Low libido describes a decreased interest in sexual activity.
It’s common to lose interest in sex from time to time, and libido levels vary through life. It’s also normal for your interest not to match your partner’s at times.
However, low libido for a long period of time may cause concern for some people. It can sometimes be an indicator of an underlying health condition.
Here are a few potential causes of low libido in men.Low testosterone
Normal testosterone levels will vary. However, adult men are considered to have low testosterone, or low T, when their levels fall below 300 nanograms per deciliter (ng/dL), according to guidelines from the American Urological Association (AUA).
When your testosterone levels decrease, your desire for sex also decreases.
Decreasing testosterone is a normal part of aging. However, a drastic drop in testosterone can lead to decreased libido.
Taking certain medications can lower testosterone levels, which in turn may lead to low libido.
Other medications that can lower testosterone levels include:
- chemotherapy or radiation treatments for cancer
- hormones used to treat prostate cancer
- opioid pain relievers, such as morphine (MorphaBond, MS Contin) and oxycodone (OxyContin, Percocet)
- an antifungal medication called ketoconazole
- cimetidine (Tagamet), which is used for heartburn and gastroesophageal reflux disease (GERD)
- anabolic steroids, which may be used by athletes to increase muscle mass
- certain antidepressants
If you’re experiencing the effects of low testosterone, talk to your doctor. They may advise you to switch medications.Restless legs syndrome (RLS)
Restless legs syndrome (RLS) is the uncontrollable urge to move your legs. A study found that men with RLS are at higher risk for developing erectile dysfunction (ED) than those without RLS. ED occurs when a man can’t have or maintain an erection.
In the study, researchers discovered that men who had RLS occurrences at least five times per month were about 50 percent more likely to develop ED than men without RLS.
Also, men who had RLS episodes more frequently were even more likely to become impotent.Depression
Low libido is also a side effect of some antidepressants, including:
- serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta)
- selective serotonin reuptake inhibitors (SSRIs), like fluoxetine (Prozac) and sertraline (Zoloft)
However, the norepinephrine and dopamine reuptake inhibitor (NRDI) bupropion (Wellbutrin SR, Wellbutrin XL) hasn’t been shown to reduce the libido.
Talk to your doctor if you’re taking antidepressants and you have a low libido. They might address your side effects by adjusting your dose or having you switch to another medication.Chronic illness
When you’re not feeling well due to the effects of a chronic health condition, such as chronic pain, sex is likely low on your list of priorities.
Certain illnesses, such as cancer, can reduce your sperm production counts as well.
Other chronic illnesses that can take a toll on your libido include:
- type 2 diabetes
- high blood pressure
- high cholesterol
- chronic lung, heart, kidney, and liver failure
A study in the Journal of Clinical Sleep Medicine found that nonobese men with obstructive sleep apnea (OSA) experience lower testosterone levels. In turn, this leads to decreased sexual activity and libido.
In the study, researchers found that nearly one-third of the men who had severe sleep apnea also had reduced levels of testosterone.
In another recent study in young, healthy men, testosterone levels were decreased by 10 to 15 percent after a week of sleep restriction to five hours per night.
The researchers found that the effects of restricting sleep on testosterone levels were especially evident between 2:00 pm and 10:00 pm the next day.
Check your testosterone level with an at-home test
LetsGetChecked offers at-home testing kits for testosterone. Receive online results in 2–5 days. It’s easy, affordable, and confidential. Get free shipping and 30% off today.
Testosterone levels, which are linked to libido, are at their highest when men are in their late teens.
However, medications are available that can help treat these issues.Stress
If you’re distracted by situations or periods of high pressure, sexual desire may decrease. This is because stress can disrupt your hormone levels. Your arteries can narrow in times of stress. This narrowing restricts blood flow and potentially causes ED.
One study published in Scientific Research and Essays supported the notion that stress has a direct effect on sexual problems in both men and women.
Stress is hard to avoid. Relationship problems, divorce, facing the death of a loved one, financial worries, a new baby, or a busy work environment are just some of the life events that can greatly affect the desire for sex.
In one study, for example, men who were newly diagnosed with ED showed significant improvement in erectile function scores after participating in an 8‐week stress management program.Low self-esteem
Self-esteem is defined as the general opinion a person has about their own self. Low self-esteem, low confidence, and poor body image can take a toll on your emotional health and well-being.
If you feel that you’re unattractive, or undesirable, it’ll likely put a damper on sexual encounters. Not liking what you see in the mirror can even make you want to avoid having sex altogether.
