A Functional Medicine Protocol for Low Libido in Men

Low libido is a common condition affecting 20 to 25% of men. This condition can affect relationships and the overall quality of life. This article will discuss libido and the signs and causes of low libido in men. It will also discuss functional medicine testing and options that may help address low libido in men.

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What is Libido?

Libido is another word for a person's sex drive or sexual desire. Although libido will vary from person to person, low libido occurs when a person's frequency or intensity of sexual desire is lower than it once was. Low libido can be a temporary or ongoing concern.

Signs of Low Libido in Men

Men with low libido may have fewer sexual encounters than they once had due to less interest. Sexual provocation in the form of touch, sight, and words does not seem to make a difference. These men may also experience fewer thoughts and fantasies in relation to sex.

What Causes Low Libido in Men?

Common causes of low libido in men include:

Psychosocial Factors

Traumatic childhood experiences and the learned behavior of suppressing sexual thoughts can contribute to low libido. Relationship issues can also affect libido levels.

Medications

Many medications have the potential to influence libido. Certain antidepressants, psychotropics, antihistamines, and cardiovascular drugs have been associated with changes in libido.

Hormones

Low testosterone can be linked to low libido. Testosterone is a hormone responsible for primary and secondary sex characteristics in men, including sperm production, testicular and penile development, voice changes, hair growth, and libido, among others. Testosterone levels naturally begin to decline after 30 years of age.

Thyroid hormones may influence libido as well. The thyroid gland, located in the neck, produces hormones that every body system uses, including the reproductive system. Low levels of thyroid hormones, referred to as hypothyroidism, can be associated with low libido.

Cortisol is an adrenal hormone that is released when we undergo stress. Elevated cortisol levels can influence testosterone levels and thus may affect libido.

Lifestyle Factors

Smoking can influence testosterone levels, which then may affect libido. Alcohol and recreational drug use have also been linked to changes in libido in men.

Other Medical Conditions

Certain medical conditions, such as erectile dysfunction and delayed or premature ejaculation, can impact a man's libido due to anxiety surrounding those conditions. Depression, heart disease, cancer, and diabetes can also be associated with low libido.

Functional Medicine Labs to Test for Root Cause of Low Libido in Males

The following functional medicine labs can help analyze potential factors contributing to low libido in men:

Male Hormone Panel

Access Medical Laboratories offers a Comprehensive Male Panel Plus that assesses the male reproductive hormones in one test, including total testosterone, free testosterone, sex hormone binding globulin (SHBG), estradiol, DHEAS, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and many more. Free testosterone is the amount of testosterone that is freely circulating in the blood and is readily available for use. This differs from total testosterone, as total testosterone includes the amount of free testosterone and unavailable testosterone bound to its carrier molecule, SHBG. This is why it is also important to see levels of SHBG. Assessing estradiol levels is also important, as testosterone can convert into estradiol. Some men can have genetic predispositions that cause this conversion to occur rapidly, leaving them with lower testosterone and higher estradiol levels. DHEA is a hormone made by the adrenal glands and is a precursor to testosterone. Low levels have been linked to low libido. LH and FSH are hormones released from the brain that control the production of testosterone, as well as sperm, in men.

Additionally, this test also includes thyroid hormones, of which low levels may be associated with low libido.

Stress Hormones

The body's primary stress hormone is the adrenal hormone cortisol. Cortisol can influence testosterone levels, which may affect libido. Many lab companies offer salivary cortisol testing, such as the Adrenal Stress Panel by Ayumetrix. This panel assesses cortisol throughout the day for a thorough analysis.

Micronutrient Test

Various micronutrients play a role in hormone production and function, such as zinc, vitamin D, and magnesium. Micronutrient tests such as the Micronutrient Test by Spectracell Laboratories will show many micronutrient levels on one test, including the ones previously mentioned.

