Low sex drive and low testosterone – what’s the link?

Low sex drive 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.

Testosterone is something that is associated with increasing sex drive but often low testosterone and low sex drive are not thought of as related.

Here we look at how low testosterone levels can impact your sex drive and what you can do to fix a low libido!

Low sex drive or erectile dysfunction?

Whilst a lot of men suffer from erectile dysfunction, 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 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

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

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


Low sex drive and low testosterone symptoms

– 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.

– Low testosterone

The most common cause of low sex drive. 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’.

What to do if you have a low sex drive caused by low testosterone

The first step is to get a blood test and get reviewed by a specialist.

Without a blood test, you do not know if this is definitely the cause. As you can see there are lots of different potential explanations as to why you may have a low sex drive.

Low sex drive and low testosterone ED

However, if you also have some of the other symptoms associated with low testosterone then this may indicate that your low sex drive and low testosterone are linked.You can check whether you have other low testosterone symptoms here.

The most common symptoms other than low libido are:

– Low mood

– Low energy

Erectile dysfunction

– Reduced muscle mass

– Brain fog

– Poor motivation

– Reduced height (usually in older men due to reduced bone density)


Low sex drive is a common symptom that is seen in men with low testosterone.

Whilst other conditions, such as depression, can cause this issue, low testosterone is a common cause and one worth investigating.

Low sex drive and low testosterone go hand in hand, if you are suffering from low libido then get in touch to find out how we can help with either low testosterone or erection issues.

Our simple blood test will tell you more about whether low testosterone is an issue.

You can read more about testosterone replacement therapy here.

Dr Chris Airey

Dr Chris Airey

Medical Director

This article has been medically reviewed for accuracy by Dr Airey on 12th September 2020.

Dr Chris Airey is a fully registered UK doctor with the GMC (General Medical Council) Reference No: 7490533.
He trained at the University Hospital Southampton and graduated as a Doctor with a joint Bachelor of Medicine and a Bachelor of Surgery, plus a Masters in Medical Science, completing his research project in the Medical Neurosciences Department.
He is undertaking a Master of Science course in Endocrinology and is a member of the European Society for Sexual Medicine, and the Androgen Society.
He has personal experience with taking Testosterone Replacement Therapy and is a pioneer in UK treatment protocols for Testosterone Deficiency Syndrome.