Libido is the appetite part of sex: the thoughts, fantasies and pull towards sexual activity, separate from the mechanics of getting an erection. You can have a strong drive and erection problems, or reliable erections and very little interest.
There's no correct level. Desire differs hugely between men and shifts with age, stress, health and relationship stage. Britain's national sex survey found that 23.4% of men in a relationship reported an imbalance between how interested they and their partner were in sex.1 A mismatch is common and isn't, by itself, a disorder.
Low libido becomes a problem when it's a change for you, or when it causes you or a partner distress. That's the point to start looking for a cause.
What affects a man's sex drive?
Hormones, mental health, physical health, sleep, medicines and relationships all play a part. Usually it's a combination rather than a single cause.
Mood has a big effect. In the Natsal-3 survey, men with depression had about 3.7 times the odds of low overall sexual function after allowing for age, and being unhappy in the relationship or unable to talk easily about sex were also strongly linked.1
Everyday factors deserve a look before anything exotic. Our guides to sleep and sex drive and how stress affects erections and libido cover two of the most common in depth.
Does low testosterone cause low libido?
It can. Low sexual desire is one of three sexual symptoms most closely linked with low testosterone, but plenty of other things lower desire too, so a blood test is the only way to know.
In the European Male Ageing Study of 3,369 men aged 40 to 79, low sexual desire, poor morning erections and erectile dysfunction were the symptoms that tracked falling testosterone. Late-onset hypogonadism was defined as all three sexual symptoms plus total testosterone below 11 nmol/L and free testosterone below 220 pmol/L.2
The Endocrine Society recommends diagnosing testosterone deficiency only when symptoms are present and low levels are confirmed on repeat fasting morning blood tests.3 So low libido on its own isn't a reason to start testosterone therapy. Our post on testosterone and sex drive covers the detail.
Is low libido normal as you get older?
Some change is common, but it isn't inevitable, and a sudden drop at any age deserves attention. In Britain's national survey, low sexual function became more common with age.
Natsal-3 found low sexual function was associated with increasing age in men and women.1 But the same survey found that while 41.6% of sexually active men reported at least one problem with sexual response, only 9.9% were distressed about their sex life. A change in drive isn't necessarily a problem to the person living with it.
Where it does bother you, look at sleep, stress, mood, medicines and the relationship before assuming it's all hormonal. For the hormone side, see how testosterone changes after 40.
When should I see a doctor about low sex drive?
If it's a clear change from your normal, has lasted a couple of months, or comes with erection problems, fatigue or low mood. A GP can review medicines and check hormones.
Bring a list of medicines and supplements, and be honest about mood, alcohol and stress. If low desire comes with fading morning erections and erection problems, ask about a testosterone test, because that combination is the pattern most closely linked with low levels.2
Common questions
What is a normal libido for a man?
There isn't one. Desire varies widely between men and over a lifetime; what matters is whether your level suits you and your relationships. Mismatches between partners are common, reported by nearly a quarter of men in relationships in a British national survey.1
Can you increase libido naturally?
Often, by dealing with whatever is suppressing it, such as poor sleep, stress, low mood, heavy drinking or relationship strain. If you are considering a supplement, our guide to guide to supplement ingredients and the research covers what has been studied and who took part.
Is low libido the same as erectile dysfunction?
No. Libido is wanting sex; erectile dysfunction is difficulty getting or keeping an erection. They can overlap, and both are among the symptoms linked with low testosterone, but one can happen without the other.2
Read more on this
Does testosterone affect sex drive? Separating myth from mechanism
Sleep and sex drive: the overlooked connection
How stress affects erections and libido
Sources
- Mitchell KR, et al. Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet. 2013;382(9907):1817-29. PubMed
- Wu FC, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363(2):123-35. PubMed
- Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. PubMed
Not medical advice. Written by Eric Stephens from the research cited above; not reviewed by a doctor. If something worries you, see a GP.