Declining sexual desire is a common issue experienced by both men and women. However, it remains a challenging topic to discuss and address, as libido plays a significant role in manhood. Despite this, it is important to recognize that low sexual desire in men can be associated with underlying reproductive system pathologies that need to be identified, treated, and cured.
Causes of Declining Desire in Men
The libido of many men can naturally fluctuate throughout their lives. It is usual for sexual interest to ebb and flow. Some potential causes of low libido in men include:
- Low testosterone levels: Decreased testosterone levels can lead to a decrease in sexual desire;
- Age: Testosterone levels naturally decline as men age. However, in some cases, even young individuals can have below-normal testosterone levels, reducing sexual desire. Investigating the underlying causes is crucial in these situations;
- Presence of chronic diseases: Certain diseases such as diabetes, kidney failure, arthritis, or cancer can contribute to a decrease in libido;
- Medication intake: Some medications used for chemotherapy or radiation therapy, painkillers like morphine, or hormones used to treat prostate cancer can lower testosterone levels;
- Sexual problems: Difficulties with erections, premature or delayed ejaculation can cause anxiety during sexual activity, leading to a decrease in pleasure;
- Depression: Depression can result in a reduced or complete lack of interest in activities once found pleasurable, including sex;
- Couple-related issues;
- Sleep problems: studies have shown that individuals with sleep apnea often have reduced testosterone levels.
When to Consult an Andrologist?
If low testosterone levels are suspected, it is vital to consult an andrologist. Insufficient production of testosterone by the testes can lead to various symptoms, including:
- Decreased sexual desire
- Ejaculation disorders
- Erectile dysfunction
- Fertility problems
- Depression
- Changes in body composition and bone health
Therefore, when these symptoms are present, seeking the advice of a specialist is crucial.
Dealing with Declining Desire
When faced with a decrease in desire, the first step is to contact a specialist who can identify the underlying cause.
The patient will undergo several investigations, including an objective examination to identify any anatomical abnormalities contributing to the decline in desire and evaluations for concomitant pathologies and the potential influence of current therapies.
Laboratory tests performed include:
- Hormone profiling (testosterone, prolactin, FSH, LH, and thyroid hormones)
- Glucose profiling
If necessary, instrumental tests might be performed, such as:
- Scrotal ultrasound
- Genito-urinary apparatus
- Thyroid apparatus
- MRI sella turcica
In cases where the issue is of psychogenic origin, referral to a psychosexologist for psychological and/or psychiatric approaches, either individual or couple therapy, may be necessary.
If an organic or biological cause is identified during the initial evaluation, with low testosterone values, and after addressing any underlying issues and optimizing the patient’s metabolic status (such as weight reduction in case of obesity or diabetes control and increasing physical activity), hormonal drug therapy may be recommended using appropriate modalities and formulations, if no contraindications are present.
