The real reason for low sex drive in men-especially bodybuilders

By Kim Crawford, M.D. Last updated: April 20, 2020

Low sex drive in men:

We hear about how “horny” men are. Yet, as an Anti-aging doctor, I’m here to tell you there is an epidemic of low sex drive in our men. We, women, are famously publicized as having a lower sex drive than our male counterparts, and another article will cover women’s issues (promise!). More importantly, low sex drive is multi-faceted and most “regular doctors” don’t spend enough time with patients to figure it out.

That’s to say if they COULD figure it out, which most, being non A4M trained, just plain could not.  “I keep up, ” and some things are just totally common knowledge in my specialty. If I regularly read studies (which I do) and repeatedly read that X leads to Y or Z, I figure that my imparting that sort of knowledge to you will be useful. Further, if you see something you want specific studies on, use pubmed.gov and find all the studies you need.

Low sex drive in everyone- the basics:

This is going to be the only paragraph you men can share with your women about their low sex drive, as what I’m about to discuss is universal. If you are sleep deprived or feeling stressed, that will lower your sex drive. If you are depressed, that will lower your sex drive. Medications ranging from blood pressure medications to anti-depressants (oddly enough!) can lead to low sex drive.

Addictions to drugs and alcohol will do the same. Finally, low testosterone in both males and females will lower your sex drive AKA libido. If you’re a young pre-menopausal woman, this is unlikely you. However, even young men can develop testosterone deficiency. This is where we’ll say good-bye to the women reading this unless you are reading to find out why your guy isn’t “interested.”

A word about excess “porn” watching:

Before I get into the hormonal stuff, I want to say something about this topic. I write all of this with absolutely no judgment. I’m just giving you medical facts here. Many young men and a staggering number of college aged young men and yes, women too, are watching porn to the exclusion of normal sexual relationships either with a partner or alone…and you get my meaning there, right?

What is then happening is, in males, especially, the presence of pornographic images, mainly videos, are required for arousal and sexual activity. No porn = disinterest = low sex drive which is considered “normal.” This issue has spawned all sorts of support groups and campus counseling centers. This isn’t something afflicting merely teens either. If a male is too porn-dependent such that he needs it to have normal, consensual sexual relations, he needs to wean or get help weaning to gain control of his sexuality.




Low-T in men:

When men’s bodies produce insufficient levels of testosterone, a condition called hypogonadism results. Hypogonadism can be caused by testicular injury, infection, or much less common, cancer. Disorders of the pituitary and hypothalamus glands need to be ruled out as causes. Occasionally a  benign pituitary adenoma that generally knocks down human growth hormone production too is the cause. Very rarely a malignancy is a cause. Klinefelter’s syndrome (a chromosomal abnormality) is yet another rare cause.

A rather common reason is a history of contact sports such as football, hockey, and wrestling where the head is “whacked” or jostled, causing the pituitary gland to malfunction. This can also apply to repeated trauma to the groin and has been reported in elite cyclists.

Lastly, due to the “street availability” of testosterone and the young male’s desire to have a great physique, past use of testosterone for more than a couple of months can dis-engage the HPA (hypothalamic-pituitary axis). As a result, this causes the pituitary and testes to “stop communicating.”  This issue has cycled a lot over the years, and most of the time the men have not even thought about being professional bodybuilders.

 Some telltale signs “Low-T” are:

Fatigue and the feeling of low energy all day. This is not the same as the energy issues seen with any of the stages of adrenal fatigue as I’ll get into in a bit.

Low sex drive or complete loss of interest.

Erectile dysfunction or inability to maintain an erection. Note: If this is the only “sign” you have, it is more likely a microvascular issue rather than a testosterone issue which most doctors don’t realize. The most common issue is undiagnosed diabetes so have a fasting blood sugar, and HGB A1c checked pronto.

Irritability and or depressed mood.

Disturbances of sleep including sleep initiation and sleep maintenance problems.

Aches and pains in the joints.

Loss of weight due to muscle mass loss OR weight gain due to metabolic decrease from fat mass replacing muscle mass which is more the norm.

I have taken the time to “go into” low testosterone symptoms because this is often why men have low sex drive. It’s never “just” low sex drive; men are fatigued and more.

What about low estrogen and sex drive?

If you are not a bodybuilder or are someone who is on testosterone replacement WITH aromatase inhibitors, then this doesn’t apply to you. Bodybuilders are generally dosing themselves with testosterone. They sometimes take “aromatase inhibitors.” (Testosterone aromatizes into estradiol metabolites if this enzyme isn’t blocked). They sometimes do not and I will discuss high estrogen in a moment.

