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Libido/Sex Drive

Kelly Brown MD, MBA

Reviewed by Kelly Brown MD, MBA

Written by Erica Garza

Published 10/10/2024

A common stereotype about guys of all ages is that sex is always on the mind. In fact, for years, people believed men thought about sex every seven seconds, though a 2011 study corrected that stat (it’s actually around 19 thoughts a day).

If you’re struggling with a low libido (low sex drive), you probably aren’t thinking about sex every day. Or, maybe instead of fantasizing about sex, you’re wondering why you don’t feel like having it lately.

While libidos vary greatly between individuals and change over time, when a lack of sexual interest causes distress for you and/or your partner, you may be struggling with a sexual dysfunction. Stress, low testosterone, and even erectile dysfunction (ED) can all contribute to a low libido.

In this guide, we’ll discuss how your sex drive works, what causes a high or low sex drive, and what you can do to increase your libido for a more fulfilling sex life.

A man’s libido refers to his sex drive or desire for sex. It’s influenced by a combination of biological and psychological factors.

Biologically, sex hormones like testosterone and neurotransmitters like dopamine regulate the libido, helping to prime the brain to become sensitive to internal and external sexual cues. Medical conditions, medications, and lifestyle habits that alter these hormones and neurotransmitters can lead to fluctuations in your sex drive.

Your libido is also governed by psychological and social factors like stress, mental health conditions, and even relationship dynamics.

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Sex drive varies between individuals and can fluctuate over one’s lifetime. If you have less interest in sex now than you did at the start of your relationship or when you were a teenager, it doesn’t necessarily indicate a problem.

However, if your libido has suddenly shifted or your lack of sexual activity is causing issues for you and your partner, you may want to seek advice from a healthcare professional to rule out medical or mental health issues.

“Sex drive is complicated and very multifactorial,” explains Dr. Peter J. Stahl, MD, SVP of Men’s Sexual Health & Urology at Hims & Hers. “As a urologist, I tend to approach libido from a very medical POV. That means first checking for organic causes of low sex drive like hormonal imbalances, medication side effects, and other sexual problems like ED that could be contributing.” He says once those biological issues are ruled out or successfully treated, he encourages patients to address psychological and relationship issues with a sex therapist, psychiatrist, or psychologist.

It’s not unusual to go through periods in your life where your sex drive is high, like at the start of a brand new relationship. But a high sex drive can also be caused by higher testosterone levels, drugs, and even your exercise routine.

Factors that may cause a high sex drive in men:

  • Sex hormones. Since testosterone plays a key role in libido, higher testosterone can also contribute to a higher sex drive. In some cases, higher free testosterone, the type that is unbound to proteins, can lead to such high sexual desire that it triggers compulsive sexual behavior.

  • Exercise. Moderate-intensity exercise has also been shown to increase sexual functioning in men (including ED) by boosting testosterone levels.

  • Increased emotional intimacy. Research suggests that higher levels of intimacy are correlated with higher levels of sexual desire in long-term relationships.

  • Drugs. Recreational drugs like cocaine may increase sexual desire, potentially leading to risky behavior like unprotected sex.

Having a high sex drive doesn’t necessarily mean you have hypersexuality or will engage in compulsive sexual behavior. But for some men and women, a persistent high sex drive and low self-control can lead to health issues and problems in your relationships. It’s best to reach out to a healthcare professional if your sex drive has become problematic for you. Learn more about how to stop male arousal.

What if your partner has a high sex drive but you don’t? Check out these tips on how to date a woman with a high libido.

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Around eight percent of men deal with hypoactive sexual desire disorder, which refers to a persistent or recurrent lack of desire for sexual activity, sexual fantasies, and masturbation. Researchers think this occurs when brain areas involved with sexual desire become less active, and areas involved with self-monitoring behavior become hyperactive. This shift leads to a lack of sexual desire and increased distress.

But not every guy with a low libido has hypoactive sexual desire disorder. Certain health conditions like low testosterone or heart disease can contribute to a lower sex drive than normal. Mental health conditions and relationship issues can also cause a low sex drive.

Factors that cause a low sex drive in men include:

  • Low testosterone. If high T can cause a high sex drive, it makes sense that low T can cause a low sex drive. Decreased libido is one of the most common symptoms of low testosterone, and studies show that testosterone therapy can help reverse this and other aspects of sexual function.

  • Stress. Studies show that stress can interfere with sex hormone secretion and also distract individuals from sexual cues, leading to a low libido.

  • Mental health conditions. Mental health issues like depression are known to decrease sexual desire and overall satisfaction with sex. It can also cause orgasm problems.

  • Medication. One of the most common side effects of antidepressants is low libido, as shown in numerous studies. Some drugs for high blood pressure have also been shown to affect libido.

  • Medical conditions. Cardiovascular diseases, including heart failure, heart attack, and congenital heart disease, are linked to low sexual desire. Sleep apnea can also affect your sex drive, likely by lowering your T levels.

  • Sexual problems. Having another sexual dysfunction like ED or premature ejaculation increases your chances of having a low libido as sexual activity becomes a source of stress and shame.

  • Relationship issues. Relationship issues can cause a lack of intimacy between partners. This can lead to a lower sex drive.

If you’re dealing with a low libido, you should reach out to a healthcare provider to figure out what’s going on. They may run a blood test to rule out low testosterone or other health conditions that may be contributing.

