Low sex drive in men

A man’s virility is perceived as the bedrock of his manhood — this means that he is always expected to desire sex. But urologist Dr Gareth Reid says there are a number of factors that can cause men to develop low libido.

“A decreased interest in sexual activity, otherwise known as a low libido or hypoactive sexual desire disorder, can be a significant problem in many men, which affects their self-confidence as well as their relationship with their partners,” Dr Reid said.

He pointed out that while there are no statistics to reflect the scope of the problem, the current estimates suggest that up to one in five men experience this problem.

Dr Reid pointed out that it is expected that virility will wane gradually with age, but there are a plethora of other reasons that could contribute to a man’s decreased sexual desires, divided mainly into two broad categories — medical and psychological.

“Medical causes associated with a low sex drive include low testosterone, health conditions such as diabetes, hypertension, obesity, hypothyroidism, as well as side effects of medications used to treat these conditions. Stress, anxiety, exhaustion, depression and relationship problems, on the other hand, have been attributed as being among the most common psychological causes of the condition,” Dr Reid said

He pointed out that other practices that are associated with low libido in men include drugs and alcohol.

Dr Reid highlighted that with the advancements in medicine coupled with positive lifestyle changes, the possibility of a man losing his sexual prowess should be slim. But acquiring the required treatment is a process.

“The first treatment regimen I give to my patients is to encourage a healthier lifestyle. This includes eating healthier, increasing the fruits and vegetables in the diet, cutting down on fatty and processed foods. I encourage the need for exercise, at least a 30-minute walk three times a week and in general, for them to avoid stress triggers and to limit their alcohol intake, as this could also have some benefit.”

In addressing the age-related decrease in libido, Dr Reid said that there is reliable evidence which has revealed that the decline in testosterone levels is parallel to the condition.

“Testosterone levels remain relatively stable until the fifth decade of life. After this, the testosterone levels decline due to decreased production from the testicles. These levels decline to the point that by the age of 80 the levels are about a sixth of those of a younger man,” Dr Reid said.

But Dr Reid said that while testosterone replacement therapy has shown excellent benefit in the man who has been shown to have low testosterone levels within his blood, with associated symptoms such as low libido, erectile dysfunction, fatigue and a lack of concentration, there is no evidence to suggest that administering a massive amount of testosterone to an 80-year-old man will return his libido to that of an 18-year-old, even if his testosterone levels were within the normal range before treatment.

He said that if the investigations reveal that the cause of a man’s low libido is resulting from a medical condition such as a low testosterone level, then testosterone replacement therapy may be recommended if the patient fits the criteria for treatment.

In instances where the condition is linked to medications used to treat other medical conditions, Dr Reid pointed out that consultations with the specialists treating the patient for the specific condition/s may be required to request a change in the medication or ask that the dosage be adjusted with the hope that the effects it has on the libido will be reversed.

He advised that patients whose conditions are psychologically related show vast or complete improvement with adequate counselling. He said that it is generally recommended that their partners attend the sessions as well, since they are also affected. Overall, he emphasised the importance of seeking a health care professional’s assistance if low libido persists.

A most important part of the treatment process is conversing with the patient to determine the most significant factor or factors affecting his sex drive. This will help to steer the investigation and exploration of the most suited treatment options.