Low Libido
Low libido in men -- clinically, hypoactive sexual desire disorder -- means a persistent, distressing lack of interest in sex lasting 6 months or more, per DSM-5-TR criteria. When linked to low testosterone, evaluation follows the Endocrine Society’s 2018 testosterone therapy guideline.
Symptoms
Reduced sexual thoughts and desire, present most of the time, causing personal distress rather than simply reflecting a normal difference in desire between partners.
Causes and risk
Low testosterone, depression, relationship stress, chronic illness, and certain medications (SSRIs especially) are all common contributors, and often more than one applies at once.
How it is evaluated
Confirming low testosterone requires two early-morning (7-10 AM), fasting blood draws, since up to 30% of initially low values normalize on repeat testing.
Treatment
Reversible causes are addressed first -- weight loss is especially effective for obesity-related low testosterone. Testosterone therapy is reserved for men with confirmed, symptomatic deficiency, where it provides a real but modest libido benefit, per recent evidence.
When to seek care
Low libido is not an emergency. Headache, visual changes, or unexpected nipple discharge alongside it can point to a pituitary problem and warrant imaging, so mention these specifically at your visit.