Causes and Treatment of Low Libido in Men

Male Sexual Dysfunction

Causes and Treatment of Low Libido in Men

Sexual dysfunction can affect men of all ages, but is especially common in older men. The most common problems related to sexual dysfunction include ejaculation disorders, erectile dysfunction and inhibited sexual desire. These issues can often be corrected by treating the underlying causes.

Sexual Dysfunction in Males

Sexual dysfunction is any physical or psychological problem that prevents you or your partner from getting sexual satisfaction. Male sexual dysfunction is a common health problem affecting men of all ages, but is more common with increasing age.

Treatment can often help men suffering from sexual dysfunction.

The main types of male sexual dysfunction are:

  • Erectile dysfunction (difficulty getting/keeping an erection).
  • Premature ejaculation (reaching orgasm too quickly).
  • Delayed or inhibited ejaculation (reaching orgasm too slowly or not at all).
  • Low libido (reduced interest in sex).

Physical causes of overall sexual dysfunction may be:

Psychological causes might include:

  • Concern about sexual performance.
  • Marital or relationship problems.
  • Depression, feelings of guilt.
  • Effects of past sexual trauma.
  • Work-related stress and anxiety.

How does sexual dysfunction affect men?

The most common problems men face with sexual dysfunction are troubles with ejaculation, getting and keeping an erection, and reduced sexual desire.

Ejaculation disorders

Problems with ejaculation are:

  • Premature ejaculation (PE): Ejaculation that occurs before or too soon after penetration.
  • Inhibited or delayed ejaculation: Ejaculation does not happen or takes a very long time.
  • Retrograde ejaculation: At orgasm, the ejaculate is forced back into the bladder rather than through the end of the penis.

The exact cause of premature ejaculation (PE) is not known. While in many cases PE is due to performance anxiety during sex, other factors may be:

  • Stress.
  • Temporary depression.
  • History of sexual repression.
  • Low self-confidence.
  • Lack of communication or unresolved conflict with partner.

Studies suggest that the breakdown of serotonin (a natural chemical that affects mood) may play a role in PE. Certain drugs, including some antidepressants, may affect ejaculation, as can nerve damage to the back or spinal cord.

Physical causes for inhibited or delayed ejaculation may include chronic (long-term) health problems, medication side effects, alcohol abuse, or surgeries. The problem can also be caused by psychological factors such as depression, anxiety, stress or relationship problems.

Retrograde ejaculation is most common in males with diabetes who suffer from diabetic nerve damage. Problems with the nerves in the bladder and the bladder neck force the ejaculate to flow backward. In other men, retrograde ejaculation may be a side effect of some medications, or happen after an operation on the bladder neck or prostate.

Erectile dysfunction (ED)

Erectile dysfunction (ED) is the inability to get and keep an erection for sexual intercourse. ED is quite common, with studies showing that about one half of American men over age 40 are affected. Causes of ED include:

  • Diseases affecting blood flow such as hardening of the arteries.
  • Nerve disorders.
  • Stress, relationship conflicts, depression and performance anxiety.
  • Injury to the penis.
  • Chronic illness such as diabetes and high blood pressure.
  • Unhealthy habits smoking, drinking too much alcohol, overeating and lack of exercise.

Low libido (reduced sexual desire)

Low libido means your desire or interest in sex has decreased. The condition is often linked with low levels of the male hormone testosterone. Testosterone maintains sex drive, sperm production, muscle, hair and bone. Low testosterone can affect your body and mood.

Reduced sexual desire may also be caused by depression, anxiety or relationship difficulties. Diabetes, high blood pressure, and certain medications antidepressants may also contribute to a low libido.

Your doctor may begin the diagnosis process with a physical exam. Physical tests may include:

  • Blood tests to check your testosterone levels, blood sugar (for diabetes) and cholesterol.
  • Blood pressure check.
  • Rectal exam to check your prostate.
  • Examination of your penis and testicles.

Other tests can show if you have problems with blood flow to the penis.

Your doctor may also ask questions about your symptoms and your medical and sexual history. Though these questions may seem very personal, do not be embarrassed. It is important to answer honestly so the best treatment can be recommended. You may be sent to a different type of doctor (urologist, endocrinologist or sex therapist, for example) who can help you.

Many cases of sexual dysfunction can be corrected by treating the mental or physical problems that cause it. Treatments include:

  • Medications: Drugs that help improve sexual function by increasing blood flow to the penis. Sildenafil (Viagra®), vardenafil (Levitra®), and tadalafil (Cialis®) are safe and effective for most men.
  • Hormone therapy: Low levels of testosterone raised by hormone replacement therapies that include injections, patches or gels.
  • Psychological therapy: A psychological counselor to help you address feelings of anxiety, depression, fear or guilt that may affect sexual function.
  • Mechanical aids: Vacuum devices and penile implants that can help some men with erectile dysfunction.

While male sexual dysfunction cannot be prevented, dealing with the causes of the dysfunction can help you better understand and cope with the problem when it happens. To help maintain good sexual function you should follow the same program that is recommended to maintain cardiovascular health.

  • Follow your doctor’s treatment plan for any of your medical/health conditions.
  • Limit your alcohol intake.
  • Quit smoking.
  • Eat a heart healthy diet (the Mediterranean diet is often recommended).
  • Get regular aerobic and weight building exercise.
  • Get treatment if needed for any emotional or psychological problems such as stress, depression and anxiety.
  • Communicate better and more often with your partner.

Last reviewed by a Cleveland Clinic medical professional on 10/14/2019.

