Sexual Healing

Do you find that you're just not as interested in sex anymore? Low libido (reduced sex drive) can strike men at any age, but it becomes more common as a man gets older. It may be caused by:

• psychological factors, such as child abuse, depression, or relationship issues
• physical factors, such as low testosterone or medication side effects (such as antidepressants, oral medications used to treat prostate problems or hair loss, and blood pressure medications)

A man with low libido thinks less about sex and is less interested in having sex or masturbating. However, he usually doesn't lose his physical ability to have sex. Low libido can become a problem when it is distressing to the man or his partner, or when it starts to affect the relationship.

The good news is that low libido can be treated. If low libido is caused by a medication side effect, your doctor or pharmacist can suggest a different medication that is less likely to cause low libido.

Low libido that's caused by low testosterone can be treated with testosterone replacement therapy. Your doctor can do a simple blood test to see if your testosterone levels are low. Testosterone is available in a patch, gel, injection, and capsules.

• Men who are concerned about their ability to maintain an active lifestyle may prefer to use a patch. Applied once daily, these are convenient to use and can be applied to the back, abdomen, upper arms, or thighs. They can be worn during activities such as exercising, showering, or swimming. The patch mimics the normal production rhythm of testosterone in healthy young men. Patches may cause skin irritation, but using a topical corticosteroid cream (which can be purchased at a pharmacy) before applying the patch can usually prevent this.
• Gels may also be convenient to use, and are applied once daily. Men must wait several minutes to allow the gel to dry before dressing and should not bathe or shower until 5 to 6 hours after application. They should cover the treated area with a shirt to prevent accidental skin-to-skin transfer of the gel to women or children (which can cause them to develop male features such as lower voices or facial hair over time).
• Injections only need to be given every three to four weeks, and are administered in a doctor's office. Injections may cause mood swings due to sharp "ups and downs" in testosterone levels (they are higher after the injection and lower just before the next injection).
• Capsules are taken twice daily with meals. People taking testosterone in capsule form need to have their liver function tested regularly.

Testosterone replacement is not appropriate for everyone. All forms of testosterone therapy may have some side effects and risks, including acne, decreased sperm production, fluid retention, and stimulation of prostate growth. Talk to your doctor about risks and benefits before starting treatment.

What about medications like Viagra® (sildenafil)? These medications (which also include tadalafil [Cialis®] and vardenafil [Levitra®]) help men who can't get an erection because of problems with blood flow into the penis. They do not help increase sex drive, so they are not useful for treating low libido.

If the cause is psychological, counseling and a treatment called sensate focus technique may help. This technique helps partners become more aware of the sensations they find pleasurable.

If you suffer from low libido, speak with your doctor to pinpoint the cause and see which treatment option may be right for you.