Low sex drive in men linked to chemical imbalance, study says

‘It just didn’t enter my mind to initiate sex;’ Low sex drive in men linked to chemical imbalance

By Sandee LaMotte, CNN
Updated 3:23 AM EDT, Wed April 12, 2023

This article is a repost which originally appeared on CNN

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ Not everyone thinks of sex in the same way.

‧ The hormone Kisspeptin plays a role in pubertal development and reproduction.

‧ Distress over sexual interest can itself contribute to issues.

While hanging out with his college roommates, Peter (not his real name) realized he felt differently about sex than other heterosexual men.
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“I’ve never been somebody who was interested in pornography, but I’d laugh along with their jokes,” said Peter, now 44, who is British. “Of course I never mentioned that … as a man, you’d be kicked out of the herd.”

As he developed “proper, serious relationships” with women, Peter discovered he didn’t have the sexual drive many of his partners did.

“I would make excuses around getting tired or feeling stressed, that kind of thing,” he said. “It wasn’t an issue with attraction to my partner. It just didn’t enter my mind to initiate sex.”

In 2021, Peter saw an ad recruiting male volunteers for a new study on hypoactive sexual desire disorder, or HSDD. Researchers planned to inject the study’s participants with kisspeptin —a naturally occurring sexual hormone — to see if it increased their sex drive. Kisspeptin plays a key role in reproduction; without adequate levels of the hormone children do not go through puberty, for example.

In a long-term, committed relationship with a woman he says has a higher sexual appetite, Peter signed up, intrigued by the thought that a biological imbalance might help explain his behavior.

In the week after the final session, Peter said, something amazing occurred.

“All of a sudden, I wanted to initiate intimacy. I can only presume it was driven not by my mind remembering something, but my body wanting something,” he said. “I did initiate sex more and it improved things with my partner incredibly.”

Wiring in the brain

Experts believe HSDD affects at least 10% of women and up to 8% of men, although those numbers may be low, said Stanley Althof, a professor emeritus of psychology at Case Western Reserve University School of Medicine in Cleveland, Ohio and executive director of the Center for Marital and Sexual Health of South Florida.

“Men are embarrassed to go to the doctor to begin with, and you’re supposed to be a macho guy,” said Althof, who was not involved in the kisspeptin study.

“So it’s difficult for men to say, ‘Hey, I’ve got a problem with my sex drive.’ That’s why the majority of male patients I see with HSDD are sent in by their partners.”

To be diagnosed with the disorder, a person must have no other issues that might cause a change in libido, such as erectile dysfunction or premature ejaculation.

“Losing interest due to performance issues is common, but HSDD is its own thing,” Althof said. “It’s an absence of erotic thoughts and a lack of desire for sex that has to be present for six months. It also cannot be better explained by another disorder or other stressors: It can’t be due to depression. It can’t be due to a bad relationship. It can’t be due to taking an antidepressant.”

One more key point: A man or woman must have clinically significant distress to have HSDD, said clinical psychologist Dr. Sheryl Kingsberg, a professor in reproductive biology and psychiatry at Case Western Reserve University, who was also not involved in the kisspeptin study.

“Some people aren’t bothered by their lack of interest in sex, so we wouldn’t treat them for HSDD,” said Kingsberg, who is also chief of behavioral medicine at MacDonald Women’s Hospital and University Hospitals Cleveland Medical Center.

“The women coming into my office are deeply distressed,” she said. “They tell me ‘I used to have desire but it’s gone. I could be on a desert island with no pressures, but I just don’t have the appetite. I want it back.’ Those women have HSDD.”

‘Surreal’ experience

Dr. Waljit Dhillo, a professor in endocrinology and metabolism at Imperial College London, has been studying the relationship between low sexual desire and the hormone kisspeptin for years, first in animals, then in people.

Prior studies by Dhillo of healthy men with no libido problems found giving them kisspeptin boosted levels of testosterone and luteinizing hormone, which is important for gonad function.

His newest study, published in the journal JAMA Network Open in February, enrolled 32 men with verified HSDD. Peter was one of them.

“So many people say to themselves, ‘It’s just me. I’ve got a problem.’ But actually, HSDD may be how your brain is wired,” said Dhillo, who is a dean at the United Kingdom’s National Institute for Health and Care Research Academy in Newcastle upon Tyne.

“The biology is telling us there’s increased activation of inhibitory areas in the brain — the same areas that tell us it’s not OK to walk around in public naked — and those areas are switching off sexual desire. How can we tackle that? We give a hormone that would naturally give you increased sexual desire, essentially hijacking the normal system.”