First, to resume, let’s discuss a low estrogen level. If someone is “running their estradiol” too low meaning less than 5-10 pg/ml they can experience “odd” symptoms. These include not feeling great, or having joint pains and/or low sex drive. Low sex drive is unusual, but it has been reported. Some non-qualified doctors do HRT (hormone replacement therapy) and prescribe too high of a dose of “aromatase inhibitor drugs” or worse, none at all. That is up next.

What about high estrogen and sex drive?

Glad you asked! This drives me a bit insane when I analyze the bloodwork of AWS consult clients. I see high estrogens “all over the place, ” and only one group of people have a good reason for it. If you are an elite bodybuilder, I will usually have you “run” your estradiol/estrogen high. In detail, as high as 50-60 pg/ml if you are on anabolics because they drop your HDL or good cholesterol. As a result, they leave you open to coronary artery placquing which we cannot totally counter with the methods I have for placqing and bodybuilders.

WE are then saying “fine” with low sex drive in order to protect the heart. There is no other reason to “run” estrogens this high as long term, it is associated with issues such as prostate cancer and more. If a man is getting HRT from an unqualified doctor, that doctor might not know that he/she needs to check estradiol. I’m not kidding here.

I see this ALL THE TIME.

Men say they have a low sex drive. Then, I check an estradiol and voila, it high. I’ll bet I see this as often as low T.  Another issue doctors don’t think of when they see a man with a big belly is it’s an “estrogen belly.” Aromatase levels increase as men get older. Then, livers don’t process hormones as well. As a result, it is not uncommon to see a normal testosterone and a high estradiol in a middle-aged man with a low sex drive. This is then treated with aromatase inhibitors.

What about cortisol?

The most common culprit, I daresay, in this stress-filled world is cortisol. If you haven’t read my blogs on adrenal fatigue, I discuss in detail what causes high cortisol and what to do about it. Let me refer you to the what is adrenal fatigue and adrenal fatigue supplements articles. To resume, I’ll give you the “highlights” to consider if this might be you. You will have a high fasting cortisol if you have a painful medical condition. You’ll have high cortisol if you are not sleeping well. You’ll have high cortisol if you have a fast pace, hard-charging lifestyle or high personal stress at home or at work. Lastly, you will have high cortisol if you take anabolic steroids.

In fact, I have an AWS client who is a national level bodybuilder who had a sky-high cortisol. Notably enough, when fixed, it allowed him to win a major competition. High cortisol will be exacerbated by excess caffeine, sinus medications, ADHD medications and energy drinks. It will initially not cause symptoms you can pinpoint but decreased sex drive is one of them. Next, you will notice some loss of energy, and then, sleep disruption. This is all treatable but if you ignore it, it rarely just goes away.

What if there is no “real cause”?

It is rare that there is no cause, even if low sex drive is just a way to say “I’m bored.” Let me point out non-trained doctors see testosterone levels in men which fall “in range” on the lab slip and call it normal when they should not.

Have a consult with me, and I’ll analyze your labs and give you the “straight scoop” if you need it. High cortisol levels and adrenal fatigue are a lot more common than you might think, with people compensating with “substances.”

Then, there is undiagnosed low-grade depression and all sorts of other things too. So, you are a bit stressed or bored and want to up your libido. Is there anything that works?

Actually, yes.

First of all, all testosterone boosters only give you a minute boost. In addition, you need to get that replaced correctly and then, estrogen adjusted properly. You need to attend to cortisol needs which often occur due to dealing with the symptoms of “low-T.”

While this is occurring, there is a natural herb that has been studied to be an aphrodisiac.

Eurycoma Longifolia is the herb commonly known as  Malaysian Ginseng. The aphrodisiac effects of Eurycoma Longifolia are reportedly quite reliable and span a large variety of animal models. Most studies have been done with male rats, with no supportive human studies. Claims of testosterone boosting are hard to support with all but certain selected strains of the herb, but claims of increased sperm counts seem to be decently proven.

Bottom line:

Get to the root cause, as always. If your doctor isn’t giving you answers, try a consult with me. If you are a male with belly fat, due to excess cortisol and/or estrogen (not beer), address it. Also, if you’re a bodybuilder, watch the anabolics! There is nothing ‘out there’ that is otherwise proven as a libido amper. Oxytocin doesn’t do it for males; It promotes bonding but not sexual interest. I hope I covered all of your concerns on this most delicate topic! Here’s your FREE guide:

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