TRT & The Male Sex Drive
Do You Have the Features of Testosterone Deficiency?
The Androgen Deficiency in Aging Males (ADAM) questionnaire is an easy way to answer questions about your sexual health, which can help to see if you need your testosterone level checked.
It is an internationally accredited assessment tool which is often used by doctors when making the assessment and diagnosis of Testosterone Deficiency. A positive result does not necessarily mean that you have a low testosterone level or require treatment, but can be a helpful guide when discussing your symptoms with your doctor.
ADAM Questionnaire
Please answer the questions below.
Is A Decreased Libido (Sex Drive) Common In Men?
Having a low interest in sex, or a low sex drive, is something many adults face at some point.
This can happen because of stress, being sick, feeling down, not having a partner, or changes in body hormones. It's okay not to always feel like having sex, but what if you rarely feel like it?
Men usually have a higher sex drive than women, primarily because of differences in body hormones. But, some men, especially as they get older, might find their interest in sex decreasing.
In this article, we'll look at why some men might not feel like having sex and what they can do to help bring back their desire for it!
Decreased Libido (Sex Drive) Or Erectile Dysfunction?
While many men deal with erectile dysfunction (ED), which means having trouble getting or keeping an erection, having a low sex drive is different.
Men with ED usually want to have sex but find they can't get an erection when they need to.
Sometimes, they might get an erection that's not strong enough for sex. These men want to have sex but can't because of physical issues.
If this sounds like you, there might be a physical reason for your ED, and it's a good idea to talk to a doctor, especially for older men or those with health problems. Medications like tadalafil and Viagra can help with ED for some men. ED might signify a different or more serious health problem for others.
Men Experience Low Sex Drive Differently
Some men might not be interested in sex at all. They don't think about it and don't start anything sexual with their partners. Because they're not interested, they don't get turned on and also don't get an erection. This is sometimes called secondary erectile dysfunction because the problem with getting an erection comes from not having much interest in sex.
This situation can make their partners upset and might even make them think the man is cheating or doesn't care about them anymore.
In the worst cases, it could cause relationships to end or partners to seek intimacy elsewhere.
This significant issue can have serious effects and often embarrasses the man.
Low Sex Drive Causes In Men
Just like erectile dysfunction, there exist numerous potential causes for low sex drive in men.
Some origins of low testosterone are physical, while others stem from psychological or mental factors.
Hormonal imbalances also frequently contribute, directly impacting an individual's level of sexual desire.
Physical Causes
Restless Legs Syndrome
Also known as Willis-Ekbom disease, this issue causes an overwhelming desire to move one’s legs. It may also be accompanied by strange sensations, both of which may lead to a lack of sexual desire.
Sleep Problems
Having not enough sleep may lead to fatigue or exhaustion. Again, this can mean that the body does not prioritise sex.
Psychological Or Mental Causes
Sexual Problems
Both erectile dysfunction and premature ejaculation can have psychological origins, leading to feelings of embarrassment and reluctance to engage in sexual activity due to concerns about performance in the bedroom.
Stress
Stress can significantly diminish a man's sex drive, particularly prevalent in individuals with high-stress occupations or those experiencing anxiety. In such cases, the mind is often preoccupied and not inclined to consider sexual activity. The body's response to stress, often in a fight-or-flight mode, further diminishes sexual desire as it prioritises other physiological responses over libido.
Depression
Similar to stress, depression can severely dampen libido. Individuals experiencing depression are frequently not in the appropriate mental state to consider or engage in sexual activity, leading to a diminished sex drive.
Low Self-Esteem
Low self-esteem can lead to hesitancy in initiating sex or concerns about body image, causing embarrassment or anxiety. These emotional barriers can create stress and mental obstacles, ultimately suppressing sexual desires.
Hormonal Causes
Elevated Oestrogen Levels In Men
High levels of estrogen in men can diminish sex drive. This is often observed in individuals with high body fat percentages or those undergoing testosterone therapy with excessive doses, leading to increased conversion of testosterone into estrogen.
