Low libido is far more common than you may imagine. People just do not talk much about it. In context, it’s not automatically a cause for concern. People can temporarily experience low libido for some pretty obvious and common reasons. These can include general stress, pregnancy and childbirth, being super busy, body image problems, and relationship strife.
What to Do About Low Libido Dr Rick Pomfret Therapy4Men
Another major cause of decreased sex drive is poor communication. Caring for your sex life is as much about trust as it is about lust. Busy couples that have been together for a long time can unintentionally neglect this reality. So, let’s explore some ways to turn that dynamic around.
Trends That Can Get Mistaken For Low Libido
Firstly, it helps to comprehend that not all loss of sexual desire is caused by low libido. Some other possibilities include:
Sexual Incompatibility
This can manifest in several ways. For example, you could be bored with the sex you are having. You may feel awkward asking for a specific time of sex or intimacy. Also, some folks express a spontaneous desire while their partner is more the responsive type. This can easily and accidentally be confused with a low sex drive. Sometimes our bodies do not respond the way we want them to respond. This can lead to escalating pressure and anxiety that creates challenges for both partners.
Societal Standards
If we were to trust pop culture or social media, we would come out on the short end of almost any kind of societal comparison. Unrealistic expectations can result in all sorts of shame, guilt, and resentment. Focus on you and your partner and do not factor in romantic comedies or romance novels. Pornography is often a factor in the unrealistic expectations some people have of themselves and their partners.
Mental Health Issues
Anxiety, when connected in any way to sex, can appear as low libido. In reality, you might be subconsciously avoiding anything that appears to be triggering or risky.
4 Small Steps To Take When You Have Low Libido
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Talk to Medical Doctor
Why not rule out any number of possible physical issues? It can be a source of relief (either way) to discover that there is or isn’t a physical component to this problem. The obvious thing to do is get your testosterone level checked. Keep in mind that After your check-up, you will be better able to decide what happens next. There are definitely different opinions about what is considered “acceptable” or “normal” testosterone levels in middle-aged men.
Here’s a breakdown:
Medical Guidelines (Conventional Medicine):
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The American Urological Association (AUA) defines low testosterone (“hypogonadism”) as a total testosterone level below 300 ng/dL (nanograms per deciliter).
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The Endocrine Society has a similar threshold (about 264–300 ng/dL), but they emphasize that symptoms matter too (fatigue, low libido, depression, etc.), not just the number.
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Normal ranges typically cited: 300–1000 ng/dL.
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Doctors usually require two separate morning blood tests to diagnose low T, because levels naturally fluctuate.
Functional/Anti-Aging Medicine:
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Some doctors who focus on “optimal health” or anti-aging take a more aggressive stance, aiming for higher testosterone levels, often 600–900 ng/dL.
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They believe that many men feel better when they are on the higher end of normal, even if they technically aren’t below 300.
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They often advocate for testosterone replacement therapy (TRT) based on symptoms, even if levels are “within normal limits” but relatively low (like 350 or 400 ng/dL).
Scientific Debate Points:
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Some researchers argue that testosterone naturally declines with age (about 1% per year after age 30), and not all declines are pathological.
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Others argue that modern lifestyles (obesity, poor sleep, environmental toxins) cause unnatural declines, and therefore treating low-normal levels may be beneficial.
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There’s ongoing debate about the risks of TRT, including heart disease, prostate issues, and blood clots, versus its benefits (better energy, mood, muscle mass, bone density).
Bottom line:
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There is no universal agreement.
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Some doctors are very cautious and stick to strict criteria (T < 300 + symptoms), others are more open to treating “low-normal” levels based on quality of life.
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The decision often comes down to individual goals, symptoms, health risks, and finding a doctor whose philosophy aligns with yours.
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Talk to Your Partner
Until you both open up about how you’re feeling, this topic will feel more and more shameful. There is nothing unusual about sex-related issues. In fact, they give you a golden opportunity to clear the air on multiple levels.
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Think Seriously About the Kind of Sex You DO Want
As touched on above, you may just have a low libido for certain kinds of sex or intimacy. You may also feel weird or nervous to ask for what you want. Take the time to ponder what turns you on. Without making demands, you have every right to share this information with your partner. Asking for what you want and need in a constructive way also gives your partner the space to ask for the same.
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Don’t Jump to Conclusions
Everyone has cold spells so be patient with yourself. Yes, of course, problems pertaining to our sex lives can be disproportionately more intense than other concerns. Resist the urge to default to the worst-case scenario. Once again, gather information, communicate openly, and trust yourself to find the right steps to take.
Talk to a Mental Health Professional
While you digest and consider all of the above information, there is another step to keep at the top of your to-do list. Contact a therapist to get the ball rolling on a process that can be life-changing. Low libido would be the catalyst you need to ask new questions and discover new answers.
Committing together to explore these issues is a powerful way to reconnect and build new trust. I have worked with plenty of individuals on issues related to sex and intimacy. I’d love to help you out as well, so reach out to me if you are ready to begin.
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Therapy for Men is a practice led by Dr. Rick Pomfret that offers solution focused counseling and psychotherapy services tailored to the needs of men. Their services encompass anxiety therapy, depression therapy, relationship therapy, men’s issues and support for those navigating life transitions or divorce. With offices in San Francisco and Corte Madera, Therapy4Men provides convenient access to mental health care for men in the San Francisco Bay Area and online across California.