Low self-esteem may also cause anxiety about sexual performance, which can lead to issues with ED and reduced sexual desire.
Over time, self-esteem issues can result in larger mental health problems, such as depression, anxiety, and drug or alcohol abuse — all of which have been linked to low libido.Too little (or too much) exercise
Too little or too much exercise can also be responsible for low sex drive in men.
Too little exercise (or none at all) can lead to a range of health problems that can affect sexual desire and arousal.
Getting regular exercise may reduce your risk for chronic conditions such as obesity, high blood pressure, and type 2 diabetes, all of which are associated with low libido. Moderate exercise is known to lower cortisol levels at night and reduce stress, which can help increase sex drive.
On the other hand, over-exercising has also been shown to affect sexual health. In one study, higher levels of chronic intense and lengthy endurance training on a regular basis were strongly associated with decreased libido scores in men.Alcohol
Heavy alcohol drinking, or more than 14 mixed drinks in a week, has also been linked to a decrease in testosterone production. Over a long period of time, excessive amounts of alcohol can reduce your sex drive.
The Cleveland Clinic recommends that men who consume more than three or more alcoholic beverages regularly should consider drinking less. The Centers for Disease Control and Prevention suggest that an average adult male should have two or fewer alcoholic beverages daily; any more than this can lead to long-term health deterioration.Drug use
Smoking has also been found to have a negative impact on sperm production and sperm movement.Physical and emotional side effects of low libido
A decreased sex drive can be very unsettling for men. Low libido can lead to a vicious cycle of physical and emotional side effects, including ED — the inability to maintain an erection long enough to have satisfactory sex.
ED may cause a man to experience anxiety around sex. This can lead to tension and conflicts between him and his partner, which may in turn lead to fewer sexual encounters and more relationship issues.
Failure to perform due to ED can trigger feelings of depression, self-esteem issues, and poor body image.Bottom Line:
Treating low libido often depends on treating the underlying issue. If low libido is caused by an underlying health condition, you may need to switch medications. If your low libido has psychological causes, you may need to visit a therapist for relationship counseling.
You can also take steps to boost your libido on your own. The following actions have the potential to increase your libido:
- living a healthier lifestyle
- getting enough sleep
- practicing stress management
- eating a healthier diet
Q&A: When to be concerned
Since it’s natural for libido to fluctuate from time to time, when (at what time duration) is low libido a cause for concern?
The definition of low libido depends on the person experiencing the low libido, that is, it must be compared to what is considered that person’s normal libido. However, if someone notes issues with libido without a clear stimulus for several weeks, it is reasonable to discuss the problem with a physician, who may be able to determine if an underlying physiologic or psychological issue is causing these concerns.
Daniel Murrell, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.References:
Written by Stacey Feintuch — Updated on April 1, 2019
Anawait B, et al. (2018). Decreased libido.
Bodenmann G, et al. (2006). Associations among everyday stress, critical life events, and sexual problems. DOI:
Breyer BN, et al. (2014). Sexual dysfunction in male Iraq and Afghanistan war veterans: Association with posttraumatic stress disorder and other combat‐related mental health disorders: A population‐based cohort study. DOI:
Burschtin O, et al. (2016). Testosterone deficiency and sleep apnea. DOI:
Can prescription medications affect testosterone levels? (n.d.).
Drugs and male fertility. (2017).
Evaluation and management of testosterone deficiency. (2018).
Gettler LT, et al. (2011). Longitudinal evidence that fatherhood decreases testosterone in human males.
Hackney AC, et al. (2017). Endurance exercise training and male sexual libido. DOI:
Kalaitzidou I, et al. (2013). Stress management and erectile dysfunction: A pilot comparative study. DOI:
Leproult R, et al. (2011). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. DOI:
Li Y, et al. (2013). Prospective study of restless legs syndrome and risk of erectile dysfunction. DOI:
Loss of libido (reduced sex drive). (2017).
Mayo Clinic Staff. (2015). High blood pressure and sex: Overcome the challenges.
Mayo Clinic Staff. (2017). Sexual health and aging: Keep the passion alive.
Rajiah K, et al. (2012). Psychological impotence: Psychological erectile dysfunction and erectile dysfunction causes, diagnostic methods and management options.
Rivas AM, et al. (2014). Diagnosing and managing low serum testosterone.
Sexual dysfunction in males. (2015).
Test ID: TTFB. Testosterone, total, bioavailable, and free, serum. (n.d.).
Viana A, et al. (2017). Nocturnal hypoxemia is associated with low testosterone levels in overweight males and older men with normal weight. DOI:
Photo Credit: Phil Desforges