It happens to a lot of guys, but few of them want to talk about it — especially when “it” is a low libido. After all, virility plays a big role in our concept of manhood. There’s this idea you’re supposed to live up to: “Real men are always in the mood.”

But that’s not true. Lots of men have low sex drive, for a lot of reasons. And there are many ways to treat it.

Cause

Any number of things, some physical and some psychological. Sometimes it’s both.

Physical issues that can cause low libido include low testosterone, prescription medicines, too little or too much exercise, and alcohol and drug use. Psychological issues can include depression, stress, and problems in your relationship.

About 4 out of 10 men over age 45 have low testosterone. While testosterone replacement therapy remains somewhat controversial, it’s also a common solution to the problem.

“Replacement therapy with any of the various testosterone available can boost libido,” says M. Leon Seard, II, MD, a urologist in Nashville, TN. “Also, simply getting healthy can help.”

No one thing causes low libido. So it’s crucial to talk to your doctor if you’re worried your sex drive has dropped.