Elevated Prolactin Levels
Prolactin is released after ejaculation, contributing to the refractory period that prevents immediate ejaculatory response. While less common, significantly elevated prolactin levels can adversely affect sex drive. Men who have recently become fathers are more prone to elevated prolactin levels, possibly due to evolutionary reasons. In some cases, a condition called prolactinoma, characterised by a non-cancerous tumour in the pituitary gland, can cause excessively high prolactin production, leading to libido issues.
Low Testosterone
The biggest reason for low sex drive in men is often low testosterone. This hormone is essential for making you interested in sex.
When guys have low testosterone, they might not feel like having sex much. They say that they don't feel turned on even when they see someone they usually find attractive. Instead, they appreciate how the person looks, like looking at a piece of art without wanting anything more.
Treatment Options For Low Sex Drive
Sleep
Not getting enough sleep can make men less interested in sex.
To help with this, it's good to have healthy sleep habits. This means going to bed at the same time every night, ensuring where you sleep is dark, calm, and quiet (using earplugs and eye masks can help), and not looking at screens or bright lights before bed.
Lack Of Exercise
Not exercising can also lower your interest in sex. When you don't exercise, your body might not feel ready for sex, and you could have less energy. Plus, not exercising might lead to gaining weight, which can mess with your hormone levels. Regular exercise, like working out a few times a week, can keep you healthy and boost your energy levels.
Sexual Issues – Erectile Dysfunction
Erectile dysfunction (ED) is a big reason why some men might not feel like having sex. If a man can't get an erection, it's tough to have sex. This problem can also make a man feel bad or stressed, which can make him even less interested in sex.
There are a lot of reasons why a man might have ED, but medicines like sildenafil (Viagra) and tadalafil (Cialis) can help. These medicines make it easier for blood to flow to the penis, which helps with getting an erection.
Psychological – Stress And Low Sex Drive
Stress can also make men not want to have sex. When you're stressed, your mind isn't focused on sex.
Doing things like mindfulness or meditation can help lower stress. Exercise is also great because it releases endorphins, which are chemicals in your body that make you feel good and can help make you more interested in sex.
Talking to a psychologist or psychiatrist can also help if you're feeling stressed or have other mental health issues. They can help you work through your problems, which might help improve your sex drive.
High Oestrogen
If you have high oestrogen levels, it might be because you have more body fat or how your body works genetically. High estrogen can also be linked to having low testosterone or other hormone issues.
Eating less to lose body fat can help lower the estrogen from testosterone.
For men with genetic conditions, taking a medicine that stops the enzyme aromatase can also lower estrogen levels.
High Prolactin
High levels of prolactin, another hormone, can happen for various reasons. For example, men might have higher prolactin when they become fathers, which can naturally make them less interested in sex. If you think your prolactin levels might be high, a blood test can confirm it. If they are high, you should talk to your doctor.
In such cases, you should see a specialist called an endocrinologist and get an MRI scan of your brain. Treatment often involves taking medicine to manage the problem.
Low Testosterone
If you think low testosterone is the issue, the first step is to get a blood test to check your levels.
If your testosterone is indeed low, treatment might involve taking testosterone in different forms like injections, pellets, gels, or creams to help bring your levels back to normal.
Conclusion
Having a low sex drive is something many men experience for various reasons.
You don't have to deal with this quietly on your own.
A simple blood test can check if low testosterone is part of the problem. We can provide treatments for men with hormone imbalances, including testosterone replacement and ways to manage oestrogen levels. We can also prescribe medications for erectile dysfunction, like tadalafil (Cialis) or sildenafil (Viagra) if needed.
References
Rastrelli, G., Corona, G., & Maggi, M. Testosterone and Sexual Function in Men.
Galansky, L. B., Levy, J. A., & Burnett, A. L. Testosterone and Male Sexual Function.
McBride, J. A., Carson, C. C., III, & Coward, R. M. Testosterone Deficiency in the Aging Male.
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