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Low libido

What’s testosterone got to do with it?

Article Author: Katelyn Vogt

Article Date:

Couple sitting on a fence

Libido, or desire for sex, varies widely from one person to the next. When sex drive is diminished in men, testosterone levels are often assumed to be the culprit. However, according to Lael Stieglitz, MD, a urologist with Baptist MD Anderson Cancer Center, this is often not the case.

Drivers of sex drive

While studies have shown low testosterone levels can cause low libido, there isn’t a direct relationship between the two. Men can have normal and even high testosterone levels and still experience a reduced sex drive.

“Low libido is multi-factorial. If it’s related to low testosterone and replacing the hormone fixes it, then that’s a great outcome. But it usually isn’t that simple,” Dr. Stieglitz said.

Instead, Dr. Stieglitz suggested examining what’s going on in the person’s everyday life. Libido can be affected by a multitude of factors including:

  • Stress
  • Life changes (such as a new medical diagnosis or caring for an ill family member)
  • Challenges with self-confidence
  • Anxiety
  • Performance anxiety
  • Depression
  • Medication

“Libido starts in the brain. As I evaluate patients who complain about low sex drive, I often find that life stressors are the main source,” she said. “This is when you need to ask yourself, ‘What’s going on in my life that's affecting me this way?’ It’s not an easy question, but if you try, there’s usually an answer – or several.”

Boost your mood

So, if you’re experiencing a lowered sex drive, how can you increase it? Dr. Stieglitz recommended determining the root cause and reaching out to your primary care physician for medical advice.

“If a man has low libido related to self-confidence with his erections, I often find that fixing the erections restores libido,” she said. “The bigger issue is that we don’t talk about these things, and sexual health should be a part of general medical care.”

It may feel uncomfortable to bring up sensitive subjects with your physician, but you can’t fix it if you don’t talk about it! And for challenges with reduced libido, there are a range of treatment options available.

“We’ve been trying to break down this communication barrier for decades,” Dr. Stieglitz said. “Talking about sex should not be taboo.”

Conversation starters

If you’re looking for a way to break the ice on sensitive subjects with your physician, Dr. Stieglitz offered a few openers:

  • “I was reading about…”
  • “My friend and I were discussing…”
  • “I saw a commercial and it made me realize…”
  • “My anniversary is coming up, and I’d like to make sure I’m ready for a romantic evening…”

“While I’m the one who will prompt my patients to talk about their sexual health, some beat me to it with openers like this,” Dr. Stieglitz said. “You don’t know if you don’t ask. Sexual health is natural and normal and should be a part of routine health care.”


If you're experiencing a lowered libido, consult a primary care physician for advice on what steps may help. To find the right one for you, call 202.4YOU or click here to fill out an appointment request form.

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