Causes of his low libido
THE theory that ‘real men’ are supposed to be always in the mood is a concept that has long dictated the idea of manhood. But this is not always the case, and when it isn’t, urologist Dr Gareth Reid says that many men are too afraid of being judged to explore the proper avenues for identifying the causes of or treatment for the condition.
“A decreased interest in sexual activity, otherwise known as a low libido or hypoactive sexual desire disorder, can severely lower a man’s self-confidence as well as his relationship with his partner. At this point it is probably unknown how common this sexual dysfunction is, but most men will simply believe it is associated with the normal ageing process and not seek medical attention for it,” Dr Reid said.
He noted that the current estimates suggest that up to one in five men experience this problem, with most cases sharing an association with the ageing process.
But this is not always the case. In fact, Dr Reid said that the underlying causes of low libido are quite variable and can be filed under two broad categories — medical and psychological.
“The medical causes associated with a low sex drive include low testosterone, medical conditions such as diabetes, hypertension, obesity, hypothyroidism, and also as a side effect of the medications used to treat these conditions,” Dr Reid outlined.
On the other hand, psychological causes of a low libido, which Dr Reid said are perhaps the most common causes, include stress, anxiety, exhaustion and relationship problems. He said other associated medical conditions such as depression have also been shown to affect a man’s libido. Additionally, Dr Reid said that drugs and alcohol may also negatively impact a man’s sexual desire.
With regards to ageing, Dr Reid said that successive studies have shown that a decline in testosterone levels parallel the decline in a man’s libido.
“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 explained.
And while some experts have suggested testosterone replacement to increase libido, Dr Reid said that there is no evidence to support this.
“Testosterone replacement may not increase a man’s sexual desire in the setting of a normal baseline testosterone level. In simpler terms, administering a massive amount of testosterone to an 80-year-old man will not return his libido to that of an 18-year-old if his testosterone level was within the normal range before treatment,” the urologist explained.
But testosterone replacement therapy has shown excellent benefit in the man who has been shown to have low testosterone levels within his blood, with other associated symptoms such as a low libido, erectile dysfunction, fatigue and a lack of concentration.
Dr Reid said uncovering the most significant factor(s) affecting sex drive will provide adequate guidance for relevant investigations and treatment options for men.
“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, and cutting down on fatty and processed foods. Certainly, encouraging more exercise, at least a 30-minute walk three times a week, and in general trying to reduce stress in their lives is helpful. Limiting alcohol intake may also have some benefit.”
Where low libido is related to a medical condition such as a low testosterone, then testosterone replacement therapy may be indicated if the patient fits the criteria for treatment. Dr Reid underscored that a low libido related to medications used to treat other medical conditions may be helped by changing the medications or adjusting the dosage.
In the case of a decreased sexual desire related to psychological issues, Dr Reid pointed out that most patients will respond to counselling with their partners and healthcare professionals.
