Low Libido in Men: Causes, Myths, Treatment Options
What is “low libido”?
To read about the concept of low libido generally, read this blog here.
Specifically for men, the concept of low libido can be especially challenging. Not necessarily because “low libido” itself is challenging, but because of the stereotypes and unrealistic expectations regarding men and sexuality.
Libido, desire, the motivation for sex naturally fluctuates over an individual’s life span, including ones experience of spontaneous or responsive desire (read here to learn more about these terms specifically).
In a Western culture, men tend to be portrayed as sex crazed- always wanting and always ready for sex. Masculinity tends to be tied towards sexual conquest and sexual performance. Therefore when the motivation for sex is low or absent, men tend to perceive that there is something intrinsically wrong with them, not only as an individual, but as a man.
It is also important to distinguish between low libido and the specific medical diagnosis of Hypoactive Sexual Desire Disorder (HSDD). Low libido, while frustrating, is not always “disordered”.
HSDD is the persistent, recurring absence or low sexual thoughts, fantasies, or desire for sexual activity. This must be persistent for a minimum of 6 months, be a cause of significant distress or relationship difficulties. Other potential causes must also be ruled out (e.g. depression) for the diagnosis of HSDD. For example, if someone is experiencing depression and this is the factor that explains low desire, then that person would not meet the criteria for HSDD.
HSDD can be lifelong, since the earliest sexual experiences, or more commonly acquired after a period of sexual functioning.
For many men who experience “low libido” they may be describing what is defined by the International Society of Sexual Medicine as Low Sexual Desire/Interest (LSD/I), and not HSDD. LSD/I describes a more general reduction in sexual interest or thoughts. LSD/I is a symptom caused by other factors such as depression, stress, relationship conflict, or medication side effects.
This is why I tend to challenge the idea of “low libido”, as I think this can unhelpfully distract from what is the underlying problem. Many men internalise low libido as the main problem due to scripting around the want for sex being as natural as breathing air. In fact, there are times where it makes sense to not be wanting sex.
What are the causes of low libido in men?
If low libido tends to be a symptom and not the root issue, what are some of the root issues? The answer is that it can be a complex interplay between the biological, psychological, and societal factors.
Biological: spontaneous desire which tends to be more biologically fuelled can be impacted by low levels of testosterone (hypogonadism), thyroid dysfunction, and elevated prolactin levels. Chronic diseases can sap overall physical energy which then has a flow on effect to motivation generally, including sexual motivation. Antidepressant medications (SRRIs) can also decrease overall sexual motivation.
Psychological: Major depression can impact on energy levels and dampen overall sense of pleasure, which can drain sexual desire. If an individual is in survival mode due to stress, anxiety or trauma, the body reserves and prioritises energy for survival rather than sexual pleasure.
Relational: if there is significant conflict, disconnection, or power struggles in a relationship, this can also reduce an individual’s desire to connect sexually.
Sexual secrets: when the absence of desire is specific to partnered sex, there can in some cases be hidden sexual secrets. A man may prefer and depend on masturbation, pornography, experience a specific arousal pattern (such as a fetish), or there may be unresolved trauma. All of these can be a potential reason for a man to withdraw from partnered sex.
Other sexual dysfunctions or challenges: low sexual desire can often be in response to another sexual challenge. It is common for men who experience erection difficulties to be so stressed and anxious about their erections, that this impacts their desire for sex. Rather than want sex, they feel anxious about it, and withdraw from sex all together.
What are the Myths about Male Libido?
Real men are always ready for sex: as I wrote above, this is an unrealistic and unnatural expectation of men. Men are varied between each other, and even within themselves. Expect change in desire across a lifetime, as this is normal and natural. It is normal for fluctuations to occur from mood, age, physical health, stress, and relationship dynamics.
Low desire means he is not attracted to his partner: while men internalise their sense of low libido, partners can also internalise reduced sexual activity as something being wrong with them. While it may be true in some circumstances that attraction has diminished, for many men, performance anxiety and fear may drive them to withdraw, rather than a lack of attraction.
Sexual desire and function are spontaneous: desire is often responsive, especially with age and longer-term relationships. Responsive desire is the want for sex that comes out of emotional connection, or an openness to physical and sexual intimacy which then produces the motivation. Similarly, many men have the unrealistic expectation that erections, like desire are always meant to be spontaneous.
Can low desire be treated?
When dealing with low desire, it is important to consider what is uniquely going on for that individual and the potential root causes. Treatment that deals with the root is for more effective than just dealing with the symptoms. Think of it like a weed, rather than cutting back the leaves, you want to pull it out by the root. When it comes to addressing sexual health, a holistic approach that considers the biological, psychological, and relational is far more effective than a single, “magic pill” approach.
The following are options for treatment:
Testosterone Replacement Therapy (TRT)- this is specifically for men who have low testosterone levels or hypogonadism and must be medically prescribed and monitored. TRT is for the treatment of hypogonadism.
