Wei from Canberra, ACT writes: I am a 50-year-old man who has been living with HIV for about 20 years and I find these days that I have no desire for sex at all. Sometimes this doesn’t worry me but other times I wish I had a better sex drive.
I don’t have a problem getting an erection but often find coming difficult. I have had very few problems associated with HIV and the only other medication I am taking at the moment is an antidepressant.
Dr Louise replies: I can almost see other readers nodding with you in agreement, Wei. This problem is very common.
But before I can really answer you directly I would need to know a little bit more about you personally.
Have you ever been on HIV treatments? How long have you been on antidepressants and which ones? Have you any other medical conditions or past history? How are you feeling at the moment? Are you in a relationship?
Libido is a complex thing relying on a combination of biological, personal and relationship factors all working together. At different times in our life, depending on all those things, our libidos may be high or low.
Many conditions can alter libido. Medical conditions (especially chronic ones), pain, fatigue and stressors, along with relationship problems can all lower libido.
Depression itself can affect sex drive and ability to have an erection or ejaculate. Unfortunately, even the medication used to treat depression can also have negative side effects – including decreased libido and problems with ejaculation.
Depression itself can affect sex drive and the ability to have an erection or ejaculate. Exercising a little each day, quitting smoking and using alcohol only in moderation will help.
Are your symptoms of depression improving or do you suffer from anxiety? I would encourage you to exercise a little each day, quit smoking and use alcohol only in moderation. Alcohol and marijuana can also lower feelings of sexual desire.
Are there areas of your relationship that could be improved? Many people in long-term relationships notice a decline in sexual interest. One-on-one or couple counselling may help.
Sometimes people need to take time to reset the sexual interest bar, perhaps going to a little trouble and doing something special to rekindle sexual sparks.
Ensure you have a thorough medical check up – particularly your cardiovascular and endocrine systems – and discuss these issues with your GP. You might wonder about testosterone levels.
This hormone plays a key role in male sexual and reproductive functioning. It is also important in good muscle and bone health and can affect mood.
Testosterone levels can decline with age and in some cases deficiency can cause symptoms. Testosterone levels can be measured with two blood tests on separate occasions. If deficiency is diagnosed, some people may benefit from testosterone replacement.
There are some good fact sheets available at www.andrologyaustralia.org that may be helpful.