Ashlee Williams, MD: Did you know that nearly one in five men experienced low libido at some point in their lives? Low sex drive can not only affect physical health, but also emotional wellbeing and intimate relationships. A wide range of factors from hormonal imbalances and chronic conditions to stress and certain medications can influence sex drive.

Welcome to The Healthier You Podcast. I'm Dr. Ashlee Williams, and today I'm joined with Dr. Dock Winston, a Board Certified Urologist and Men's Health Specialist here at Kaiser Permanente. We'll be diving into the most common causes of low libido in men, and more importantly, what can be done about it. Dr. Winston, thanks so much for being here.

Dock Winston, MD: My pleasure.

Host: All right, so we always just like to start with the basics. What is low libido and how common is it in men?

Dock Winston, MD: Thanks Dr. Williams. So low libido means a reduced interest or desire for sexual activity andis more common than many men and people think. Low libido or decreased sex drive is a common issue among men with some studies indicating it affects up to one in five men at some point in their lives. The likelihood of experiencing low libido tends to increase with age.

A drop of libido isn't always a cause for concern. It's normal for sexual interest to fluctuate depending on factors such as stress, sleep, and overall health. But if it lasts a long time and it begins to affect your mental health or your relationships, it's definitely worth talking to a doctor.

Host: Okay, so it seems like libido can fluctuate depending on multiple factors. When is it time to actually come and talk to a doctor about it?

Dock Winston, MD: It depends on the patient. I mean, some men it can happen during moments of stress, really busy lives with work or with their families and their sex drive may just be low for a week or so and it goes back to normal. For those men, really if it comes back to normal, there's really no cause for concern.

But if it persists and it begins to impact the overall quality of their life, particularly with their relationships or even with the way they feel about themselves, that's definitely is a time to speak with a healthcare provider.

Host: So they've decided to come and see a healthcare provider. What treatment options are there for low libido?

Dock Winston, MD: So the treatment options really depends on the root cause of the low libido. Reasons why someone's libido can be low, could be many factors, such as they can have low testosterone. This is a major reason for low libido. Testosterone levels naturally decline with age, for some men, they experience a sharper drop that affects their libido.

Other reasons for a low libido could be a chronic condition such as diabetes, heart disease, obesity, and even smoking, which it can reduce blood flow, impact hormone levels, and lower interest in sex. Another factor that can be impacting libido could be medications such as antidepressants, certain blood pressure medications and treatments for prostate conditions can also damper sex drive.

Another factor is also mental health. Depression, anxiety, or chronic stress are huge factors, and they're often overlooked. Another factor can also be relationship dynamics, tension with your partner or partners, lack of communications or just emotional disconnectivity, between the individual, and their partners.

And then finally, lifestyle factors can be a major role, including poor sleep, overwork, or excessive drug and alcohol use can be major contributors. And then based off of these factors really will help the provider determine what will be the course of action. So for example, if someone is found to have low testosterone, they may be candidates for testosterone replacement therapy. And with that replacement therapy, libido has shown to rebound. If medications are a cause, then the provider may want to look at switching up a different prescription, to help alleviate these symptoms. Sometimes patients their low libido really is just impacting their erectile function.

And if that's the case, they may need to have erectile dysfunction medications such as Viagra or Cialis, which can help with their performance, which may also have a indirect impact on their desire for sexual activity. If there's lifestyle changes that need to be made, such as improving their diet, increasing their exercise or just getting better sleep; those all can help with the libido. And then finally, if it's something more emotional such as with anxiety or depression, they may really benefit from counseling. In my practice, I've found that, for most men coming in with low libido, sometimes it's very rare that it is just one factor and it can be a combination of all these factors I've mentioned.

And it's really important for men when they do talk with their physician to really, go to a place where, they're comfortable and they share everything that's going on in their life because there may be factors involved that they aren't aware are impacting their health and their libido.

Host: That's all great information, about how we can share with our doctor. Do you have any tips on how someone should share their low libido concerns with their partner? Any tips on that?

Dock Winston, MD: That is probably the toughest question that patients will ask, and it's not easy. I think for a lot of men, for this intimate partner lives is really difficult to really talk about it. So communication is very important and, having a, honest open community conversation can definitely ease tension and can bring them closer to their partner.

Talking about what feels good, what's changed, what each of you need, both emotionally and physically can also maybe help alleviate some of the factors that is impacting the libido. I tell patients during these times there's also a good idea to focus on the emotional intimacy, the non-sexual affection, and spending quality time together, which for a lot of couples can help them get back to that physical part in their relationship and also big reminder that it's not just about the performance, it's also about the connection, the confidence, and the wellbeing with sexual wellness.

Host: Got it. Are there any self-care tips that you recommend that can help improve libido naturally?

Dock Winston, MD: Definitely, small daily habits can make a huge impact. When patients come to me in my practice, they want a quick fix and I always tell them that they probably did not develop their low libido, overnight. And is going take some time for them to really get the libido back to where they want, but just small incremental steps can be so helpful. Those steps can include just exercising regularly. And that could be as simple as just walking around the block. This simple activity alone could just boost natural testosterone production. It could improve circulation and help with mood. Getting enough sleep. Fatigue is a major libido killer.

And, while it's generally recommended to get between seven to eight hours of sleep, we know with busy lifestyles, with work and family demands, sometimes you may need to just make that sleep on the weekends or when you can. Also managing stress. And that can come in many forms such as mindfulness, breathing exercises, therapy can all help lower hormones such as cortisol, which tends to kill your libido and also boost the hormones that help with your desire. Also, nutrition, eating well, eating nutrition rich diets that support hormone health, energy levels such as whole foods, vegetables, and then limiting processed meats. And then finally just cutting back on alcohol and drug use. Both can negatively impact your blood flow and hormone levels. And then finally, make time for things that make you feel good and confidant such as, you know, whatever that activity may be, because that in itself can help with overall wellness.

Host: Thanks so much for this insight, Dr. Winston. Here are some key takeaways from today's episode. One, low libido in men can be an influenced by physical, emotional and relationship factors. Two, common causes include low testosterone, chronic conditions, certain medications, and mental health challenges.

Three, treatment options range from hormone therapy and medication changes to lifestyle improvement and therapy. Four, open communication with your partner and your doctor can make a big difference. And five, small, consistent self-care habits like exercise, sleep, and stress reduction can naturally support a healthy sex drive.

For more expert advice, visit kp.org and listen to more episodes of Healthier You wherever you get your podcast. If you found this episode helpful, don't forget to subscribe and share it with others. Thank you, and from all of us at Kaiser Permanente, be well.