I am 45 years old and over the past year my

sex drive has dwindled greatly. What should

I do?

Question of the Week:

November 9, 2001

"I am 45 years old and over the past year my sex drive has dwindled greatly. What should I do?"

Dear Questioner:

Your not indicating your gender in the question gives me the opportunity to stress a point about sex drive (libido) and aging. Before doing so, it should be said that there are many psychological and physical issues that impact one's libido: depression, job stress, perception of lack of time, anger issues with one's partner, poor health, back or abdominal pain, vaginal dryness, erectile dysfunction, etc. If, however, none of these is in play, and you've noticed a decrease in libido gradually over the past few years, then starting in one's forties a decreased testosterone level is near the top of the list of causes-for both men and women.

A growing body of well-controlled studies of the relationship between libido and aging have implicated declining testosterone levels. There are testosterone receptors, not just in muscle and reproductive tissues, but also in the brain that are important in generating libido.

I suggest you take one of the questionnaires that can be found in our 'Andropause' and 'Peri-menopause' sections under 'PADAM test' for men, and 'Women-testosterone' for women. If your answers are indicative of probable testosterone deficiency, you are a candidate for testosterone replacement therapy that will likely improve or totally reinvigorate your sex drive.

Joseph M. Raffaele, MD