Low Libido in Men

Low libido means your desire for sex has dropped. You may think about sex less, initiate less, need more to get turned on, or simply realize that you do not want it the way you used to.

The change may be obvious or gradual. When low desire is persistent and causes personal or relationship distress, it may be diagnosed as male hypoactive sexual desire disorder, or HSDD.

You do not need a diagnosis to want more. At Bawa Medical, the goal is to restore or optimize desire, sexual function and performance while helping men protect their SexSpan™.

Male libido depends on more than age. Hormones, overall health, medications, blood flow, sexual performance, sleep, stress, depression and relationships can all affect desire, and several factors often overlap.

Hormones

Testosterone plays an important role in male libido, but it is not the only hormone that matters. Thyroid hormones, prolactin, estradiol and SHBG may also affect sexual function, which is why Dr. Bawa looks beyond a single testosterone result.

In a placebo-controlled trial of 470 men with low testosterone and low libido, testosterone treatment significantly improved sexual desire and sexual activity. [3]

For men who want to support their body’s own testosterone production, DSF.me® Renew® is Dr. Bawa’s U.S.-made testosterone booster taken at night.

Overall Health

Weight gain, diabetes, cardiovascular disease, chronic illness, fatigue, poor sleep and sleep apnea can all contribute to lower desire. In men with type 2 diabetes, about one in four reported low sexual desire, while men reporting poorer overall health had more than three times the odds of low libido. [2,4]

A declining sex drive can be a clue to something bigger.

Medications

Antidepressants, some blood-pressure medications, opioids and finasteride can reduce desire, alter hormones, affect sensation or interfere with sexual performance. Dr. Bawa reviews medications as part of the evaluation to identify possible contributors and appropriate alternatives.

Performance and Blood Flow

Libido and sexual performance affect each other. When erections are stronger, sensation is better and sex feels more rewarding, desire may improve. When performance declines, sex can begin to feel like work and desire may fade.

Nearly one-third of men seeking help for erectile dysfunction who did not think they had low libido actually screened positive for it. [1] Improving circulation, tissue health, sensation and performance can therefore be an important part of improving the sexual experience.

Stress, Depression and Performance Anxiety

Stress, depression, anxiety and performance anxiety can all affect libido. When sex starts to feel stressful instead of exciting, a man may think about it less, initiate less or begin avoiding it.

In a study of 228 couples, greater sexual performance anxiety was associated with greater sexual distress and lower sexual and relationship satisfaction for both partners. [5] Men with depression had approximately three times the odds of low libido. [2]

Physical and emotional factors often reinforce each other, which is why both should be considered when desire changes.

Learn more about Performance Anxiety in Men.

The best place to start is by identifying what is affecting your desire and what else can be improved at the same time. The Bawa Method looks at libido as part of a connected system that includes hormones, circulation, tissue health, sensation, performance, medications, weight, sleep and overall health.

A man whose hormones need improvement may need a different plan from one whose declining performance has made sex less rewarding. Better performance can also lead to better libido, which is why Dr. Bawa may incorporate treatments that improve circulation, erection quality, sensation and overall sexual function when appropriate.

Dr. Bawa may also incorporate DSF.me® supplements into a broader plan. Renew® supports the body’s natural testosterone production, Passion® supports libido and sexual desire, and Enhance® supports nitric oxide production, blood flow and circulation. These supplements can be combined with Bawa Medical treatments to support libido, hormones, circulation, sensation and performance.

You should not wait for something to decline. Men can optimize sexual wellness proactively and protect their SexSpan™ while things are still working well.

Treatment options may include:

• Testosterone
• DSF.me®

When a man's desire changes, his partner often notices. Less initiation can feel like rejection, while the man may be dealing with hormones, health changes, declining performance, stress or anxiety that he has not fully understood or discussed.

That emotional distance can matter. Men who did not feel emotionally close to their partner during sex had 3.7 times the odds of low sexual interest. [2] Addressing low libido can help restore connection, confidence, communication and a sexual life both partners can enjoy—and for some couples, protecting that connection can also help strengthen the relationship and keep the family unit intact.

1. Cilio S, Boeri L, Pozzi E, et al. Prevalence and predictors of unrecognised low sexual desire/interest in men with new onset erectile dysfunction: findings from a cross-sectional, real-life study. International Journal of Impotence Research. 2024;36:83-88. doi:10.1038/s41443-022-00647-4.

2. Graham CA, Mercer CH, Tanton C, et al. What factors are associated with reporting lacking interest in sex and how do these vary by gender? Findings from the third British National Survey of Sexual Attitudes and Lifestyles. BMJ Open. 2017;7:e016942. doi:10.1136/bmjopen-2017-016942.

3. Cunningham GR, Stephens-Shields AJ, Rosen RC, et al. Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels. Journal of Clinical Endocrinology & Metabolism. 2016;101(8):3096-3104. doi:10.1210/jc.2016-1645.

4. Pedersen MB, Giraldi A, Kristensen E, Lauritzen T, Sandbæk A, Charles M. Prevalence of sexual desire and satisfaction among patients with screen-detected diabetes and impact of intensive multifactorial treatment: results from the ADDITION-Denmark study. Scandinavian Journal of Primary Health Care. 2015;33(1):3-10. doi:10.3109/02813432.2014.1002295.

5. Bockaj A, Muise MD, Belu CF, Rosen NO, O'Sullivan LF. Under Pressure: Men's and Women's Sexual Performance Anxiety in the Sexual Interactions of Adult Couples. Journal of Sex Research. 2025;62(8):1442-1454. doi:10.1080/00224499.2024.2357587.