Women also deal with low sex drive or hypoactive arousal disorder, often due to hormonal changes like menopause. Along with a low libido, they may experience vaginal dryness or painful sex due to a drop in estrogen.

Low sex drive in women can also be triggered by hormonal contraception (like birth control pills) or breastfeeding. If you have a female partner struggling with a low sex drive, she may be dealing with hormonal imbalances. She can ask her gynecologist about hormone therapies and make sex more comfortable with lubricants or more foreplay.

From hormone therapy to lifestyle changes, there are many things you can do to increase your libido.

They include:

  • Testosterone treatment. According to Dr. Stahl, many patients who visit their providers for low libido end up finding out they have low testosterone. He says treatment to raise their testosterone levels can be “transformative,” leading to “meaningful improvements in libido, energy, physical strength, mood, body composition, and even motivation." Research backs this up. In a study of middle-aged and older men with low T and low libido, two years of testosterone replacement therapy improved sexual activity, low T symptoms, and sexual desire.

  • Therapy or counseling. If you suspect that your low libido is due to a mental health condition or chronic stress, meeting with a sex therapist or counselor can be helpful.

  • Treatment for other sexual dysfunctions. While ED medication like Viagra® (sildenafil) or Cialis® (tadalafil) won’t increase your libido directly, treating this sexual dysfunction may make sex less stressful and indirectly increase your sex drive. Treatment for premature ejaculation can work similarly. Lasting longer in bed can help reduce anxiety that may be driving your libido down.

  • Treatment for other medical conditions. If your low libido is caused by other medical conditions like sleep apnea, getting treatment may help improve your sexual functioning.

  • Lifestyle changes. More physical activity, a better diet, and more sleep may help improve your sex drive naturally.

The one-stop sex shop

Your libido is an important part of your sex life, so when something goes awry, you’ll want to find a solution fast. Remember:

  • There’s no such thing as a normal sex drive. While having a lower libido from time to time isn’t usually cause for concern if you’re under stress or not feeling well, you should seek help if it causes distress for you and your partner.

  • Your sex drive is influenced by biological and psychological factors. From your hormones to your stress levels, there are many different causes of a high or low sex drive.

  • Want to know how to increase male libido? Get your testosterone levels checked, rule out other medical conditions, and consider therapy or counseling if you’re struggling with low libido.

For more knowledge on how to increase your sex drive, check out which drinks might boost your libido, find out if men stop being sexually active at a certain age, and explore a full range of sexual health products here.

16 Sources

  1. American Psychological Association. (2018). Stress effects on the body. https://www.apa.org/topics/stress/body
  2. Ballester-Arnal RA, et al. (2023). Salivary testosterone levels are associated with Compulsive Sexual Behavior (CSB) in men but not in women in a community sample. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562815/
  3. Fisher TE, et al. (2011). Sex on the Brain?: An Examination of Frequency of Sexual Cognitions as a Function of Gender, Erotophilia, and Social Desirability. https://www.researchgate.net/publication/51070065_Sex_on_the_Brain_An_Examination_of_Frequency_of_Sexual_Cognitions_as_a_Function_of_Gender_Erotophilia_and_Social_Desirability
  4. Higgins AG, et al. (2010). Antidepressant-associated sexual dysfunction: impact, effects, and treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108697/
  5. Johnson MA, et al. (2016). Cocaine administration dose-dependently increases sexual desire and decreases condom use likelihood: The role of delay and probability discounting in connecting cocaine with HIV. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343757/
  6. Khoo JO, et al. (2013). Comparing effects of low- and high-volume moderate-intensity exercise on sexual function and testosterone in obese men. https://pubmed.ncbi.nlm.nih.gov/23635309/
  7. Lou IN, et al. (2023). Relationship Between Hypertension, Antihypertensive Drugs and Sexual Dysfunction in Men and Women: A Literature Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629452/
  8. Mills ED, et al. (2023). Effects of Kisspeptin on Sexual Brain Processing and Penile Tumescence in Men With Hypoactive Sexual Desire Disorder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9898824/
  9. Mun JU, et al. (2018). Sleep and libido in men with obstructive sleep apnea syndrome. https://pubmed.ncbi.nlm.nih.gov/30340202/
  10. Nascimento EL, et al. (2013). Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3812559/
  11. Pencina KA, et al. (2024). Effect of Testosterone Replacement Therapy on Sexual Function and Hypogonadal Symptoms in Men with Hypogonadism. https://pubmed.ncbi.nlm.nih.gov/37589949/
  12. Rizk PA, et al. (2018). Testosterone Therapy Improves Erectile Function and Libido in Hypogonadal Men. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649360
  13. Rodríguez-Nieto GE. (2021). Individual Differences in Testosterone and Self-Control Predict Compulsive Sexual Behavior Proneness in Young Males. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8677662
  14. Thakurdesai AB, et al. (2018). A prospective study on sexual dysfunctions in depressed males and the response to treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278224/
  15. Van Lankveld JA, et al. (2018). The associations of intimacy and sexuality in daily life. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987853/
  16. Waldinger MA. (2015). Psychiatric disorders and sexual dysfunction. https://www.sciencedirect.com/science/article/abs/pii/B9780444632470000274
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kelly Brown MD, MBA
Kelly Brown MD, MBA

Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown was previously Medical Director of a male fertility startup where she lead strategy and design of their digital health platform, an innovative education and telehealth model for delivering expert male fertility care.

She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.

Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.

Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.

Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.

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