Low sex drive? Here’s what guys can do about it

We asked registered sex therapist Emma Waring about what causes a low sex drive in men; what affects his desire and how to deal with the causes of low sexual desire, so that couples can face any issues together.

What is sexual desire and how is it different to libido?

Sexual desire is the interest we have in sexual activity, including sexual thoughts, fantasies or actual sexual contact with ourselves or another person, and this process usually starts in our minds (yes for guys too!) Sex drive, or ‘libido, is the biological driving force for us to act on our desire and pursue sexual activity. Although the basis for sexual drive is a biological force, it is a complex process incorporating many factors such as our hormones, general health and fitness, self-esteem, past sexual experiences, confidence, and the quality of our relationship.

What might cause a dip in sexual desire and what can be done?

I see as many men with low desire in my clinic as I do women, and there are lots of causes. He may be suffering with stress, work pressures, financial worries and mental health issues and sometimes simply talking through these can be very helpful.

It is not always easy to know what is impacting desire. A very simple test can be to go away for a night or for a holiday and see if this has a positive impact. If the his desire comes back this indicates that there is unlikely to be an underlying physical problem, but rather that sex has been pushed to the bottom of the priority list. If this is the case then it is good to talk as a couple to work out ways to reprioritise it again.

There may be conflict in the relationship, or his partner may have little or no interest in sex, and this makes it difficult for him to get aroused. Couple counselling can be helpful in exploring these issues further. Resolving conflict and creating closer emotional intimacy plays a huge part in rekindling lost desire. It’s important to explore and face any issues together, as a couple, rather than seeing a loss of desire as only his problem.

How to deal with physical causes

If a change in circumstances doesn’t make a difference then there could be an underlying physical cause. It may be that the low desire is secondary to another sexual problem such as erectile dysfunction. The good news is that if this is resolved the desire returns spontaneously. As with all sexual problems the man, or woman, needs to see their GP first to rule out any underlying physical issues.

It may be that the man is diagnosed with hypogonadism which is a condition where the body is unable to make enough testosterone to work normally. Men are more likely to develop hypogonadism as they get older. The body starts to produce testosterone during puberty, and it is essential for the development and maintenance of male characteristics.

We know that low testosterone levels increase a man’s risk of developing cardiovascular disease (CVD), and they may feel tired, depressed, or notice impaired concentration. Some men may notice they have decreased body hair, are losing muscle mass, becoming weaker, or gaining weight, so being assessed and treated can positively restore many aspects of life not simply the sexual desire.

To make an accurate diagnosis your doctor will consider your symptoms as well as check your testosterone levels. If you have low testosterone, you may be offered testosterone replacement therapy (TRT), which can have a positive effect on restoring your libido and other associated issues with low testosterone. The TRT can be given as a daily gel, or as a long-acting injection. Once a man starts TRT, he should see his doctor for regular reviews to ensure symptoms are improving and side effects are not problematic.

Keeping things in perspective…

It’s good to remind ourselves that a relationship isn’t just about good sex. Intimacy in a relationship has many dimensions, including: the way a couple communicates, feelings are shared and levels of trust; also, how arguments are worked through and friendship is built; as well as romance and sexual intimacy. It’s normal to experience ups and downs. Dealing with problems together, sexual or anything else, and working on all aspects of intimacy will build a great relationship and better sex.

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