Nov. 7, 2001 -- Which sexual problem do men find hardest to
discuss? Well, it's not premature ejaculation, which the Journal of the
American Medical Association cites as the most common sexual dysfunction.
And it's certainly not erectile dysfunction, which even a former presidential
candidate has discussed in detail on national television. No, the answer is low
sex drive, or low "mojo," as Austin Powers would put it.
What defines a low libido for an individual is subjective and
depends upon many variables, says Richard Kogan, M.D., a psychiatrist in
private practice who specializes in the treatment of sexual dysfunction in New
York City. Physical and mental health are key factors, and although many men
are happy exceptions to the trend, sex drive generally decreases with age.
Listening to Andy Garcia talk about his son's latest hobby, you get the
sense that a toy caboose is just as important to the actor, director, and
musician as the release of his latest feature film, Ocean's Thirteen,
which opened last month to fanfare, here and abroad.
"He plays a lot of trains," Garcia says of the 5-year-old aficionado, and
then adds with gravitas: "He's an avid collector."
Unlike some of his overtly ambitious, publicity-seeking peers, Garcia, 51,
is a private man who treasures...
"Impotence and loss of libido are two very separate
things," says Richard Milsten, MD, a New Jersey-based urologist and
co-author of The Sexual Male. However, men who experience impotence
commonly experience a decrease in libido over time, he adds. When libido drops
and impotence, or erectile dysfunction, is not a problem, there are numerous
factors a doctor might suspect as the cause.
When You're Sick, Libido Suffers
Any medical problem or chronic physical condition can reduce a
man's sex drive. If a man is diagnosed with cancer, sex may be the furthest
thing from his mind for a time. But even minor illnesses can diminish a man's
sexual interest. Conversely, when men improve their health -- through exercise,
a low-fat diet, or, if necessary, medical treatment -- their libido is likely
While any illness can decrease sex drive, some conditions, such
as thyroid disease, tumors of the pituitary gland (which controls most hormone
production, including sex hormones), and depression, are directly linked to low
libido, according to Milsten. Similarly, insufficient amounts of the male sex
hormone testosterone may cause low libido, though such a condition is unlikely
to affect erectile function. Kogan advises men who feel their physical
condition has decreased their sex drive to consult a physician, keeping in mind
that loss of libido is sometimes the only recognizable symptom of a medical
The Sexual Side Effects of Drugs
Drugs can also decrease libido. Many prescription
antidepressants can diminish sex drive. Other medications with this side effect
include tranquilizers and blood pressure medications. Illicit substances, such
as heroin, cocaine, and marijuana, when used heavily and chronically, may lower
libido, according to Milsten. He suggests that if a prescription medicine has
hampered a man's sex drive to a distressful degree, he should ask his doctor
about the possibility of swapping the medication with a similar-functioning one
that doesn't cause sexual side effects.
Stress Can Sabotage Sex Drive
Imagine this scenario: You and your dream lover are naked in
bed together. Then, all of a sudden, a stranger barges into the room with a
gun. You've just lost all interest in sex, and now the only plan you have for
your privates is keeping them out of harm's way. In short, you've reprioritized
your activities as a survival instinct.
This is an extreme example, but any kind of serious stress --
whether related to work, relationships, or any other area of life -- is going
to diminish your sex drive. To have a healthy libido, you need to be engaged in
the moment -- not angry or hurt. If you're having shouting matches with your
partner, your libido is nearly certain to take a nose-dive, says Milsten.
Fortunately, if you work on your differences and good feelings are restored,
sex drive is likely to return to baseline levels.
Some problems, however, such as depression or anxiety, intense
job stress, family worries, serious marital conflicts, experiences of past
abuse, or conflicts about sexual orientation may require professional
assistance. It is essential to seek such help if negative feelings interfere
with the rest of life, if they are overwhelming, or if you are no longer able
to experience pleasure.