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Conventional Approaches for Low Libido in Men

Testosterone replacement therapy (TRT) is an option for men with low libido and low testosterone levels (hypogonadism). TRT can come in the form of injections, creams, gels, pellets, and more.

Functional Medicine Considerations for Low Libido In Males

A functional medicine approach to low libido in men aims to address potential underlying factors. Below are some of the most beneficial evidence-based considerations:

Therapeutic Diet and Nutrition Considerations for Male Low Libido

While there is no diet to specifically increase libido, the Mediterranean Diet may play a role in supporting healthy testosterone levels, which can influence libido. A study published in the European Heart Journal assessed the effects of the Mediterranean Diet on cardiovascular function and erectile function in 250 men with hypertension. The results showed positive improvements in cardiovascular function, including erections, by supporting testosterone levels.

The Mediterranean Diet consists of fresh fruits, vegetables, and herbs, legumes and beans, minimally processed whole grains, and healthy fats in the form of fatty fish, nuts, and seeds. This diet also puts an emphasis on eating locally produced foods that are in season. Processed foods, added sugars, refined seed oils, trans fats, processed meats, and artificial sweeteners are avoided on this diet.  

Supplement Considerations for Low Libido In Men

In addition to a healthy diet, certain supplements such as the following, may be beneficial for supporting libido in men:

Fenugreek

Trigonella foenum-graecum is commonly known as Fenugreek. This botanical is native to Europe, Asia, and the Mediterranean region and has been used as a medicinal plant to aid in blood sugar regulation and sex hormone regulation. There was a study done on 60 men that were split into two groups. One group was given a placebo, the other was given a Fenugreek supplement (Testofen) for six weeks. Results showed that the Fenugreek group saw improvements in libido, specifically orgasms and sexual arousal, but also the quality of life, muscle strength, energy, and well-being.

Dose: Fenugreek seed powder 5-10 grams (g) daily for up to three years or Fenugreek seed extract 0.6-1.2 g per day

Tongkat Ali

Eurycoma longifolia, commonly known as Tongkat Ali, is a botanical that is native to Asia. It has been used as a folk remedy for aging, anxiety, exercise recovery, osteoporosis, sexual functioning, and more. A 12-week study was done on 109 men assessing Tongkat Ali’s effects on quality of life and sexual well-being in men. The men were split into two groups; one group was given Tongkat Ali, and the other group was given a placebo. The group given Tongkat Ali had significant improvements in physical fitness, quality of life, and sexual well-being, including libido.

Dose: The study discussed above used 75 mg four times per day (300 mg total) of a freeze-dried Tongkat Ali extract per day for three months. Other recommendations include 100-200 mg daily for up to nine months.

Zinc

Zinc is a mineral necessary for numerous functions in the body, including neurological, intestinal, immune, and reproductive functions. Zinc is one of the necessary components for the creation of testosterone in the body, and since low testosterone can be associated with low libido, low levels of zinc may be a contributing factor. A systematic review including eight clinical studies concluded that men with low testosterone had low serum zinc levels, and supplementing with zinc may support testosterone levels.

Dose: 50 mg elemental zinc (220 mg zinc sulfate) two times per day for one to four months

DHEA

DHEA is a hormone primarily made in the adrenal glands but also the brain, nerves, and reproductive organs. DHEA is a precursor to testosterone and also functions as a neurosteroid, a molecule that can quickly affect brain function and behavior. DHEA is also a stress hormone and can support the brain in managing the impacts of high stress or high cortisol levels. Low DHEA levels have been associated with low libido.

Dose: 25-50 mg daily

When to Retest Labs for Low Libido

Hormone labs are typically rechecked every three to six months due to the complexity and interconnectedness of hormones. However, each lab may differ slightly. Please speak with your healthcare provider about retesting your specific labs.

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Summary

Low libido can significantly impact a man’s quality of life. Low libido can be due to a variety of reasons, and functional medicine testing can help to explore potential contributing factors. Evidence-based functional medicine approaches may be helpful in addressing low libido.