Low Libido in Men
Sex drive naturally rises and falls with stress, sleep, health and relationships. Low testosterone is a cause much less often than the ads suggest. It’s worth a chat with your GP when it bothers you or your partner.
Common causes
- Stress, tiredness and poor sleep, including untreated sleep apnoea
- Depression and anxiety, and the medicines for them (especially SSRIs and SNRIs)
- Other medicines: opioids, finasteride and dutasteride, spironolactone, some blood pressure and prostate cancer treatments
- Relationship issues, conflict, or erection problems that make sex feel like an exam
- Alcohol, cannabis and anabolic steroids (especially coming off them)
- Health conditions: low testosterone, diabetes, obesity, thyroid disease, high prolactin, chronic illness
Tests your GP may do
- Morning testosterone (before 10 am, ideally fasting), repeated if low. One low result isn’t a diagnosis.
- LH and FSH, prolactin, iron studies, thyroid, sugar and cholesterol
- Screening for low mood, alcohol use and sleep apnoea
What helps
Start with the cause. Testosterone only helps men who truly have low testosterone.
- Step 1 · Self-careSleep, exercise, alcohol and stressFix the basics that quietly drain desire.
- Works
- Exercise and weight loss raise testosterone and energy; less alcohol helps erections and drive
- Cost
- Free
- How long
- Ongoing
- Watch for
- Snoring with daytime tiredness: ask about sleep apnoea.
Libido hates being tired, drunk and stressed. So do most people.
- Step 2 · TalkTalk with your partner, or see a counsellor or sex therapistDesire is often about context: conflict, routine, pressure or a mismatch in drive.
- Works
- Sex therapy and couples counselling help many couples; good for desire mismatch
- Cost
- Counselling varies; Medicare rebates for some psychology with a GP plan
- How long
- Several sessions
- Watch for
- Feeling flat most days for 2 weeks or more: that may be depression.
- Step 3 · Review medicinesCheck whether a medicine is the culpritYour GP may lower a dose, switch, or add something.
- Works
- Switching or adding bupropion can help antidepressant-related low libido
- Cost
- Usual script costs
- How long
- Weeks
- Watch for
- Don’t stop antidepressants suddenly; taper with your doctor.
- Step 4 · Treat the causeTreat erection problems, low mood or other conditionsE.g. PDE5 inhibitors for erections, treatment for depression, diabetes or sleep apnoea.
- Works
- Treating erection problems often restores confidence and desire
- Cost
- Varies
- How long
- Varies
- Watch for
- Step 5 · SpecialistTestosterone, only for confirmed low testosteronePrescribed after repeated low morning levels plus symptoms, usually with a specialist or under PBS rules.
- Works
- Improves libido in men with genuinely low levels; little benefit if levels are normal
- Cost
- $25 a script on the PBS when criteria are met; otherwise private
- How long
- Long term, with monitoring
- Watch for
- Testosterone stops sperm production: not for men wanting children. Needs blood count and prostate monitoring.
Testosterone isn’t a libido supplement. In normal-level men it’s mostly side effects with extra steps.
Costs are rough Australian prices and vary by pharmacy and provider. PBS co-payment: $25, or $7.70 with a concession card. Results are typical figures from trials, not promises.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- “Testosterone booster” supplementsTribulus, fenugreek, horny goat weed and friends: no good evidence they raise testosterone or desire.
- Testosterone with normal levelsLittle benefit, real risks: shrunken testes, infertility, thick blood and acne.
- Online men’s health subscriptions without a proper checkFine for some, but skipping the history and tests can miss depression, diabetes or heart disease.
Common questions
What causes low libido in men?
Most often stress, tiredness, poor sleep, depression, relationship issues, alcohol and medicines such as antidepressants. Low testosterone is a less common cause.
Should I get my testosterone checked?
Yes, if low libido persists, especially with erection problems, fatigue or loss of morning erections. It needs a morning test, repeated if low.
Will testosterone fix my libido?
Only if your testosterone is genuinely low. In men with normal levels it adds little and can cause infertility and other side effects.
Helpful resources
- Healthy MaleMen’s health information from Andrology Australia. Free.
- Society of Australian SexologistsFind a qualified sex therapist.
Evidence and more information
maladywise.com/low-libido-men/