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5 Reasons Your Sex Drive is AWOL

It’s natural for your libido to ebb and flow. Here’s what’s normal, and when to talk to your doctor.
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Fast Facts

  • Low sex drive in men can be harmless or a symptom of an underlying condition.
  • Low testosterone, mood disorders, and certain medications can dampen libido.
  • Treatments including testosterone replacement therapy and psychotherapy can help get your sex drive back to your normal range.

When it comes to sex, men are expected to be rearing and ready to go at the drop of a hat (or bra). So if your libido—and not your mind—is suddenly in the gutter, most guys’ go-to reaction is to worry that something is wrong. Low sex drive can signal that something is up with your health. But it could also be that you’re just going through a not-so-horny patch. 

“Low libido is pretty subjective. In today’s day and age, fueled largely by the adult film industry, most dudes think that they need to be ready to have sex at any second,” says urologist Joshua Calvert, M.D. “But from a clinical perspective, low libido just means that you are less interested in sex than you were historically.”

But a consistently low libido could also be due to a testosterone deficiency or another health condition, so it’s worth biting the proverbial bullet and talking to your doctor.

So what’s putting your sex drive in park? Here are some of the most common culprits for low sex drive in men, along with solutions to get it back to normal (or better).

What Is Low Sex Drive in Men?

Your libido peaks in your late teens and early 20s, so using that as a baseline, low libido is having less of an interest in sex than you did at that apex, and that it is negatively impacting your (or your significant other’s) quality of life, says Calvert. But “libido clearly varies with age and life circumstances,” he says.

Possible Causes For Low Sex Drive In Men

A lagging libido can be caused by a shift in hormones, medications, or even just stress. The most common medical reasons for a lackluster libido include:

Low testosterone

“Men with low testosterone have lower libidos,” says Calvert. You are considered to have low testosterone when your total testosterone level falls below 300 nanograms per deciliter (ng/dL). Other symptoms that sign that low T is behind your low sex drive:

  • Fatigue
  • Erectile dysfunction
  • Unexplained weight gain
  • Decreased muscle mass
  • Mood swings
  • Brain fog
 

Researchers aren’t sure why having low testosterone levels can cause your sex drive to sputter, and not all men who have low T lose interest in sex (1). But a low sex drive is one of the most common reasons men get their testosterone levels checked, according to research in the Journal of Sexual Medicine (2).

Depression and anxiety

Mood disorders including depression and anxiety can also cause low sex drive in men (3).

Medication to treat depression can also explain why you’re no longer a walking erection. “Unfortunately, many treatments including selective serotonin reuptake inhibitors (SSRIs) for mood disorders decrease your libido and orgasmic potential,” adds Calvert. If your lack of interest in sex started around the same time as you started one of these meds, your doctor may be able to switch you to another drug that’s less likely to tank your libido, such as bupropion (Wellbutrin) or mirtazapine (Remeron). (4)

Age

Conventional wisdom says that as you get older your sex drive gets less robust. But that’s a bit of a myth, says Calvert. “Many, largely healthy men, in their 70s, 80s, and even 90s have a strong desire for sex.”

Still, the stressors that mount with age (such as increased career, family, and financial responsibilities) can cause your libido to drop.

Sexual trauma

Men who have experienced childhood sexual abuse may experience sexual dysfunction, including low sexual drive, problems with arousal, and difficulties with orgasm and pain, according to one 2020 study (5). Having a negative, traumatic, or painful sexual encounter as an adult can also zap your desire for sex.

Chronic kidney disease

Chronic kidney disease (CKD), where your kidneys’ ability to filter blood deteriorates, is associated with decreased libido (6). “The most common causes of CKD are hypertension and diabetes, so keeping your overall health in check is important to prevent libido decreases,” says Calvert.

Diabetes

According to the American Diabetes Association, men with diabetes have about twice the risk of low testosterone than men without diabetes. Insulin stimulates testosterone production, so if you have insulin resistance, your T levels can drop, says Calvert.

Certain Medications

Beyond SSRIs, high blood pressure medications (like diuretics and beta blockers), seizure medications (topiramate), antipsychotics (haloperidol), and more can all cause a low sex drive in men, says Calvert.

What’s going on with my libido?

  • A lagging libido can be caused by a shift in hormones, aging, or diseases like kidney disease and diabetes.
  • Men with low testosterone also have lower libidos. 
  • You are considered to have low testosterone when your total testosterone level falls below 300 nanograms per deciliter (ng/dL)

Treatments For a Low Sex Drive

The right treatment for a low libido depends on the cause. But according to Calvert, the two main treatments for low sex drive in men are testosterone therapy and counseling/sex therapy.

TRT

“Testosterone therapy can help with underlying biochemical deficiencies leading to decreased libido,” says Calvert. Research backs this up: In one study, men with low libido and low testosterone levels showed more interest in sex and engaged in more sexual activity when they underwent TRT (7).

“It’s in your best interest as a patient to suggest to your primary care physician that low testosterone could be driving these symptoms. If they are willing to check your (morning) testosterone level, great, if they are not you can always go online to a resource like Hone and find out if testosterone deficiency is driving your symptoms,” he says.

He adds that your doctor may also refer you to a urologist or endocrinologist who can further help with testosterone management.

Counseling

If your sex drive has decreased because of stress or depression, counseling may help, says Calvert. A mental health therapist is a good place to start, especially if you’ve experienced sexual trauma or abuse (8). Specially trained sex therapists can help with sexual concerns, problems, and relationship issues.

Medication changes

If you are taking any medications, talk to your doctor to see if they may be the cause of your low libido. As mentioned above, there are a bevy of medications that can cause low sex drive in men. Your doctor may be able to help you find an alternative.

How to Increase Low Sex Drive

The first place to start is to talk with your primary care doctor about any changes you notice in your libido. He or she may prescribe tests that reveal low T or another libido-dampening condition like CKD.

If you suspect stress or a mental health struggle is behind your bedtime woes, try therapy. In conjunction with those steps, there are a few other things you can do to increase low sex drive in men:

  • Get moving: Exercise, specifically strength training (9), has been linked to increased testosterone levels.
 
  • Cut back on alcohol: Decreasing your alcohol intake can also increase your testosterone levels.
 
  • Get more sleep: One study (10) found that just five hours of sleep decreased their testosterone levels by 10 percent to 15 percent. Aim to get 7-9 hours.
 
  • Talk to your partner: If you notice a dip in your sex drive, talk to your partner. One study found that couples who discussed discrepancies in their sex drives reported higher levels of sexual and relationship satisfaction (11).

The Bottom Line

If your sex drive has decreased, your doctor may suggest hormone testing, and possible TRT (testosterone replacement therapy) to help get your sex drive back to normal. However, if your decreased libido is related to mental health, lifestyle, or other medical conditions, your doctor may suggest psychotherapy or other treatments.

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