Men's Health: In-depth Analysis of the Causes of Decreased and Increased Libido and Home Rehabilitation Treatment

Hypoactive and Hyperactive Libido

Libido refers to the desire to engage in sexual intercourse under appropriate stimulation; that is, sexual arousal is achieved under certain stimuli. In healthy men, penile erection occurs when libido reaches a certain level. Calculating the average frequency of intercourse per week or month can reflect the strength of libido.

Changes in libido can be divided into two types: one is hyperactive libido, also known as excessive libido, which is less common clinically. The other is hypoactive libido or lack of libido, the latter being a more common clinical symptom. Libido is closely related to age and overall health, and individual differences are significant. Therefore, whether or not libido has changed cannot be judged solely based on some phenomena in individual cases; it should be measured by consistent responses. Only when libido is not aroused under appropriate sexual stimulation for a long period of time, or when libido changes significantly under the same conditions, can it be considered abnormal. For example, some unmarried young men claim to have no libido or low libido, but in reality, it is because they lack sufficient sexual stimulation that they do not experience libido.

Low Libido

1. Meaning of Low Libido

Aside from age-related decline in libido, any decrease in libido that is incompatible with age and discordant within normal young adults or middle-aged and elderly individuals is considered abnormal and can be termed low libido. These patients often complain of having no sexual desire regardless of the time elapsed between sexual encounters with their wives; or they report having no interest in intercourse whatsoever, only engaging in sexual activity occasionally when their wives initiate it.

2. Factors Causing Low Libido

Sexual activity is accomplished under the control of a series of conditioned and unconditioned reflexes, involving multiple systems including the nervous, endocrine, reproductive, musculoskeletal, respiratory, and circulatory systems. The performance of sexual function is not only affected by the functions of various bodily systems, but also by psychological, mental, and physical factors, all of which can negatively impact sexual function.

① Physical factors: Sexual activity requires the participation of multiple bodily systems. Extreme fatigue or weakness can affect emotions and the state of the higher nervous system in the cerebral cortex. Therefore, after excessive physical exertion or a serious illness, or when physical strength is extremely weakened due to a long-term chronic disease, low libido or a lack of libido is likely to occur.

② Energy factors: This is most common among mental laborers such as intellectuals or government officials. Excessive mental exertion, excessive mental tension, or constant thinking about work-related problems keeps the excitation point of the central nervous system focused on work, causing the sexual center to be in an inhibited state, thus resulting in low libido.

③ Psychological factors: This is a very important and common factor. Excessive sadness, worry, anger, or fear, among other emotions, affect mental and psychological states. A lack of sexual stimulation or attraction to the opposite sex is necessary to trigger libido. This can occur when a husband has an affair and abandons his wife, or when the marital relationship breaks down for other reasons. After prolonged neglect from their wives, such as when the wife has an affair, remains indifferent, or for various reasons has prevented the wife from achieving sexual satisfaction, leading to frigidity or apathy, or due to the wife's fear of pregnancy or aversion to the uncleanliness after ejaculation, resulting in repeated rejection of intercourse, some elderly men believe that they should no longer be interested in sex due to old age. They consider sexual behavior to be lewd, unclean, and sacrilegious, thus developing aversion.

④ Endocrine factors: Normal levels of male hormones in the blood maintain a certain level of responsiveness in the sexual center, eliciting sexual responses under appropriate stimulation. Male hormones can increase the excitability of the sexual center, making certain stimuli more effective in arousing sexual desire. Conversely, when testicular function declines and male hormone production is insufficient, libido declines. Therefore, due to the decline in testicular function compared to young adults, older men require a longer time to achieve an erection, unlike younger men who achieve an erection quickly upon sexual stimulation. Sometimes, older men require direct stimulation of the nerve endings in the glans penis to achieve an erection, and the firmness of their erections is also weaker than in younger men.

⑤ Other factors: Factors that can cause impotence or premature ejaculation, such as chronic inflammation of the reproductive tract, if not cured for a prolonged period after causing premature ejaculation or impotence, can further affect libido, leading to a lack of desire for intercourse.

3. Treatment of Low Libido

① The underlying cause of low libido should be identified, and appropriate treatment should be administered. This includes improving physical condition, eliminating excessive mental stress and fatigue, administering intramuscular or oral male hormones, and treating chronic reproductive tract inflammation, all of which can achieve good therapeutic results.

② Sex Therapy and Guidance: Individuals with sexual experience acquire various conditioned reflexes that can excite the sexual center of the cerebral cortex. Stimuli from higher sensory organs, such as concepts, memories, vision, hearing, and other sensations like touch, can also arouse sexual excitement, similar to unconditioned reflexes (stimulation of the glans penis). Therefore, psychological and mental treatment plays a crucial role. Sex therapy, based on the above mechanisms, has been proven to be an effective treatment method and has received widespread attention both domestically and internationally. Couples should consult a doctor simultaneously for guidance. Mutual caresses between partners can arouse and stimulate the sexual center of the nervous system, changing states of low libido, frigidity, sexual apathy, and sexual aversion, restoring normal libido.

③ Local Massage Therapy

Method 1: First, rub the testicles. This can be done sitting, lying down, or standing. Alternately rub the testicles with both hands, gently massaging them like counting beads, 100-300 times each morning and evening. The second step is to pull the scrotum. Do this once in the morning and once in the evening. Grasp the scrotum and penis together with your hands and pull downwards 100-200 times. The goal is to feel a slight soreness and swelling in the penis and testicles, and a pulling sensation in both sides of the lower abdomen. Do not use excessive force.

Method Two: This method is similar to the first, but involves more movements. First, rub your hands together to warm them. Support the scrotum and testicles with one hand, and place the other hand on the pubic hair area in front of the pubic symphysis. Use one hand to pull upwards and the other downwards, squeezing and rubbing the penis, scrotum, and testicles together about 100 times. Then switch the positions of your hands and squeeze and rub about 100 times again. Second, rub your hands together to warm them. Place your hands on either side of the penis and scrotum, holding the penis, scrotum, and testicles together, and rub back and forth about 100 times. The third step, as in the second step, involves firmly grasping the penis, scrotum, and testicles with both palms, pulling upwards and downwards approximately 100 times each. The fourth step involves rubbing the scrotum and testicles on the same side with the same hand, alternating between left and right hands, rubbing each testicle 100 times on each side, like counting beads.

The intensity and frequency of this method should be increased gradually, aiming for a level that does not cause pain or discomfort. Gradually increase the force and frequency; once a certain level is reached, the force should be as great as possible, and the number of repetitions can be increased to several hundred. This exercise is best performed in bed, morning and evening. Those with genital inflammation or skin diseases should cure them before practicing this method.

This massage therapy is not only suitable for those with low libido but also beneficial for the health and maintenance of normal sexual function in middle-aged and elderly individuals. From the perspective of promoting blood circulation and local metabolism through massage, this method is beneficial for both vascular and endocrine-related erectile dysfunction.