TRT & The Male Sex Drive

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Low sex drive in men is a common issue. It can often be confused with erectile dysfunction, although both issues can affect each other. There are many causes of low sex drive, some psychological, some physical and some caused by hormonal issues such as low testosterone. The treatment depends on the cause of your low sex drive, for low testosterone TRT is a good treatment option. For psychological causes you may need to find a way of reducing stress or seeing a psychologist.

Is low sex drive in men common?

Low sex drive, or low libido, is something that most adults will experience at some time in their lives.

This could be due to stress, illness, mood, lack of a sexual partner or hormonal changes. It is normal to not have a high sex drive the whole time, but what about if you are noticing that you are never in the mood?

Low sex drive in men is less common than in women, probably due to hormonal differences. However, it does still occur, particularly in older men.

Here we explore the different causes of low sex drive in men as well as the potential treatment options that may help you to fire up your libido again!

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ADAM Questionnaire

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The ADAM questionnaire has been shown to have 88% sensitivity in testing for low testosterone.

Low sex drive or erectile dysfunction?

Whilst a lot of men suffer from erectile dysfunction (ED), low sex drive or low libido is quite different.

Men who have ED often want to have sexual intercourse but find that they can’t ‘get it up’ when the time comes.

They may also find that they can get an erection sometimes, or partially, but that it doesn’t allow proper sex to occur. These men are trying to have sexual intercourse but can’t for physical reasons.

If this is you, then it may be that you have a physical reason for your erectile dysfunction that requires a doctor’s input, this is particularly true for older men who have health issues. For some men,tadalafil and viagra are good ways of treating erectile dysfunction, for others, it is hiding a different issue. This can be something more serious or a warning sign of health issues.

Having a low sex drive in men is different.

Men may find that they are not at all interested in sex, they don’t think about it and they certainly don’t instigate it with their partners. As they aren’t interested, they aren’t sexually aroused and therefore also won’t have an erection. This can be called secondary erectile dysfunction, as the erection issue is secondary to having a low libido.

This can lead to their partners becoming frustrated and even thinking that the man is cheating or not interested in them anymore.

In the worst cases, it can lead to break-ups or the partner looking for sex elsewhere.

Clearly, this is a serious issue with real repercussions and often a lot of embarrassment for the man involved.

Causes of low sex drive in men

As with erectile dysfunction, there are many potential causes of low sex drive in men.

Some of the reasons for low testosterone are physical in nature whereas others are psychological/mental in origin.

Another common cause is hormonal issues which can have a direct effect on how much sexual desire someone has.

Physical causes

Common causes of low sex drive in men

•  Restless legs syndrome

Also known as Willis-Ekbom disease, this issue causes an overwhelming desire to move one’s legs. It may also be accompanied by strange sensations, both of which may lead to a lack of sexual desire.

•  Sleep problems

Having not enough sleep may lead to fatigue or exhaustion. Again this can mean that the body does not prioritise sex.

Psychological or mental causes

•  Sexual problems – e.g. premature ejaculation or erectile dysfunction.

Both of these issues can stem from psychological sources but cause a man to be put off having sex as they are embarrassed at not being able to perform in the bedroom.

•  Stress

Stress can have a major impact on a man’s sex drive. Low sex drive is common in those with high-stress jobs or who have anxiety – the mind is racing and in a place where sex is not considered. The body may be in a fight or flight mode which means sexual desire is not a priority.

•  Depression

Similar to the above, low mood can really kill libido. Those with depression are often not in the right headspace to be thinking about sex and therefore have a low sex drive.

 Low self-esteem

Having low self-esteem may mean that a man is embarrassed to initiate sex or is worried about getting undressed. This can lead to stress and mental barriers which stop any sexual desires from occurring.

Hormonal Causes

•  High oestrogen in men

In men, having a high oestrogen level can actually reduce sex drive. This is common in men with high body fat percentages or those on testosterone whose dose is too high or who convert more testosterone into oestrogen.

•  High prolactin

Prolactin is released when a man ejaculates and prevents the man from ejaculating again too soon after. This is called the refractory period.

Whilst less common, a very raised prolactin can cause issues with sex drive.

Men who have had a baby recently are also more likely to have raised prolactin. This can lead to issues with libido – there may be an evolutionary reason for this. It may also be very raised in some men if they have something called a prolactinoma. This is a pituitary issue where the pituitary gland produces very high amounts of prolactin due to a non-cancerous tumour.

•  Low testosterone

Low-sex-drive low testosterone tank

The most common cause of low sex drive in men. A low testosterone is closely linked to having a low sex drive.

Men with low testosterone will notice that their libido is low and sex becomes less interesting. Men report that instead of being sexually aroused, they find attractive partners to appear ‘more like art than someone they want to have sex with’.

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Treatments for low sex drive


Having a lack of sleep can cause a drop in sex drive in men.

Improving sleep through better sleep hygiene is really important to ensure you are not tired.  Sleep hygiene involves going to bed at regular times each day, making sure the sleep environment is dark, cool and free of loud noise (you can use ear plugs and eye masks to help with this), and avoiding screens and blue light a few hours before bed.

Lack of exercise

If you are not exercising then your body is not prepared for sex and may have less energy. This can impact your sex drive. It may also lead to weight gain which can affect hormone levels. Ensuring that you get some regular exercise, at least a few times a week, ensures that you are healthy and fit.

Sexual issues – Erectile dysfunction

Erectile dysfunction is a serious and common cause of low sex drive in men. It is impossible to have sex without an erection, and not being able to get an erection can affect men mentally, making libido lower.

Whilst there are many potential causes of erectile dysfunction, medications such as sildenafil (Viagra) and tadalafil (Cialis) are very effective at improving blood flow to the penis and therefore erections.

Please contact us for more information on how to get these treatments.

Psychological – Stress and low sex drive

There are lots of mental causes of low sex drive. One of the main ones is high stress-levels.

Mindfulness/meditation can be a very effective way of reducing stress.  Exercise releases endorphins which can also reduce stress and improve sex drive.

Seeing a psychologist or psychiatrist can be useful for discussing mental health issues and working through any problems you may have.

High Oestrogen

If you have high oestrogen levels then this is usually due to a higher body fat percentage or your genetics. It can also be related to a low testosterone or other hormonal disturbances.

Losing bodyfat through a reduction in calories can reduce the amount of testosterone converted into oestrogen.

An aromatase inhibitor, for men with genetic issues, inhibits the aromatase enzyme and reduces the amount of oestrogen produced.

High prolactin

Prolactin levels can be high for a number of reasons. It can be raised in men when they have children, which reduces their sex drive for natural reasons.  If you suspect this then our blood test will tell you whether prolactin levels are raised (greater than 1000 in this case), you should also speak to your GP.

In this case you will need to see an endocrinologist to have an MRI scan of your brain, treatment usually involves taking tablets to reduce the size and effect of the tumour.

Low testosterone

If you suspect low testosterone is the cause of your symptoms then the first step is to get a blood test to see whether your levels are low.

If low then the usual treatment is testosterone replacement therapy – the replacement of testosterone levels with injections, pellets, gels or creams.


Low sex drive is a common symptom that is seen in men for many different reasons.

You don’t need to suffer with this symptom in silence.

Our simple blood test will tell you whether low testosterone is an issue. We can offer testosterone replacement and oestrogen control for men with hormonal disturbances, we can also offer erectile dysfunction medications on prescription, such as tadalafil (Cialis) or sildenafil (Viagra).

Contact us for more information below.

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