Do most of you guys have a good sex drive?

[Donkeykong]

I wish. I take Lexapro for anxiety and this kills libido for many people.
I am 62yrs old and have ED with several things against me. Diabetes, heart disease, high cholesterol (hereditary) and at least three meds that help me but do not help a sex life, Metoprolo, Lexapro and Adderal.
MY testosterone is mid point for my age. I had asked about Clomifine to boost testosterone without shrinking testes. Regular Dr. would not. Urologist acted like she did not even hear me say it.

If your testosterone is mid point it's doubtful that's the problem. It's mostly guys whose testosterone was very low before who notice any difference with testosterone treatment. I am actually on TRT with good testosterone levels and even so I have no libido (unless I use cannabis, which brings it's own problems).

Clomiphene isn't usually prescribed for long term treatment of low testosterone because it can have bad side effects. For example it can damage the retina leading to vision loss. Guys who take it for fertility, or bodybuilders, usually take it for limited periods so the risk doesn't add up as much. And I've read a lot of guys saying that it doesn't necessarily raise their libido even if it raises testosterone.

I would first talk to the doctor who prescribes your psych meds if I were you. You are taking a trifecta (at least) of libido killers! Sometimes they can add or change something to help libido.

[Martin6469]

Vvs111: You've identified T and free T, but there's a lot more to our T-related endocrines. There are dihydrotestosterone, bioavailable testosterone, estradiol, sex hormone-binding globulin, luteinizing hormone, gonadotropin releasing hormone, prolactin, follicle-stimulating hormone, thyroid-stimulating hormone, and more. In some cases ED can be caused by a brain tumor which changes some of these hormones! You need a full endocrinologist workup. Don't try to analyze your own situation as in your December 8 post.

If you don't get results from your endocrinologist, look for an endocrinologist who specializes in mens' sexual health. If it's hard to find such a specialist endocrinologist, a medical school might help. Professors like challenges. Send an e-mail to their endocrinology department with a full description of your situation, offering yourself as a study subject.

[Lost Sheep]

I don’t have any urges. They just vanished. All I have are memories of the way I used to feel, and now I’m stuck in the loop of trying to figure out the cause.

There’s psychological and hormonal, but everyone seems to lump those causes together. But they should have distinguishable differences, right?

I remember having a physical ache down there that increased the longer I abstained. You know like when you have to pee, you can feel the discomfort.

But the sexual feeling was there whether you’re hanging with your buddies or working, and there’s nothing to trigger your dopamine like when you see an attractive person or with your significant other.

You see success stories of TRT or a psych medicine but they just give the vague, “sex drive is high again” but never give detailed symptoms where you could pinpoint details.

My situation might be informative. I am 76 years old and on testosterone suppression for prostate cancer.

I developed ED over time and in 2017 finally got a penile implant (after a couple decades using pills which gradually lost effectiveness). My libido was always moderate. In October 2023 a prostatectomy also removed my implant's reservoir, so I spent 14 months without erections at all. Being unable to have penetrative sex, my girlfriend and I managed sex a couple of times, but my desire was not there partly due to knowledge that I could not follow through with coitus. (Our usual pattern was foreplay followed by cunnilingus to get her wet with a couple orgasms and sometimes fellatio, then coitus to produce my orgasm followed by cuddling.)

Back in 2017 when I first got my implant, my libido got a boost because having that weighty phallus out in front of me was a tremendous feeling. I expected something similar with the installation of my new implant in December 2024. The new implant did not produce as radical a boost as my first one did, but now that we CAN, we do.

My sex drive was always driven more by my cranial head than my penile head and that remains even more true now than before April 2024.

What happened in April 2024 is that I went on ADT (Androgen Deprivation Therapy) to combat prostate cancer. My Total Testosterone was 590 ng/dl before and is now below 20 (medical term is "castrate level"). My hormonal libido (the penile head-generated) is totally absent. My intellectual libido (the cranial head) is as strong as ever (because I love my partner and she loves me...and our sex). Yes, I incorporate HER libido to supplement mine.

So, the gonadal ache for release is not there any more (with no prostate, there is not even any ejaculate - but orgasmic contractions feel the same). The longing for physical intimacy is still there. I don't kiss her as much as I used to. That dopamine rush (as you characterize it) is absent for me. But that does not stop us. I generate my libido by other means than testosterone.

The advice you got from donkeykong and Martin6469 about seeking a sexual health endocrinologist or perhaps a psychologist specializing in sexual (dys)function may help sorting out your particular situation. My situation may or may not be informative or useful.

[Vvs111]

Vvs111: You've identified T and free T, but there's a lot more to our T-related endocrines. There are dihydrotestosterone, bioavailable testosterone, estradiol, sex hormone-binding globulin, luteinizing hormone, gonadotropin releasing hormone, prolactin, follicle-stimulating hormone, thyroid-stimulating hormone, and more. In some cases ED can be caused by a brain tumor which changes some of these hormones! You need a full endocrinologist workup. Don't try to analyze your own situation as in your December 8 post.

