About 1 in 5 men suffer from a loss of libido (sex drive) at some point in their life. And because sex drive is seen as a cornerstone of masculinity, men are often devastated when their desire suddenly wanes.
It is often assumed that libido decreases naturally with age, but that’s not always the case. “There is no doubt that there are a significant number of men who, as they get older, lose some of their sex drive, but it’s not an inevitable part of ageing,” says Dr Zaki a consultant urologist at BMI Priory Hospital in Birmingham. “A significant number of men will continue to have a normal libido as they get older.”
So, if not age, then what causes libido to decline?
Sometimes the problem is physical and other times it is psychological, but it can be a combination of both-the organic and the mental.
Sally Austen, a consultant clinical psychologist, says that first thing she would do if someone came to her, suffering from a loss of libido, would be to send them for a medical check-up. “There are so many physical causes of loss of libido,” says Dr Austen, “some of which are quite significant like heart or circulation problems.”
Here are some of the reasons men lose their libido
Testosterone levels in men fall by about 1-2% per cent a year as they age. Men with testosterone deficiency will have low energy, poor concentration and reduced libido.
“Libido is related to the level of testosterone,” says Dr Almallah. “If your testosterone is low, your libido will be low.”
Men who have low testosterone are sometimes prescribed testosterone replacement that comes in gel, tablet, capsule, and injection forms. Although testosterone can boost libido, it does not always improve a man’s erection. Also, testosterone may reduce a man’s sperm count and negatively affect his fertility, so it is not recommended for couples who are looking to conceive.
Impotence, or erectile dysfunction (ED), is not the same as loss of libido, but when you experience one, sooner or later you are likely to feel the other as well.
Although ED medicines can’t increase a man’s libido, they can help overcome the anxiety caused by not being able to perform in bed. And anxiety is a real libido killer.
“If someone’s got a physical problem that they then worry about, to break that cycle and have a few good evenings where everything works better than usual, gives men a chance to get their confidence back and to break that cycle of worry, which has been deflating things,” says Dr Austen. “It is a purely, temporary, physical intervention but most erectile dysfunction has at least an element of anxiety in it, so you’re breaking that cycle of anxious thinking, raising their confidence and getting their self-esteem back so that they can enjoy sex again rather than dread it.”
Sometimes, not being able to get an erection is a sign of a more serious underlying health problem, such as heart disease. If you speak to your GP, he will assess your overall health before prescribing ED medicines.
Obesity can lower testosterone levels, which in turn can lower libido. Obesity is also associated with other health problems such as heart disease and high blood pressure, which also tend to have a dampening effect on libido.
Some medicines are known to affect libido. Selective serotonin-reuptake inhibitors (SSRIs), a type of antidepressant medicine, can dampen libido, as can medicines used to treat benign prostatic hyperplasia (enlarged prostate). Some medicines used to treat high blood pressure, such as beta-blockers and diuretics, can also reduce sex drive.
It is best to check with your GP if you are on long-term medication to see if it is your medicine that is the cause of your loss of libido. Your GP will be able to advise you about a suitable alternative medicine for your condition that may have less of an impact on your sex drive.
Social anxiety is a fear of social situations, including intimacy.
“Social anxiety is often to do with a person’s inaccurate assumptions”, says Dr Austen. For example, a man who believes that his partner wants sex every night may find the pressure to perform overwhelming, creating stress and pressure, which in turn will have a negative effect on his libido.
Depression can also affect a person’s sex drive, says Dr Austen. “It is different from sadness in that it is of sufficient duration that starts to affect physical functioning-your appetite, your sleep pattern and also your libido,” she explains.
“One of the biggest problems is that many people are now very time poor and they are trying very hard to squeeze in a sexual relationship, but a sexual relationship needs a reasonable amount of time paid to it,” says Denise Knowles, a sex therapist and relationship counsellor at the charity Relate.
Other things that can cause libido to tumble include underactive thyroid, diabetes, anaemia, alcoholism, drug use (especially cocaine and ecstasy), and eating disorders.
The difficulty with diagnosis
Unlike erectile dysfunction, doctors and therapists have a hard time defining loss of libido. For one thing, there is no normal amount of sex. It varies greatly from person to person.
“Even what’s normal for a couple can vary,” says Dr Austen. “The summer might be more buoyant than the winter, for example.”
One way doctors might look at libido is to examine testosterone levels, but this too, has its difficulties as it doesn’t tell the whole story. “If you have a stressful life, you have no desire to do anything,” says Dr Almallah. “If you are depressed, you have no desire to do anything. So your testosterone could be normal, but if you’re depressed you won’t have the desire to do anything.”
For Dr Austen, it is up to the individual to decide if they are suffering from a low libido. You should ask yourself: is this causing me a problem and is it out of the ordinary for me? If the answer is yes to either or both of those questions, then you are suffering from loss of libido.