The men participating in the new study visited Dhillo’s lab twice. On each occasion, they were fitted with a device to objectively measure arousal, given an injection and asked to watch pornography while their brains were scanned via functional magnetic resonance imaging (fMRI).

Neither the subjects or the researchers knew if that day’s injection was kisspeptin or a placebo.

“It was extraordinarily surreal, lying there with something resembling a hangman’s noose around your bits and watching a mixture of ’70s to modern-day pornographic images and videos,” Peter said. “You’d get about five or six seconds of one type of image or video, rate your arousal for the researchers, and then move on to the next.”

Brain scans showed a significant dual effect after the kisspeptin injection, Dhillo said. Activity in the areas of the brain that inhibit behavior slowed, while areas of the brain connected to sexual interest lit up.

“As a group, the men had a 56% higher sexual response to sexual images after the kisspeptin than the placebo,” Dhillo said. “And we found no side effects at the very, very small dose that we are using.”

Peter noticed a difference immediately after finishing the treatments. His sex life was so robust, in fact, that it wasn’t long before his partner was pregnant with their first child.

As published, the study did not follow the men long-term to see if the effects of kisspeptin lasted. For Peter, however, its impact has been life-changing.

“I have found there’s been a lasting effect for me,” he said. “I do find I have a much better sexual appetite even now some years after the treatment.”

Even the arrival of a baby boy didn’t deter his new interest in sex.

“The cliche is when you have kids, your sex life takes a bit of a hit,” he told CNN. “But that hasn’t been the case for us. In fact, we’re pregnant with our second child, due in July.”

More research is needed

While Peter had a positive long-term result, it’s too soon to say kisspeptin injections were the reason, Althof said.

“When you hear dramatic results like Peter’s, I would be cautious in saying that is the typical outcome. While it’s wonderful that it happened for him, these fMRI studies are difficult to interpret and not conclusive,” he said.

“Sexual desire is very complicated — I say it’s a combination of brain function, hormones and love, wine and roses,” Althof added. “This study is promising, but it needs replication in larger groups.”

And even if future research does confirm kisspeptin’s benefits, medical treatment is not a substitution for healthy communication about sex between partners and with health care providers, Dhillo said.

“These are society’s taboos, but actually, the more we talk about real (sexual) issues that affect real people, the more we find it’s actually quite common,” he said.”If you’re not troubled by low libido, it’s not an issue at all, but if you are troubled by it, this can lead to marital breakdown, unhappiness and reduced quality of life.”

Is fish oil beneficial for men?

What to know about the benefits of fish oil for men

Medically reviewed by Grant Tinsley, PhD — Written by Zia Sherrell, MPH on March 7, 2021

This article is a repost which originally appeared on MEDICALNEWSTODAY

Edited for content

Fish oil is a common dietary supplement rich in omega-3 fatty acids. Research suggests they could be beneficial for health and protection from certain diseases. Additionally, there may also be specific benefits for men, as fish oil might help with erections and fertility.

People who eat lots of oily fish may get enough of these fatty acids from their diet. For those who do not, or only occasionally, eat fish, taking a fish oil supplement could ensure they get sufficient amounts.

This article explores the potential benefits of fish oil for men and the possible risks. It also suggests how people may increase their levels of omega-3.

Definition of fish oils

Fish oil comes from various species of oily fish, such as mackerel, tuna, and herring. Manufacturers can use many different methods to harvest fish oil, but most techniques typically involve a four-stage process that includes cooking, pressing, filtering, and centrifuging the resultant oil.

Fish oils contain omega-3 polyunsaturated fatty acids. These are essential fatty acids that the body cannot make itself. Two of the most well-known types of omega-3 are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Consuming fish oils and omega-3 may bring some health benefits and help with a number of health conditions.

List of possible benefits

Fish oil may have an impact on different areas of health and be a useful supplement for many people. The following is a list of some potential benefits of fish oil for men.

Sexual health and fertility

Although not widely reported, fish oil supplements may have benefits for sexual health and fertility.

A 2017 animal study examined the effects of omega-3 fatty acids and erectile dysfunction due to atherosclerosis. In this condition, the blood vessels narrow, which can affect erections. Rats in the treatment group fed omega-3 fatty acids demonstrated significantly improved erection quality.

It is essential to bear in mind that animal studies do not indicate the same results in humans. However, an earlier review also indicates that omega-3 could help men with erectile function.

In a 2020 study of 1,694 young male participants, those who reported using fish oil supplements had larger testes and higher semen volume and quality.

They also had a healthier-looking profile of follicle-stimulating hormone and luteinizing hormone. These are two key hormones that regulate sperm production.

