What Causes Low Libido in Men?

Low libido, or sex drive, in men can cause tension in a relationship, fostering doubt and guilt in affected men and their partners. However, low sex drive can often be treated successfully if the underlying cause is identified. 

What Is Low Libido?

Low libido is a decrease in sex drive that can interfere with sexual activity. Low sex drive in men should not be confused with erectile dysfunction (ED), although the two conditions can co-exist.

It's essential for couples to communicate honestly with each other while identifying possible causes. Treatments can vary and may involve psychotherapy, hormone replacement, lifestyle changes, and/or adjustment of medications.

Causes of Low Libido in Men

Low libido can be caused by a single factor but is more often related to a combination of several. These might include:

• Low testosterone level
• Medications
• Depression
• Chronic illness
• Stress

Low Testosterone

Testosterone is an important sex hormone. It’s responsible for typical male physical characteristics, such as facial hair and body muscle. This hormone also helps maintain sex drive and sperm production. 

Testosterone levels peak during adolescence and early adulthood, and drop with age—declining about 1% to 2% a year beginning around age 30. If levels drop below a certain point, you may have low testosterone (hypogonadism). 

Low testerone is common in older men, but it can occur in younger men as well. For younger men, a drop in testosterone levels can be caused by chronic diseases such as high blood pressure, type 2 diabetes, and heart disease.

Contrary to popular belief, low testosterone levels rarely lead to erectile dysfunction. But low testosterone can interfere with sex in other ways. Some men with low testosterone experience a drop in libido, while others lose interest in sex completely. Additional symptoms of this condition include:

• Body and facial hair loss
• Depression
• Fatigue
• Reduced muscle tone

The most common treatment for low testosterone is testosterone replacement therapy (TRT). Though effective, TRT can come with potential risks. Some of these include acne, blood clots, prostate growth, and worsening sleep apnea. Additionally, TRT may put some older men at an increased risk for heart problems.

Medication Side Effects

Certain medications may cause low sex drive in men. These may include entire classes of drugs that can affect a man's sex drive to varying degrees. Common culprits include:

• Anticonvulsants
• Antidepressants
• Antipsychotics
• Beta-blockers
• Benzodiazepines
• Statins

Even over-the-counter drugs like Tagamet (cimetidine) can cause problems if taken for long periods of time.

Stopping or changing the suspected drug may reverse the condition, although this is not always possible with certain chronic medications. A dose adjustment may also help. As always, do not change medication or dosage without first talking to your physician.

Depression

Depression and low libido may go hand in hand. Depression can not only cause a lower sex drive, but it may also be a consequence of it, making a tough situation worse. Furthermore, while antidepressants can effectively treat depression, they can exacerbate problems with sexual desire.

If you are currently taking an antidepressant and experiencing a lower sex drive, you may want to talk to your doctor about lowering your dose. Switching to a different medication, such as Wellbutrin (bupropion) or Remeron (mirtazapine), may also help. Just keep in mind that it can take time for this side effect to go away.

Chronic Illness

The high levels of pain and fatigue caused by chronic illness can take a toll on sex drive. This can be especially true for these chronic diseases and conditions:

• Arthritis
• Cancer
• Chronic fatigue syndrome
• Diabetes
• Fibromyalgia
• Heart disease
• Kidney failure

When it comes to chronic illness and the loss of sexual function, there is rarely a straight line between cause and treatment. On the one hand, chronic illness is associated with an increased risk of depression. On the other, it can directly interfere with hormonal, neurological, or vascular functions central to the male sex drive.

Moreover, the medications used to treat the chronic condition (such as chemotherapy or cardiovascular drugs) may directly impair the male libido. As such, it can be difficult to pinpoint the cause of the loss of sex drive—and to find a solution. In some cases, multiple doctors may be needed.

Stress and Sleep Disorders

While stress can impair sexual interest by distraction, its effect on sex drive is more insidious. Stress triggers the production of cortisol, a hormone that functions like built-in alarm system. Cortisol not only causes the constriction of blood vessels, contributing to ED; it can also cause a precipitous drop in testosterone.

Stress is also linked to insomnia and other sleep abnormalities, which can increase the risk of fatigue and leave you less interested in sex.

Treatments depend on the specific sleep issue and may involve stress management techniques and improved sleep hygiene for insomnia and the use of positive airway pressure to treat OSA.

If the stress is associated with an anxiety disorder, medications may be needed. But this can be challenging, because some anti-anxiety medications can lower libido even more.

Lifestyle Factors

Several lifestyle factors may contribute significantly to low libido in men. These tend to be more readily remedied by changing or stopping the behavior.

• Alcohol and drug use: Excessive or chronic drinking can result in reduced testosterone levels.
• Too much (or too little) exercise: Frequent and high intensity exercise is linked to a lower libido. Too little exercise can also lead to decreased libido.
• Obesity: Extra weight directly impairs metabolism and hormone function, resulting in significantly reduced total and free testosterone. Exercise and weight loss enhance mood and energy levels and improve sexual function and self-image.
• Smoking: This directly increases the risk of ED and indirectly impairs sexual arousal, according to a 2012 study from the University of Texas Austin.

While the detrimental effects of these behaviors are clear, it is never wise to pin low libido on a single lifestyle factor without first conferring with a doctor to explore all other possible causes.

How to Improve a Low Libido

Improving sex drive typically begins with identifying the underlying cause. For example, if it is largely linked to stress, finding ways to relax and de-stress can help increase desire for sex.

In some cases, making certain lifestyle changes may help boost sex drive. Steps you can take on your own include:

• Getting regular physical activity
• Eating a healthy, nutritious diet
• Maintaining a healthy weight
• Getting sufficient sleep

If a low sex drive is linked to psychological concerns such as anxiety or depression, or caused by issues with your relationship, speak to a mental health professional. Effective treatments are available that can improve your mental well-being. Relationship counseling may also be beneficial.

Summary

Low libido in men can have a number of different causes. Some of the most common factors that contribute to a low libido include low testosterone, medication side effects, depression, chronic illness, stress, sleep problems, and lifestyle factors. 

While libido problems can contribute to stress in relationships, treatments are available. Talk to your doctor if you are concerned about your sex drive.

A Word From Verywell

Low libido can have a variety of physical, emotional, or psychological causes. If low libido is affecting your relationship, avoid directly blaming yourself or your partner. Instead, have an open and honest conversation about how you're feeling.

If you're concerned by your low libido, talk to your doctor. There are lifestyle changes that may put you in the mood more often. The solution may even be as simple as changing a medication you are taking.

In the meantime, try to remind yourself that the loss of sexual desire is not the same thing as the loss of a desire for intimacy. Even when struggling with sexual dysfunction, make every effort to connect emotionally and physically. By doing so, you can forge a closer bond and may even end up strengthening your relationship.