Pros:
- TRT is highly effective in men who have testosterone deficiency
- In restoring testosterone, there tends to be a flow on effect to energy and spontaneous sexual desire
Cons:
- Regular monitoring by a doctor is required
- If a man’s testosterone levels are already normal, increasing testosterone does not increase sexual desire or resolve psychological or relational issues
Adjusting existing medication- if a specific drug is the cause of reduced desire, navigating the pros and cons of adjusting medication with a doctor is important. Medications may be adjusted or an alternative prescribed.
Pros:
- Sexual desire can be restored if the cause is medication impacts
Cons:
- Medication may not always be able to be adjusted due to side effect risks or if there is no alternative for the problem which the medication is prescribed for
Sex Therapy- this approach explores the psychological and relational impacts of low desire, and explores the possible connection between the relationship itself and low desire. Sex therapy can equip individuals and couples with education that combats myths, sexual and relationship skills, and support the couple in becoming a sexual team.
Pros:
- No negative physical side effects
- Skills that once learnt can be practiced lifelong
Cons:
- Investment of time, money, and vulnerability
Treating underlying sexual dysfunction- again the treatment options vary from medical, psychological and relational. The pros and cons of this approach is unique to the sexual dysfunction and its treatment.
As an important reminder, even if spontaneous desire is reduced and absent, emotional connection and other forms of physical intimacy can be nurtured. Just because spontaneous desire is low, this does not automatically have to mean a lack of connection. Responsive desire can also be nurtured, and sexual intimacy can still be pleasurably engaged in.
Does Sex Therapy help Low Libido?
If low sexual desire is causing distress for you or creating tension within your relationship, professional support can help. Many men feel isolated or ashamed when their sexual desire changes, especially given the strong cultural expectations around male sexuality. Speaking openly about these concerns in a supportive and confidential space can often be the first step toward understanding what is happening.
Sex therapy focuses on the psychological, relational, and behavioural factors that influence sexual desire. Therapy can help identify the pressures, expectations, and experiences that may be impacting libido, while also providing practical strategies to rebuild connection, pleasure, and confidence in sexual intimacy.
For couples, therapy can also support healthier communication around intimacy and reduce misunderstandings that often arise when desire levels differ.
I offer online sex therapy across Australia, supporting individuals and couples experiencing concerns related to sexual desire, arousal, and intimacy.
Frequently Asked Questions About Low Libido in Men
What causes low libido in men?
Low libido in men can be influenced by many factors including stress, depression, medication side effects, hormonal changes, relationship difficulties, fatigue, and chronic illness. Often it is not caused by a single factor but by a combination of biological, psychological, and relational influences.
Is low libido normal for men?
Yes. Sexual desire naturally fluctuates throughout life and can change due to stress, health, age, relationship dynamics, and life circumstances. Low libido becomes a concern when it is persistent and causes personal distress or relationship conflict.
Can stress reduce sexual desire?
Yes. When the body is under stress, energy is directed toward survival and coping rather than pleasure and intimacy. Stress, anxiety, and burnout are common contributors to reduced sexual desire.
Does pornography affect male libido?
For some men, frequent pornography use can influence sexual arousal patterns or expectations around sex. In some situations, this may reduce motivation for partnered sex or create a mismatch between fantasy and real-life intimacy.
Can low testosterone cause low libido?
Testosterone plays a role in sexual motivation. Low testosterone levels may contribute to reduced desire, fatigue, and decreased energy. A doctor can assess hormone levels if this is suspected.
When should someone seek support for low libido?
It may be helpful to seek support if low sexual desire has been persistent for several months, is causing distress, or is affecting intimacy within a relationship.
Final Reflection
Low sexual desire in men can feel confusing or even shameful, especially when cultural messages suggest that men should always want sex. In reality, sexual desire is influenced by many factors and naturally fluctuates throughout life.
Rather than viewing low libido as a personal failure, it can be helpful to approach it with curiosity about what might be influencing desire. When the underlying factors are understood and addressed, many men find that their relationship with intimacy and sexuality becomes more relaxed, connected, and fulfilling.
If low sexual desire is causing distress for you or your relationship, professional support can help explore the contributing factors and guide you toward practical strategies for change. I offer online sex therapy across Australia, providing a confidential and supportive space to explore sexual wellbeing and intimacy concerns.
Written by Justine
References
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DeRogatis L, Rosen RC, Goldstein I, Werneburg B, Kempthorne-Rawson J, Sand M. Characterization of hypoactive sexual desire disorder (HSDD) in men. J Sex Med. 2012;9(3):812-820.
Carvalho J, Nobre P. Biopsychosocial determinants of men's sexual desire: testing an integrative model. J Sex Med. 2011;8:754-763.
Corona G, Maggi M. Hypoactive sexual desire (libido) disorder. In: Porst H, Reisman Y, editors. ESSM Syllabus of Sexual Medicine. Amsterdam: Medix; 2012.
Corona G, Rastrelli G, Ricca V, et al. Risk factors associated with primary and secondary reduced libido in male patients with sexual dysfunction. J Sex Med. 2013;10:1074-1089.
Corona G, Tripodi F, Reisman Y, Maggi M. Male hypoactive desire disorder. In: Kirana PS, Tripodi F, Reisman Y, Porst H, editors. EFS-ESSM Syllabus of Clinical Sexology. Amsterdam: Medix; 2013.