If you don't get results from your endocrinologist, look for an endocrinologist who specializes in mens' sexual health. If it's hard to find such a specialist endocrinologist, a medical school might help. Professors like challenges. Send an e-mail to their endocrinology department with a full description of your situation, offering yourself as a study subject.

All of those tests have been done, plus a lot more of my own from TRT forum recommendations and complete lab panels.

I have seen about 5 endocrinologists plus a TRT clinic. The first one was a endocrinology professor at a top university. Gave me the runaround for about 10 years.

[Vvs111]

I don’t have any urges. They just vanished. All I have are memories of the way I used to feel, and now I’m stuck in the loop of trying to figure out the cause.

There’s psychological and hormonal, but everyone seems to lump those causes together. But they should have distinguishable differences, right?

I remember having a physical ache down there that increased the longer I abstained. You know like when you have to pee, you can feel the discomfort.

But the sexual feeling was there whether you’re hanging with your buddies or working, and there’s nothing to trigger your dopamine like when you see an attractive person or with your significant other.

You see success stories of TRT or a psych medicine but they just give the vague, “sex drive is high again” but never give detailed symptoms where you could pinpoint details.

My situation might be informative. I am 76 years old and on testosterone suppression for prostate cancer.

I developed ED over time and in 2017 finally got a penile implant (after a couple decades using pills which gradually lost effectiveness). My libido was always moderate. In October 2023 a prostatectomy also removed my implant's reservoir, so I spent 14 months without erections at all. Being unable to have penetrative sex, my girlfriend and I managed sex a couple of times, but my desire was not there partly due to knowledge that I could not follow through with coitus. (Our usual pattern was foreplay followed by cunnilingus to get her wet with a couple orgasms and sometimes fellatio, then coitus to produce my orgasm followed by cuddling.)

Back in 2017 when I first got my implant, my libido got a boost because having that weighty phallus out in front of me was a tremendous feeling. I expected something similar with the installation of my new implant in December 2024. The new implant did not produce as radical a boost as my first one did, but now that we CAN, we do.

My sex drive was always driven more by my cranial head than my penile head and that remains even more true now than before April 2024.

What happened in April 2024 is that I went on ADT (Androgen Deprivation Therapy) to combat prostate cancer. My Total Testosterone was 590 ng/dl before and is now below 20 (medical term is "castrate level"). My hormonal libido (the penile head-generated) is totally absent. My intellectual libido (the cranial head) is as strong as ever (because I love my partner and she loves me...and our sex). Yes, I incorporate HER libido to supplement mine.

So, the gonadal ache for release is not there any more (with no prostate, there is not even any ejaculate - but orgasmic contractions feel the same). The longing for physical intimacy is still there. I don't kiss her as much as I used to. That dopamine rush (as you characterize it) is absent for me. But that does not stop us. I generate my libido by other means than testosterone.

The advice you got from donkeykong and Martin6469 about seeking a sexual health endocrinologist or perhaps a psychologist specializing in sexual (dys)function may help sorting out your particular situation. My situation may or may not be informative or useful.

This is amazing information. I’m glad you took the time to write your history because it helps break down sexuality in males, rather than clumping the entire thing as libido. It really needs to be studied.

[Kodixx]

I have experienced good results with PT-141, and now THC/CBD. I just posted 2 messages in another section, one on each, one message after the other.

= Chuck

https://www.franktalk.org/phpBB3/viewtopic.php?f=12&t=8784&start=20#p248156

[Al1962]

To answer OP question, No.
I have clinical anxiety and have taken Lexapro for about 7yrs. It is common for this to affect Libido and function. I also have other issues with health that do not help. If I was more able I am sure Libido would be a little better.

[easymoney]

I had a stroke in 2022 which killed my libido . .. T level is "normal" but from what I have been reading what is normal for one man may not be normal for another. I saw an andrologist and he said at my age with the stroke and other health issues told me it would be losing battle ..

[Lost Sheep]

Easymoney and Al1962 and anyone else with no sex drive/libido but a willing partner,

My testosterone is 0.20 ng/ml (essentially zero) due to taking estrogens to suppress prostate cancer, so I should have no sex drive for two reasons. I even have breasts now (gynecomastia is a sometimes side effect of androgen deprivation therapy for the cancer).

I have pretty much no desire for sex and orgasms are elusive at the moment, but that can change as things settle down. I suppose my current experience is similar to that expressed to me by partners of the past who insisted that her sexual pleasure does not absolutely require orgasms. So, now, my sexual pleasure similarly does not require that I have an orgasm. Cherry on top, sure, but still, the icing on the cake is still delicious. (To combine metaphors).

But our (the both of us) desire for intimacy is still there and where there's a will, there's a way. I am also blessed with a penile implant which makes coitus possible, which she still enjoys immensely, and I thoroughly enjoy giving her her pleasures and she, mine. Sex drive crosses over into intimacies far beyond genitalia.