the Causes of Low Libido: A Guide for Couples

Q: the Causes of Low Libido: A Guide for Couples

Xiao An： Hello, I would like to mention that some hair loss medications can indeed affect male sexual function. <br>Although the incidence is low, there is still a possibility. <br>Generally, sexual function returns to normal after discontinuing the medication. <br>In his case, I

Low libido?

Hello Dr.
Hsu,
I have been troubled by this issue for two years and have not found a solution, which has been quite distressing.
I have been living abroad for many years, and it is not as easy to find specialists in this area as it is in Taiwan.
My boyfriend took medication for hair loss about two and a half years ago for approximately ten months and then stopped.
Since then, he has had no sexual desire at all, and he does not masturbate.
He has seen a Western medicine doctor who conducted blood tests and found nothing abnormal, and he also examined him physically, which was normal as well.
However, he has had no sexual desire for almost two years.
Why is this happening? He is nearly forty, and everything was normal before he started the medication.
I am unsure what to do; I have considered seeing a traditional Chinese medicine practitioner.
Could you provide me with some advice on why this might be happening? We have been together for about four years; do you think it is possible that being together for so long has led to a loss of novelty? Even if that were the case, how could he possibly have no basic sexual needs? I don't understand.
Thank you.

Best regards,
Xiao An

Xiao An, 30~39 year old female. Ask Date: 2005/12/31

Dr. Xu Weikai reply Urology

Xiao An: Hello, I would like to mention that some hair loss medications can indeed affect male sexual function.
Although the incidence is low, there is still a possibility.
Generally, sexual function returns to normal after discontinuing the medication.
In his case, I believe it may also be influenced by psychological factors.
It would be good to communicate with your boyfriend about this.
As for your concern about losing the sense of novelty? Some couples have been married for decades and still have sexual needs.
What do you think? Response from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2005/12/31

More Info

Low libido, or decreased sexual desire, can be a complex issue influenced by a variety of factors, including psychological, physiological, and relational dynamics. In your case, it seems that your boyfriend's loss of libido began after he stopped taking medication for hair loss, which raises several important considerations.

Firstly, it's essential to understand that certain medications, particularly those affecting hormonal levels, can have significant impacts on sexual desire. The medication your boyfriend was taking for hair loss is likely a type of 5-alpha-reductase inhibitor, such as finasteride (commonly known as Propecia). This class of drugs works by blocking the conversion of testosterone to dihydrotestosterone (DHT), a hormone that plays a crucial role in male sexual function. While many individuals tolerate these medications well, some may experience side effects, including sexual dysfunction, even after discontinuation. This phenomenon is sometimes referred to as Post-Finasteride Syndrome, where individuals report persistent sexual side effects long after stopping the medication.

Given that your boyfriend has undergone blood tests that returned normal results, it suggests that there may not be an underlying medical condition contributing to his low libido. However, it is important to consider that hormonal levels can fluctuate and may require more comprehensive testing, including testosterone levels, luteinizing hormone (LH), and follicle-stimulating hormone (FSH), to gain a clearer picture of his hormonal health.

Psychological factors can also play a significant role in libido. Stress, anxiety, depression, and relationship dynamics can all contribute to decreased sexual desire. If your boyfriend has been experiencing any emotional distress or if there are unresolved issues in your relationship, these could be impacting his libido. It might be beneficial for both of you to engage in open and honest communication about your feelings and desires. Sometimes, couples therapy can provide a safe space to explore these issues together.

Additionally, the idea of "too much familiarity" in a long-term relationship can lead to a decrease in sexual desire for some couples. While this is not universally applicable, it is worth considering whether introducing new experiences or activities together could help rekindle intimacy and excitement in your relationship.

Exploring alternative treatments, such as Traditional Chinese Medicine (TCM), could also be a viable option. TCM often takes a holistic approach to health and may provide insights into underlying imbalances that could be affecting libido. Acupuncture, herbal remedies, and dietary changes are common practices in TCM that some individuals find beneficial.

In conclusion, addressing low libido is often a multifaceted process that may require a combination of medical evaluation, psychological support, and relational work. It is advisable for your boyfriend to consult with a healthcare professional who specializes in sexual health or endocrinology to explore potential hormonal issues further. Additionally, engaging in open communication about your relationship and considering counseling may help both of you navigate this challenging situation together. Remember, seeking help is a positive step towards understanding and improving your sexual health and relationship dynamics.

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