February 19, 2011

Sex Drive

Sex driveThere are a myriad of reasons our libido or sex drive changes throughout our lives. We  see changes in sexual desire in both males and females as they age. These may be associated with substance abuse, psychologic factors, chronic and major diseases, as well as age related changes in sex hormones. These effect both sexes equally.

Individuals who have a decrease in sex drive must undergo a total evaluation including a physical exam, history, social/ life style history, exercise history,  family history and current medications. Once this is done one can begin to identify the possible causes of the decrease in sexual desire.

Sex Drive and Chronic Disease

Sexual desire changes are common in individuals with chronic and major diseases, whether it be poorly controlled diabetes, cardiac disease, rheumatoid arthritis,  hypertension, vascular disease and obesity to name a few.

Suffering from the symptoms of the disease process or from the side effects of the treatment sexual desire may decrease or be absent.

Substance abuse

Substance abuse takes many different forms, including  alcohol, illegal and prescription drugs. These drugs may altar a persons mental capacit , alter hormones or one’s physical ability.  The substance many times become more important then one’s sex drive. These often become one’s sole purpose of existing.

Psychological causes

Our sexual desire or libido can be affected  by simple things like relationship conflicts (more commonly seen in females) and more serious medical conditions like chronic depression, bipolar disease.

Simple stress from our daily lives at work or home including schedules, work dead lines and of course money ( (Or lack of it)

Hormone Changes

Hormones play a huge in role in sex drive. Hormones in both men and women decrease as we age. Men have a loss of testosterone starting at thirty . The average decrease is in the range of 1.5% a year. By the time a man is in his mid forties there is often a significant decrease in his sexual drive and energy.

Women have a more abrupt change in hormone production occurring ussualy in the mid forties as perimenopause followed by menopause. Perimenopause is associated with fluctuating hormone levels and can last from one to two years to 5- 10 years.  Menopause follows with abrupt lack of hormone production in estrogen and progesterone. This associated with thinning of the vaginal walls, dryness which can be associated with sexual discomfort.Testosterone production is also decreases in females which leads to a lack in libido as well.

Treatment for Low Sex Drive

In males a thorough history and physical is done including blood tests.  When hormone levels are abnormal and no other a problems are identified one can have their hormones replaced to reach optimal levels and improve sex drive. Medications  maybe changed or stopped if they are no longer needed. If there is psychological causes these must be addressed and counseling started. Any illicit use of medications or drugs must be addressed .

Females require similar evaluations but testosterone is not the only hormone that must be replaced. Bioidentical (progesterone and estrogen)  are also used to help improve their desire for sexual activity. These changes in females are not as simple as in males. As a women’s body changes her self perception changes as well and usually not in a positive way. With the addition of hormones there is improvement in energy, sleep, personal perception and thickening of the vaginal wall leading to a more pleasurable experience.

Related articles include, “Testosterone Deficiency” and “Low Estrogen Symptoms“.

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio. Read more about Dr. Joe Jacko

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