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It is generally assumed that if a man’s sexual drive is low, reduced levels of testosterone are to be blamed. But is it true in every case? Do all men suffering from decreased libido have low testosterone levels? Does libido only depends on testosterone?

Although several studies have shown that a reduction in the levels of testosterone can reduce a man’s sex drive, it is not the only cause of low libido. There are no studies which throw light on how testosterone levels affect the sex drive.

There are instances when men are satisfied with their libido even with relatively low levels of testosterone. And, on the other hand, there are men who experience a low libido even with normal levels of testosterone.

So what exactly are the causes behind a low libido? Let’s examine.

Causes of low sex drive


One of the top most reasons behind low sex drive is stress. Stressful situation in the workplace can play havoc with your sex life. Chronic stress can lead to a drop in the androgen levels leading to problems like erectile dysfunction. Stress can also distract your mind away from sex resulting in low libido.


Depression and libido are complicatedly inter-related. Depression can lead to multiple changes in the normal biochemistry of the body resulting in a reduced libido. It is difficult for a person who is depressed to get interested in sex.


Medicines used to treat hypertension and depression can also affect libido. Antidepressants like SSRI fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft) cause a decline in sexual functions or libido despite an improvement of depression. Similarly, use of tricyclic antidepressants and monoamine oxidase inhibitors can also lead to a decrease in libido.

Sleep deprivation

When you are deprived of sleep, you would rather catch up on it than indulging in sex. It is imperative for a healthy sexual life to have adequate sleep. Researchers say that sleep deprivation can lead to an increase in the level of cortisol which, in turn, leads to reduced libido.

Alcoholism and drug abuse

While small quantity of alcohol helps you in shedding your inhibitions, chronic alcoholism can impair your nervous system and give rise to fatigue. This leads to a fall in libido. Chronic alcoholism can also lead to liver cirrhosis. Liver is responsible for the metabolism of estrogen. Any disruption in the functioning of liver will eventually lead to estrogen –testosterone imbalance in the body resulting in reduced libido. Similarly, marijuana abuse depresses the pituitary gland which is responsible for stimulating the testicles to produce testosterone.

Erectile Dysfunction

ED is one of the commonest causes of reduced libido. And ED is caused due to atherosclerosis of the vessels. Atherosclerosed blood vessels supplying the penile tissue cannot dilate to bring in the increased amount of blood flow. Therefore, it becomes difficult to sustain the erection.

Metabolic conditions

Metabolic conditions like diabetes, high blood pressure and high cholesterol can lead to atherosclerosis of the blood vessels. This may lead to erectile dysfunction and reduced libido.

Testosterone accounts for only a minority of cases of erectile dysfunction. It is only when other causes of reduced libido are ruled out and one can safely conclude that the reduced libido can be attributed to the low levels of testosterone, that one must consider the option of testosterone therapy.

Always remember that what one man feels as a low sex drive might be perfectly normal for another. There are no clinical parameters to decide what should be the optimal frequency of sex. It is for the couples to decide what suits them best. However, if they are sure that they are suffering from a low libido due to reduced level of testosterone, they can consider replacement therapy. But one must always keep in mind the pros and cons of testosterone replacement therapy. 

  • “The Relationship between Libido and Testosterone Levels in Aging Men”, by Thomas G. Travison, et al, published in 2006 in the Journal of Clinical Endocrinology and Metabolism, accessed on March 10, 2013
  • “Depression and Sexual Desire”, by Robert L. Phillips, et al, published in the August 2004 issue of the journal American Family Physician, accessed on March 10, 2013
  • “Low Testosterone and Sex Drive’, reviewed by Brunilda Nazario on June 12, 2012, published in WebMD, accessed on March 10, 2013.
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