Man sitting at the edge of his bed appearing sad.

ED or Low Libido? How to Tell the Difference.

When men have trouble performing in bed, it can cause alarm bells to ring for everyone involved. Do I have erectile dysfunction (ED)? Is my sex drive messed up? Am I not attracted to my partner? (Partners may wonder the same thing.) What’s wrong with me? This article distinguishes between ED and low libido, describes how both are diagnosed, and gives suggestions for seeking help.

Differentiating between Erectile Dysfunction and Low Libido

Men diagnosed with ED might:

  • Have trouble getting an erection that is hard enough for sex.
  • Have trouble maintaining a firm erection throughout sex.
  • Also experience low libido.

Erectile dysfunction is most commonly caused by issues in circulation, which can be caused or exacerbated by conditions like high blood pressure, high cholesterol, and behaviors like smoking and being overweight.

Libido refers to sex drive or one’s desire to have sex. A number of factors can cause low libido, including being depressed, stressed, or tired. Just like with ED, behavioral factors like drinking too much or using illicit drugs can also affect sex drive. Even home environments can affect one’s desire to have sex.

Diagnosing Erectile Dysfunction

Medical doctor writing in a patient's chart.

How can men distinguish between occasional ‘performance issues’ in the bedroom and ED? Partially, it is about how long it’s been occurring. Men diagnosed with ED typically experience issues with erectile functioning on a regular basis.

There are a number of ways that ED can be diagnosed:

  • Self-report questionnaires
  • Tumescence tests
  • Neurological tests

Doctors can administer questionnaires to their patients to determine the frequency of their erectile functioning. One such questionnaire is the International Index of Erectile Function. Six questions specifically focus on erectile function, include prompts like:

  • How often were you able to get an erection during sexual activity?”
  • During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?

A low score on the erectile function section could indicate ED and patients are typically recommended Sildenafil, the main ingredient in Viagra.

Diagnosing Low Libido

Low libido can also be assessed through the International Index of Erectile Function with questions like:

  • How often have you felt sexual desire?
  • How would you rate your level of sexual desire?

This is obviously more subjective than determining erectile functioning over time. One important thing to remember is that libido can fluctuate, meaning it is normal to go through periods where you don’t want to have sex, or are wanting to have sex less than you normally do.

How to Deal with Both

Medical doctor having a discussion with a male patient.

Men should consult with their doctors if they feel concerned about their erectile functioning or sex drive. Once they determine what the issue is, steps can be taken to address it. For erectile dysfunction , men may be prescribed Viagra to temporarily improve erectile response. The treatment for low libido will depend on what is likely causing it. For instance, an anti-depressant may be prescribed if the doctor believes the man’s depression is affecting his sex drive. Either way, it is important to consult with a healthcare provider if men are experiencing erectile function issues and/or a decreased desire to have sex. It may be a sign of a more serious health issue.

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