About 1 in 5 men experience a loss of libido (sex drive) at some point in their life. And because sex drive is seen as a cornerstone of masculinity, men are often devastated when their desire suddenly wanes.
It is often assumed that libido decreases naturally with age, but that's not always the case. "There is no doubt that there are a significant number of men who, as they get older, lose some of their sex drive, but it's not an inevitable part of ageing," says Dr Zaki Almallah, a consultant urologist at BMI Priory Hospital in Birmingham. "A significant number of men will continue to have a normal libido as they get older."
So, if not age, then what causes libido to decline?
Sometimes the problem is physical and other times it is psychological, but it can be a combination of both.
Sally Austen, a consultant clinical psychologist, says that first thing she would do if someone came to her, suffering from a loss of libido, would be to send them for a medical check-up. "There are so many physical causes of loss of libido," says Dr Austen, "some of which are quite significant like heart or circulation problems."
Here are some of the reasons men lose their libido:
Testosterone levels in men fall by about 1-2% per cent a year as they age. Men with testosterone deficiency will have low energy, poor concentration and reduced libido.
"Libido is related to the level of testosterone," says Dr Almallah. "If your testosterone is low, your libido will be low."
Men who have low testosterone are sometimes prescribed testosterone replacement that comes in gel, tablet, capsule, patch and injection forms. Although testosterone can boost libido, it does not always improve a man's erection. Also, testosterone may reduce a man’s sperm count and negatively affect his fertility, so it is not recommended for couples who are looking to conceive.
Impotence, or erectile dysfunction (ED), is not the same as loss of libido, but when you experience one, sooner or later you are more likely to feel the other as well.
Although ED medications can't increase a man's libido, they can help overcome the anxiety caused by not being able to perform in bed. And anxiety is a real libido killer.
"If someone's got a physical problem that they then worry about, to break that cycle and have a few good evenings where everything works better than usual, gives men a chance to get their confidence back and to break that cycle of worry, which has been deflating things," says Dr Austen. "It is a purely, temporary, physical intervention but most erectile dysfunction has at least an element of anxiety in it, so you're breaking that cycle of anxious thinking, raising their confidence and getting their self-esteem back so that they can enjoy sex again rather than dread it."
Sometimes, not being able to get an erection is a sign of a more serious underlying health problem, such as heart disease. If you speak to your GP, he will assess your overall health before prescribing ED medication.
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