Low libido (low sex drive) in men: from diagnosis to treatment

Low libido, also known as low sex drive, refers to a decreased interest in sexual activity. This is not the same as erectile dysfunction but these conditions can occur together and are influenced by similar factors. In both cases, they become more common with age. 

What causes low libido in men?

Low libido in men can be caused by psychological, lifestyle and medical factors. 

Lifestyle factors include a poor diet, lack of exercise or sleep, drinking too much alcohol and smoking. Psychological factors include stress, anxiety, depression and relationship issues. Medical factors include hormonal imbalances, low testosterone levels, diabetes, obesity and cardiovascular disease, as well as the side effects of certain medications. There are also other more rare causes that may require further investigation to rule out.

All of these factors can cause both low libido and erectile dysfunction. 

When to see a doctor

If you’re experiencing persistent low libido (ie lasting several weeks or more) and this is causing you distress, affecting your quality of life and/or straining your relationships, it is important to see your doctor, as you may need a referral to a specialist, such as a urologist.

You should also see your doctor if your low libido is accompanied by other symptoms, such as fatigue, mood changes, erectile dysfunction and weight gain, as this may suggest the presence of an underlying health condition that needs treatment or side effects of a new medication you’re taking.

If you notice a sudden, significant change in your libido that appears to be unrelated to any illness or stress, it is also important to see your doctor. 

Getting a diagnosis

Your doctor will ask you about your symptoms, lifestyle, overall health, mental health and relationships. They will also take a detailed medical history, including what medications you’re taking, perform a physical examination and may refer you for blood tests. 

Blood tests may check your lipid profile (fatty acids), blood sugar levels and hormone levels, including testosterone and thyroid hormone. 

Treating low libido in men

Treatment for low libido depends on the cause. If it is due to an underlying health condition, treating this condition will in most cases improve your libido. 

If you have a hormonal imbalance, you may be referred to a doctor specialising in treating hormonal conditions (an endocrinologist). Hormone replacement therapy (HRT) may be recommended. 

Your urologist may also recommend psychosexual counselling and/or couples therapy to address any anxiety, stress or relationship issues that are contributing to your low libido. 

Lifestyle changes can also improve your libido, including following a healthy, balanced diet, getting enough sleep and regular exercise, and adopting stress management strategies (eg yoga, deep breathing techniques and mindfulness). 

If you are suffering with low libido it is important to see a specialist in order to receive tailored support and treatment, as the majority of cases of low libido are treatable. It is also important to identify and treat any underlying causes that may bring about low libido.