones used to treat cancer can lower libido.
Statins are cholesterol-lowering medications that can lower testosterone and libido.
Hormones used to treat prostate cancer can decrease libido.
Opioids are used for pain relief and can lower testosterone and libido.
If you are taking these medications and believe they may be causing your symptoms, talk to your doctor about potentially lowering your dose or switching medications.
Physical and psychological stress triggers the release of cortisol. This increases heart rate, blood pressure, and breathing rate and reduces bodily functions such as gastrointestinal function and the sex drive. Sex hormones and cortisol come from the same precursor molecule. With chronic stress and increased demand for cortisol, sex hormone levels decline.3
Stress can also have a psychological effect on sex drive. Stress can cause anxiety, depression, and distraction, which can all put the brakes on libido.
Learn stress management techniques to reduce cortisol and the psychological effects of chronic stress. Exercise, yoga, deep breathing techniques, aromatherapy, journaling, or talking with a therapist may all be helpful.
Cigarette smoke contains nearly forty thousand chemical compounds, of which 60 are extremely toxic. Smoking contributes to cardiovascular, respiratory, and circulatory disorders. Acute exposure to nicotine reduces genital stimulation by 30% and alters sexual response.4 Chronic smoking also contributes to erectile dysfunction.5
Get medical and social support to help you stop smoking.
Small to moderate amounts of alcohol decrease inhibitions, which may increase sexual desire. Larger amounts of alcohol depress brain activity, which can increase fatigue, cause erectile dysfunction, and decreased libido. Increased alcohol consumption decreases testosterone levels, which can also negatively affect libido.
The U.S. Centers for Disease Control and Prevention (CDC) defines moderate drinking for men as no more than two drinks per day. But, of course, alcohol’s effects vary by person based on how quickly they metabolize alcohol and are affected by its metabolites.
Read More: Does Alcohol Cause Erectile Dysfunction?
Exercise stimulates blood flow and improves mood. Moderate exercise can reduce stress and lower cortisol levels. Regular exercise can help prevent chronic diseases such as obesity, type 2 diabetes, and high blood pressure. These conditions all increase a man’s risk of ED and decreased libido.
On the other hand, too much exercise can also decrease libido. In one study, men who were exposed to increasingly intense and greater durations of endurance training had significantly lower libido scores than men who did not.6
Obesity is a chronic disease that, like diabetes and cardiovascular disease, negatively affects overall health and sexual function. Between 5% and 21% of men with obesity also experience erectile dysfunction and decreased libido.5
Carrying excess body fat changes metabolism and hormone balance. Excess body fat can increase estrogen and reduce testosterone in men, leading to low libido. More than 75% of men with a BMI of 40 kg/m2 or higher have low testosterone, regardless of age.
Low libido can cause tension in a relationship and cause guilt, anxiety, or depression. Stress, depression, and anxiety can lead to increased symptoms, setting off a vicious cycle. The causes of low libido are frequently very treatable. Look at your current lifestyle practices and see if you can make any improvements, such as
Contact the specialists at Invigor Medical for information about treatments for low libido. Bremelanotide (PT-141) is FDA- approved to treat hypoactive sexual desire disorder (low sex drive) in premenopausal women. It is also used to treat low libido and erectile dysfunction in men.
Start a treatment plan with Bremelanotide (PT-141) today!
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.
1. Rastrelli G, Corona G, Maggi M. Testosterone and sexual function in men. Maturitas. Jun 2018;112:46-52. doi:10.1016/j.maturitas.2018.04.004
2. Feldman HA, Longcope C, Derby CA, et al. Age Trends in the Level of Serum Testosterone and Other Hormones in Middle-Aged Men: Longitudinal Results from the Massachusetts Male Aging Study. The Journal of Clinical Endocrinology & Metabolism. 2002;87(2):589-598. doi:10.1210/jcem.87.2.8201
3. Shackleton CHL. Role of a Disordered Steroid Metabolome in the Elucidation of Sterol and Steroid Biosynthesis. Lipids. 2012/01/01 2012;47(1):1-12. doi:10.1007/s11745-011-3605-6
4. Harte CB, Meston CM. Acute Effects of Nicotine on Physiological and Subjective Sexual Arousal in Nonsmoking Men: A Randomized, Double-Blind, Placebo-Controlled Trial. The Journal of Sexual Medicine. 2008;5(1):110-121. doi:10.1111/j.1743-6109.2007.00637.x
5. Mollaioli D, Ciocca G, Limoncin E, et al. Lifestyles and sexuality in men and women: the gender perspective in sexual medicine. Reprod Biol Endocrinol. Feb 17 2020;18(1):10. doi:10.1186/s12958-019-0557-9
6. Hackney AC, Lane AR, Register-Mihalik J, Oʼleary CB. Endurance Exercise Training and Male Sexual Libido. Med Sci Sports Exerc. Jul 2017;49(7):1383-1388. doi:10.1249/mss.0000000000001235