Although the study cannot conclude that the fish oil is causing the improvement, it suggests that it may play a role.

Mental health

Research suggests that individuals with depression may have lower blood levels of omega-3 fatty acids. In a small study of 23 people published in Psychiatry Research, supplementation with omega-3s helped improve symptoms of depression within 3 weeks.

There are links between depression and memory problems. Supplementing with DHA alone or in combination with EPA may improve memory function in some groups of adults.

While studies suggest that omega-3 supplementation may help prevent cognitive decline, especially in older adults, a 2019 review notes that more research is still necessary.

Heart health

Heart disease accounts for 1 in 4 deaths in the United States each year. According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death for men in the U.S.

Eating fish may have a protective effect on heart health by reducing some of the risk factors for heart disease.

Triglycerides are a type of fat found in the blood, and although the body needs them, if levels are too high, they can increase the risk of heart disease.

Fish oil may help lower elevated triglyceride levels and blood pressure. Eating fish may also help to significantly lower low-density lipoprotein or “bad” cholesterol.

While many sources promote the potential benefits of fish oil for cardiovascular health, clinical studies do not consistently support them. For example, an analysis published in JAMA Cardiology could not find a clear link between fish oil and lower heart disease risk.

Eye health

Some evidence suggests that an adequate intake of fish oil may help protect eye health. A 2017 review notes that fish oil may play a role in the treatment of inflammatory eye diseases such as age-related macular degeneration (AMD) and dry eye disease.

A 2019 study indicates that people who regularly consume fresh fruits, vegetables, and fish were less likely to develop AMD compared with those who did not.

The American Academy of Ophthalmology (AAO) recommend fish oils to reduce the symptoms of dry eye. However, some evidence suggests they have no effect. A 2018 study found no evidence to indicate that taking fish oil supplements was more helpful than taking a placebo for dry eye.

Optometrists may recommend taking omega-3 supplements or increasing dietary fish consumption to benefit eye health, even though some scientific evidence suggests fish oils are not suitable for this purpose.

Risks and considerations

Before deciding to supplement their diets with fish oils, people should also consider the possible risks.

While some research indicates that eating a diet rich in omega-3 may help prevent prostate cancer, other research suggests otherwise. A 2013 study notes that a high fish oil intake may actually increase the risk of high-grade prostate cancer.

The National Institutes of Health (NIH) note that the link between omega-3 and different types of cancer, such as prostate, currently remains unclear.

Some people may experience mild side effects if they supplement with fish oil. These may include unpleasant taste, bad breath, diarrhea, flatulence, nausea, and other digestive symptoms.

How to increase your omega-3 level

The three primary omega-3 fatty acids are EPA, DHA, and alpha-linolenic acid (ALA). While the first two are present in fish oil, ALA comes from plant oils such as flaxseed, soybean, and canola oils.

ALA is an essential fatty acid, meaning that the body cannot make it, and it must come from a dietary source. Although the body can convert small amounts of ALA into EPA and then to DHA, the most practical way to increase these omega-3 fatty acids is from food or a nutritional supplement.

ALA is the only omega-3 that is essential, so it is the only one with a recommended adequate intake. Research suggests that males should aim for roughly 1.6 grams.

Both EPA and DHA do not have official recommended daily dosages as they are not essential nutrients. However, the British Dietetic Association suggest a daily dose of about 450 mg EPA and DHA for adults.

It can be difficult to judge the intake from nutritional supplements, as the amounts of fish oil may vary. For example, 1,000 mg of fish oil from one brand of supplement may contain less or more EPA and DHA than the same amount of oil from another brand.

People can get enough omega-3 by including the following foods in their diet:

  • fish and seafood, especially sardines, tuna, mackerel, salmon, and herring
  • nuts and seeds such as chia seeds and walnuts
  • plant oils such as flaxseed, soybean, and canola oil
  • fortified foods such as some types of eggs, yogurt, and soy beverages

Alternatively, people may benefit from a fish or vegetarian algae oil supplement to boost levels. Some evidence suggests that taking a fish oil supplement with a meal that contains fat may help to increase absorption.

Summary

Fish oil is rich in omega-3, which is an essential nutrient. Eating a diet containing oily fish, or taking a fish oil supplement, can ensure someone has an adequate amount.

Consuming more fish oil and omega-3 may offer some health benefits for men. This may include increasing fertility and improving heart health. However, men should weigh up the benefits with a potential increased risk of prostate cancer.

Anyone who is considering taking supplements should first check with a healthcare provider to ensure that it is safe.

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