The Secrets Of The Male Sex Drive (A Doctor Explains)

Written by Jeffrey Egler, M.D.
The Secrets Of The Male Sex Drive (A Doctor Explains)

We talk a lot about sex, yet we don’t really talk about it. We wonder whether it’s good or bad and whether we're having enough or too much—but we mostly just gloss over terms like libido and sex drive, what's behind them, and why they sometimes become a problem.

But we need to talk about sex drive and here’s why: Your libido is a marker of your health. Healthy people have healthy sex drives and a healthy sex drive is too often thought of as something that belongs only to younger men. We tend to think that it’s "normal" to not feel the same way when we're older, say in our late 30s (or even earlier), 40s, 50s, and beyond. And maybe it is "common." But it’s not healthy—and it’s certainly not optimal.

Sex drive isn't simple.

A healthy sex drive depends primarily on optimal hormone balance and adequate brain and neurotransmitter function. Hormones are chemical messengers in the body and they inform your body and brain of how to respond to your environment. Neurotransmitters are the chemical messengers in your brain and nervous system that play a similar role. These chemicals give your brain and body feedback on your environment and how you're treating your body.

At Parsley Health, we look at not only your genetics but how you "bathe your genes." In other words: What kind of environment are you providing for your genes? This includes how you eat, how you sleep, your level of movement and fitness, and your level of stress. All of these factors affect how your genes express themselves in order to adapt to your environment and survive. And your sex drive is linked to this survival.


Sex drive and survival.

When you're feeling and performing your best—and therefore more likely to survive—your sex drive is higher. It’s nature’s way of agreeing that perhaps you should pass your genes along. When you're feeling and performing terribly, nature’s not so sure. Hence the lower sex drive. From a medical standpoint, I often use a patient’s libido as a marker of optimal health and consider it an important clue as to how they're doing overall. And when it’s low, I try to pinpoint the reasons why and make suggestions as to how to correct them in the most effective, realistic, and sustainable way possible.

For testosterone, look at the big picture.

The first piece of the puzzle is your hormone levels. Testosterone has the reputation of being primarily responsible for your sex drive, and this is mostly true. But no hormone works alone. Testosterone needs to be checked in a 360-degree fashion. Simply testing testosterone levels doesn't really help you understand what the levels mean for an individual body. This is why speaking openly and honestly with a doctor about symptoms and lifestyle habits is incredibly important when testing hormones. Every single person has a different "normal."

Be wary of cortisol.

In addition to running an extensive panel of testosterone markers, doctors should also check your cortisol levels. Cortisol is a potent stress hormone. If it's too high or too low, it affects your other hormone levels and balance tremendously—especially testosterone. DHEA, estrogen, and progesterone levels (yes, men have them too), among others, can all affect your libido as well either directly or by influencing testosterone.


Mind your neurotransmitters.

Neurotransmitter function is also important to evaluate carefully. A good physician who spends time listening to his patients can pick up clues as to what imbalances may exist based on their history of mood swings, depressed mood, anxiety, sleep patterns, appetite, weight fluctuations, motivation, etc. Cutting-edge genetic testing may also shed further light on the underlying causes of imbalances and, subsequently, the best ways to deal with them. Even with perfect hormone levels, a decreased libido is very commonly associated with a depressed mood, a chronically stressful environment or relationship, or a genetic predisposition.

Create a sex-drive-friendly lifestyle.

Our habits are part of our environment, or, more accurately, our response to our environment. Either way, they contribute in powerful ways to your sexual health. These are some of the questions to ask yourself to see if your lifestyle could be contributing to your low libido:


1. Are you eating right?

You need proper nutrition to adequately fuel yourself and provide the essential vitamins and minerals called for at the biochemical level. Chemical messengers (like hormones and neurotransmitters) tell the body what to do, but without the right building blocks, your body cannot follow the instructions. If you can’t function optimally, you don’t feel optimal. For example, if you have no coenzyme Q10, you have no energy production and no sex drive. This goes for numerous other nutrients not typically discussed in the standard doctor’s office.

2. Are you getting enough sleep?

Even if you feel relatively rested, if your libido is in the dumps, you may not be getting enough high-quality sleep. Everyone is different and needs different amounts of sleep, but try to get at least seven hours nightly.


3. Are you stressed?

Excessive stress will drain your energy and can lead to hormonal and neurochemical imbalances but also deficiencies in nutrients that are necessary for optimal bodily function. Meditation as well as other stress reduction techniques like biofeedback, acupuncture, and massage can reduce stress and help you return to feeling like you're in your sexual prime. But finding out which modalities might best serve you can be guided by a health provider who knows you well and can interpret different biomarkers.

Changing unhealthy habits is the hardest (sometimes seemingly impossible) part of restoring yourself. Remember that healthy people have a healthy sex drive; it’s a specialized marker for peak function and optimal wellness. If your sex drive is low, nonexistent, or even just not quite what it used to be, don’t blow it off.

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