Many factors can cause decreased sexual desire, including medication and comorbid mental and physical health conditions.
A shift in your sexual desire may be a cause for concern, whether it happens abruptly or slowly over time.
There are many possible reasons for changes to your libido, including:
- aging
- comorbid mental and physical health conditions
- new medications
If you experienced a drop in your libido, you might have hypoactive sexual desire disorder (HSDD). If you were assigned male at birth (AMAB), there’s a chance you may have male hypoactive sexual desire disorder (MHSDD).
Regardless of your biological sex, a doctor or mental health professional can provide a diagnosis before you consider any treatment.
A note on gendered language
In this article, when we use “male” and “men” and “female” and “women,” we’re referring to cisgender men and women because current research on MHSDD most often applies to those who were assigned male at birth. Still, your gender identity may not align with how your body responds to this condition. A doctor can better help you understand how your specific circumstances impact your symptoms, diagnosis, and treatment.
HSDD, also known as “low sexual desire disorder,” occurs among men and women, though the symptoms, causes, and treatments can vary between sexes.
Research from 2010 estimates that 31% of men and 43% of women experience some degree of sexual dysfunction. Women are more likely to experience loss of desire. For men, erectile dysfunction (ED) is a more common experience.
Male hypoactive sexual desire disorder (MHSDD) occurs in people assigned male at birth.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) defines MHSDD as “persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity.”
Although it’s natural for sexual desire to ebb and flow, especially as you age, sexual dysfunction may cause significant distress, whether male or female.
How is MHSDD diagnosed?
MHSDD can be diagnosed only if sexual dysfunction persists for at least 6 months, according to the DSM-5.
For a diagnosis, a clinician will factor in other possible explanations, such as:
- a mental health condition
- a comorbid medical condition, such as irritable bowel syndrome (IBS) or multiple sclerosis
- the physiological effects of medication or a substance
A doctor might also look at hormonal shifts and physiological abnormalities when diagnosing MHSDD. Research shows that low androgen levels and testosterone may impact male sexual functionality.
Common symptoms of MHSDD include:
- little to no sex drive
- reduced interest in sex and sexual activities
- unaroused by visual or sexual stimulation
- inability to experience spontaneous desire
- decreased interest in self-pleasure (masturbation)
- loss of erectile/ejaculatory function
According to the DSM-5, possible biological and psychological causes of MSHDD may include:
- aging
- a side effect of a new medication
- an interpersonal conflict with a partner
- insecurity around sexual performance
- body image issues
- stress (i.e., the loss of a job)
- religious or cultural factors that discourage sexual activity
In addition, MSHDD may also be associated with an underlying mental health condition.
Research from 2015 shows that male sexual dysfunction may be caused by comorbid depression and anxiety disorders.
Other
Still, researchers have noted that men are not always comfortable reporting sexual dysfunction, despite the possible causes.
Sociocultural considerations
Society has specific expectations of men and women regarding sex and sexuality.
Men are often expected to be highly sexual beings. Women are thought to be submissive.
The idea that men are hypersexual and women are hyposexual perpetuates the shame that men with MSHDD may feel around their lack of sexual desire and is disempowering toward women.
In reality, there’s no right or wrong way to experience your sexuality, as long as it feels good to you.
Asexuality
Sexuality exists on a spectrum, which means that a lack of interest in sex is not always associated with HSDD. Just because asexual individuals may show little to no interest in sex, it doesn’t mean they’d be diagnosed with this condition, as HSDD is diagnosed only when a lack of sexual desire causes distress.
There is not enough evidence to determine specific causes of HSDD or MHSDD.
But if your doctor determines that you have low levels of androgen or testosterone, they may prescribe:
- over-the-counter supplements
- patches
- injections
- gel
- pellets
- pills
Counseling could be a solution if you think your low libido may be linked to your current relationship.
A sex therapist could focus on your sexual concerns, or a relationship counselor might assist you and your partner through any underlying issues.
If you’re asexual, there’s nothing to treat. Being on the asexual spectrum is a sexual identity, and there’s no need to change how you experience your sexuality.
Not everyone who experiences reduced sexual desire meets the diagnostic criteria for HSDD or MHSDD.
For those who do, physiological or hormonal explanations or factors might be linked to mental or physical health conditions.
Consider talking with a doctor before trying any over-the-counter treatments for sexual dysfunction. If you believe the root cause of your low libido may be behavioral or interpersonal, a mental health professional could offer some guidance.
For some people, a lack of sexual desire doesn’t cause distress. If this resonates with you, you may fall on the asexuality spectrum, but asexuality is an orientation that has no bearing on an individual’s overall health.