What affects sexual desire
Libido is formed by the interaction of several systems at once: hormonal, nervous, vascular and psychological. Testosterone plays an important, but not the only role - stress levels, sleep quality, couple relationships and overall health are also important.
Therefore, an isolated decrease in desire during normal tests is a completely real situation, and not a sign that “the doctor didn’t find something.” And vice versa: low testosterone is not always the only reason.
Separately, it is worth mentioning natural fluctuations. Attraction is not constant: it decreases during periods of overwork, illness, stress and recovers afterwards. The reason for examination is a persistent decline that continues for months and worries a man or couple.
Reasons: hormonal
- Testosterone deficiency - decreased libido is one of its most characteristic manifestations
- Elevated prolactin, including with pituitary adenoma
- Hypothyroidism and hyperthyroidism
- Excess estrogen in obesity
- Adrenal diseases
- Previous use of anabolic steroids with suppression of one’s own hormone production
Causes: lifestyle, medications and diseases
- Chronic lack of sleep and working night shifts is one of the most underestimated factors: testosterone is produced mainly during sleep
- Chronic stress and fatigue
- Obesity and metabolic syndrome
- Diabetes mellitus
- Obstructive sleep apnea syndrome
- Alcohol abuse, smoking, drugs
- Depression and anxiety disorders are a very common cause
- Taking antidepressants, antipsychotics, some blood pressure medications, finasteride, opioids
- Chronic diseases, pain, cancer and their treatment
- Chronic kidney and liver disease
- Relationship problems, accumulated conflicts, emotional distance
- Erectile dysfunction - a man begins to avoid intimacy due to fear of failure, and desire decreases again
- Excessive consumption of pornographic content with the formation of dependence on specific stimulation
Survey
- Detailed conversation: when did it start, gradually or suddenly, do you have morning erections, what is your mood and quality of sleep?
- Examination by an andrologist with assessment of secondary sexual characteristics and testicular volume
- Total testosterone in the morning on an empty stomach, free testosterone and SHBG if necessary
- Prolactin, LH, FSH, estradiol
- TSH and thyroid hormones
- Glucose and glycated hemoglobin
- Lipid profile
- Complete blood count to rule out anemia
- Ferritin
- Assessing symptoms of depression and stress levels
- Erectile function assessment
- MRI of the pituitary gland with significantly elevated prolactin
- Sleep apnea screening for snoring and daytime sleepiness
The persistence of morning and night spontaneous erections with decreased desire usually indicates a psychological or situational nature, while their disappearance along with a drop in libido more often indicates hormonal or vascular causes.
What to do: measures that really work
- Improve sleep: insufficient and interrupted sleep significantly reduces testosterone levels
- Reduce body weight if it is excess - adipose tissue converts testosterone into estrogens
- Regular physical activity, including strength training, without exhausting volumes
- Limit alcohol
- Treat sleep apnea
- Review medications taken with the prescribing doctor
- Compensate for diabetes and thyroid diseases
- Treat depression - with it, desire is restored as the condition improves
- Testosterone replacement therapy - only for laboratory-confirmed deficiency and as prescribed by a doctor
- Working with relationships as a couple, if necessary with a psychotherapist
- Reducing consumption of pornographic content when there are signs of addiction
- Treatment for erectile dysfunction, if present - often desire returns with confidence
When is it necessary to contact
- Attraction decreased sharply and significantly in a short period of time
- At the same time, morning erections disappeared
- Headaches, blurred vision, and discharge from the mammary glands appeared
- Testicles have shrunk, body hair has thinned
- There is a pronounced depressed mood
- The situation lasts more than a few months and affects the relationship
- Diabetes, obesity, snoring with sleep apnea
Where to get examined in Tashkent
The examination for decreased libido is simple: an appointment with an andrologist and a set of tests, which in most cases indicates the cause.
In Tashkent, such an examination is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic, if necessary, together with an endocrinologist.
Do not start with dietary supplements and do not prescribe testosterone for yourself: with normal levels of the hormone, it will not increase desire, but will suppress its own production and worsen fertility. Start with a blood test in the morning on an empty stomach. Clinic contacts are below.
