You might have seen recent TV commercials that encourage men to ask their doctors about treatments for “low T” — or low testosterone, the male sex hormone. One of the classic symptoms of low testosterone levels in men is reduced sex drive or, in more severe cases, complete loss of interest in sex.
Although a man’s sex drive will wax and wane throughout his adulthood, low libido becomes more common as he ages. On average, the condition affects 20 to 25 percent of U.S. men, with greater percentages in males over age 55.
A complex web of causes
Male libido is very complex, and low T is only one possible cause of lack of interest in sex. Low libido, which tends to sneak up on a male, can develop from other possible causes, including physical, emotional, and mental factors.
In addition to hormonal issues, chronic illness and chronic pain are among the physical reasons men may experience a decline in sex drive. Hormone-related causes of low libido include low testosterone as I described previously, as well as diabetes and thyroid disease. Psychological issues that can contribute to low libido include depression, anxiety, and stress. Another factor, unfortunately, is that many medications used to treat some of these conditions also can cause sex drive to plummet. Men who take certain classes of prescription medicines to treat high blood pressure or depression, for example, may experience side effects that reduce their interest in sex.
Low libido and erectile dysfunction
It is important to note that low sex drive in men is different than erectile dysfunction (ED), which is the inability to achieve or maintain an erection. A man can have either one or the other — or both.
ED is caused by many of the same factors that can cause low libido. Although I find many men fail to complain about low libido, they are more likely to speak up about ED because they want to have sex but physically can’t.
When should you talk to your doctor?
If ED or loss of interest in sex is interfering with your happiness or disturbing your relationship with your partner, it might be time to discuss your concerns with your primary care provider.
In my practice, when screening for low libido or ED, I perform a physical examination and review the patient’s medical history, medications, and emotional health. I also order routine blood tests, along with testosterone and thyroid hormone screening. In addition, I go over lifestyle factors such as alcohol consumption and use of drugs such as marijuana or narcotics because overuse or abuse of these substances can cause both low sex drive and ED.
Over the years, I have successfully diagnosed and treated many patients with both conditions. More recently, for example, a happily married 58-year-old, came to my office distraught after he began to experience erectile dysfunction. It started happening occasionally, then more often — and after a while, he totally lost interest in sex.
After interviewing and examining this patient, I determined his low libido was caused by his ED. In other words, he was so tired of trying to perform that his mind decided to lose interest in sex to avoid being distraught over lack of ability. His work-up was negative, but I eventually traced the start of his problem to a change in the dose of his heart medication a year earlier. I worked with his cardiologist to lower the dose and prescribed some Viagra so he could regain his confidence, which solved the problem — to the patient’s (and his partner’s) great relief.
Treating and preventing the problem
Treatment options for low sex drive are as variable as the causes, and generally there is no one right thing to do. Effective treatment means discovering the cause, or causes, and then correcting them. This might mean a change of medications, the use of testosterone replacement therapy, thyroid hormone replacement, or antidepressants and counseling.
The only way to help prevent low libido is to keep yourself healthy physically and mentally, which is good advice for optimal health and well-being overall. Try to avoid the development of illnesses and emotional disorders. Stay healthy and happy, eat right, avoid junk food, be physically active, and avoid excessive alcohol use and illegal drugs.
If you are having issues with low libido and ED, you should consult your primary care physician and not be embarrassed to ask for help. Treatment is available — and careful examination coupled with thorough investigation often leads to a successful cure.
If you are looking for a board-certified internal medicine doctor in central New Jersey, CentraState Medical Center’s Physician Finder provides a detailed listing of physicians from which to choose. Visit our physician finder or call 866-CENTRA7.
Edward Stoner, MD is a board-certified internal medicine specialist and primary care provider at Family Practice of CentraState in Freehold. He has a special interest in the promotion of healthy, active lifestyles and preventive medicine. To schedule an appointment with Dr. Stoner, click here or call 732-462-0100.