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Decreased libido is a reduction in sex drive.

• Possible causes include psychologic factors (such as depression, anxiety, or relationship problems), drugs, and low levels of testosterone.
• Depending on the cause, doctors may suggest psychologic therapy, prescribe a different drug, or prescribe supplemental testosterone.

Sex drive (libido) varies greatly among men. And different men find different degrees of libido satisfactory. Libido may be decreased temporarily by conditions such as fatigue or anxiety. Libido also tends to gradually decrease as a man ages. Persistent low libido may cause a man and his sex partner distress.

Occasionally, libido can be low throughout a man's life. Lifelong low libido can result from traumatic childhood sexual experiences or from learned suppression of sexual thoughts. Most often, however, low libido develops after years of normal sexual desire. Psychologic factors, such as depression, anxiety, and relationship problems, are often the cause. Some drugs (such as those used to treat high blood pressure, depression, anxiety, or widespread prostate cancer) and decreased levels of testosterone can also lower libido.

A man with decreased libido thinks less about sex. He loses interest in sexual fantasy and masturbation and also in sexual activity. Even sexual stimulation, by sights, words, or touch, may fail to provoke interest. The man often retains the capacity for sexual function. Some men continue to engage in sexual activity to satisfy their partner.

A blood test can measure the level of testosterone in the blood. However, the diagnosis is usually based on the man's description of his symptoms.

If the cause is psychologic, various psychologic therapies, including behavioral therapies, such as the sensate focus technique (see Sexual Dysfunction: Sex Therapy: Sensate Focus Technique), can help. Counseling can help address relationship issues. Men should also understand the role of stress and its impact on physical function. If the testosterone level is low, testosteroneSome Trade Names
DELATESTRYL
DEPOTESTOSTERONE
can be given, usually as a patch or gel applied to the skin or as an injection (see Biology of the Male Reproductive System: Testosterone Replacement Therapy). If a drug appears to be the cause, a doctor can often try treating the man with a different drug.

Last full review/revision September 2007 by Fran E. Kaiser, MD