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.
The Difference Between Impotence and Low Libido
"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 to increase.
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 problem.
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.