Decrease in libido – hormonal, psychological, and metabolic causes

A decrease in libido is a reduction in sexual desire, which can have hormonal, psychological, or somatic origins. Persistent drive disorders require diagnostics, as they may be a symptom of testosterone deficiency, depression, chronic diseases, or side effects of medications.

• The most common cause in men is testosterone deficiency.
• Depression and chronic stress significantly lower sexual drive.
• Menopause is associated with a decrease in sex hormones.
• Diabetes and obesity worsen sexual functions.
• SSRIs often cause libido disorders.

See also: Contraception for teenagers: when is an online consultation sufficient?

Is testosterone deficiency the main cause of decreased libido?

A decrease in libido in men is most often associated with testosterone deficiency, which plays a key role in regulating sexual drive.

Reduced testosterone levels can result from age, obesity, chronic diseases, or disorders of the hypothalamic-pituitary-gonadal axis. Symptoms often accompany fatigue, low mood, and loss of muscle mass.

In women, testosterone levels also affect libido, especially during menopause when the production of sex hormones decreases.

Do menopause and hormonal disorders affect sexual drive?

A decrease in libido in women often occurs during menopause.

A reduction in estrogen and androgen levels can lead to vaginal dryness, pain during intercourse, and a decrease in sexual desire. These changes are hormonal in nature but often coexist with psychosocial factors.

Excess prolactin and thyroid diseases can also disrupt hormonal balance and affect libido. Prolactin and thyroid hormones are measured in diagnostics.

Can depression, stress, and medications lower libido?

A decrease in libido often has a psychological basis.

Depression affects neurotransmitters that regulate pleasure perception and sexual motivation. Chronic stress leads to increased cortisol, which disrupts hormonal balance and can lower drive.

Antidepressants from the SSRI group are among the most common pharmacological causes of libido disorders. In such cases, therapy modification is possible after consulting a doctor.

Do chronic diseases contribute to decreased drive?

A decrease in libido can accompany metabolic and cardiovascular diseases.

Diabetes leads to damage to blood vessels and nerves, which worsens sexual functions. Sleep apnea syndrome causes chronic fatigue and lowers testosterone levels.

Additional factors include:

• Obesity
• Hypertension
• Heart diseases
• Alcohol abuse
• Nicotine smoking

In some cases, a specialist consultation, e.g., with a sexologist, is indicated.

Herbal preparations, such as maca root or ginseng, are under research, but their effectiveness is moderate and requires further analysis.

Q&A

Is a decrease in libido normal with age?
It may occur, but persistent disorders require medical evaluation.

Are hormonal tests necessary?
In many cases, measuring testosterone and prolactin is justified.

Can stress completely inhibit drive?
Yes, chronic stress significantly affects sexual functions.

When should you see a doctor?
When the symptom persists for a long time and affects quality of life.

Sources:

1. Corona G et al. Testosterone deficiency and sexual dysfunction. Lancet Diabetes & Endocrinology.
2. Clayton AH et al. Sexual dysfunction and depression. Journal of Clinical Psychiatry.
3. NICE Guidelines. Menopause: diagnosis and management.
4. ADA Standards of Care. Diabetes and sexual health.
5. Melmed S et al. Hyperprolactinemia. New England Journal of Medicine.