References

Источник: https://my.clevelandclinic.org/health/diseases/9122-sexual-dysfunction-in-males

Loss of libido (sex drive) causes and treatment

Causes and Treatment of Low Libido in Men

Loss of libido (sex drive) is a common problem affecting up to one in five men – and even more women – at some point in their life.

It's often linked to professional and personal stress, or important life-changing events such as pregnancy, childbirth or breastfeeding.

However, an unexpected loss of libido – especially when it lasts for a long time or keeps returning – can also indicate an underlying personal, medical or lifestyle problem, which can be upsetting to both partners in a relationship.

If you're concerned about your libido, especially if your diminished sex drive distresses you or affects your relationship, make an appointment to see your GP to discuss any underlying causes and possible medical or psychological treatments.

Doctors at your nearest family planning clinic, Integrated Sexual Health clinic, or Contraceptive and Sexual Health (CASH) clinic may also be able to help.

In the meantime, you may find the following information useful. It explains some of the most common reasons for loss of libido.

Relationship problems

The first thing you should consider is whether you're happy in your relationship. Do you have any doubts or worries that may be the real reason for your loss of sexual desire?

If you've been in a relationship for a long time, you may have become overfamiliar with your partner and feel a degree of erotic dissatisfaction. This is quite common and can have a negative effect on your sex drive.

Relationship problems are among the most common causes of loss of libido. For help and advice, you may find it useful to contact the relationship support charity Relationships Scotland.

Another thing to consider is whether the problem is a performance issue that makes sex difficult or unfulfilling.

For example, many men experience ejaculation problems or erectile dysfunction, and women can experience painful sex or vaginismus (when the muscles around the vagina tighten involuntarily before penetration). See your GP if these problems are an issue, as they're often treatable.

Your GP may feel you will benefit from psychosexual counselling. This is a form of relationship therapy where you and your partner can discuss any sexual or emotional issues that may be contributing to your loss of libido. 

Stress, anxiety and exhaustion

Stress, anxiety and exhaustion can be all-consuming and have a major impact on your happiness. If you feel you're constantly tired, stressed or anxious, you may need to make some lifestyle changes or speak to your GP for advice.

For more information and advice read about beating stress at work and 10 stress busters

Depression

Depression is very different from simply feeling unhappy, miserable or fed up for a short while. It's a serious illness where you may have feelings of extreme sadness that can last for a long time. These feelings are severe enough to interfere with your daily life, including your sex life.

You're probably depressed if you're feeling low or hopeless, or you've lost interest or pleasure in doing things you used to enjoy. In this case it's really important to see your GP. They may feel you'll benefit from antidepressants.

However, low sex drive can also be a side effect of many antidepressants. Speak to your GP if you're already taking antidepressants and think they may be causing your problems, as you may be able to switch to a different medication.

Drugs and alcohol

Drinking excess amounts of alcohol can reduce your sex drive, so it's a good idea to moderate your intake to no more than three to four units a day if you're a man, and no more than two to three units a day if you're a woman.

Read more about alcohol misuse and find out how to get support for a drinking problem.

Drug misuse is also linked to a loss of sex drive. Read more about drugs for information and advice.

Getting older

Many people lose some interest in sex as they get older, mainly as a result of falling levels of sex hormones, age-related health problems, or the side effects of medication.

Older men especially can develop low testosterone levels, which can cause fatigue, depression and a reduced sex drive.

Speak to your GP if you're concerned about this. They may carry out a blood test to check your testosterone level and can tell you about treatments if your level is low.

As women start to approach the menopause, levels of the female hormone oestrogen begin to fall, which can affect libido. Women can also suffer from low testosterone levels, especially after a hysterectomy. Testosterone is another hormone that can affect sex drive.

Speak to your GP if you're concerned the menopause may be having an effect on your libido. They may be able to offer you a trial of hormone replacement therapy (HRT) if it's suitable for you.

Hormonal problems

Less commonly, low libido may be caused by an underactive thyroid. This is where your thyroid gland (located in the neck) doesn't produce enough hormones. Common signs of an underactive thyroid are tiredness, weight gain and feeling depressed.

An underactive thyroid is easily treated by taking hormone tablets to replace the hormones your thyroid isn't making. Learn more about treating underactive thyroid.

A hormonal problem called hyperprolactinaemia can also have a negative effect on your sex drive. This is where you have a raised level of a substance called prolactin in your blood.

Contraception

Some women have reported a decreased sex drive while using some types of hormonal contraception, such as:

However, side effects of these contraceptives tend to improve within a few months and they're generally well tolerated.

Speak to your GP or local contraceptive (or family planning) clinic if you're worried your contraception is causing a loss of libido. They may suggest trying an alternative method.

Read more about choosing a method of contraception

Other medical conditions

Long-term (chronic) medical conditions such as cardiovascular disease, diabetes and obesity can also have a negative effect on your libido.

Medication

Certain medications can sometimes reduce libido, such as:

  • medication for high blood pressure, including diuretics
  • medications for depression, including SSRI antidepressants
  • medications for seizures (fits)
  • medications commonly used to treat psychosis (a mental condition where a person can't distinguish between reality and their imagination), such as haloperidol, as well as many other conditions
  • medicines such as cimetidine, finasteride and cyproterone, which block the effects or reduce the production of testosterone

See your GP if you're worried that medication you're taking is responsible for your reduced sex drive. They can review your medication and switch your prescription to something less ly to affect your libido if necessary.

Источник: https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/loss-of-libido

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