Key Takeaways:
- Men over 40 with low libido may face a higher risk of early death, even after adjusting for other health risks.
- Libido loss in women wasn’t linked to mortality in the study, but it still signals possible hormonal or emotional health issues.
- Low libido and erectile dysfunction aren’t the same—each can point to different underlying conditions.
- A lasting drop in sexual interest should prompt a medical check, not just be blamed on aging.
We often treat a declining sex drive in men as just another sign of aging—nothing unusual, nothing urgent. But research from Japan suggests it might be something more. A long-term study tracking over 20,000 adults has found that men over 40 who reported losing interest in sex had a significantly higher risk of dying early. Even after accounting for common health risks like high blood pressure, diabetes, smoking, and psychological stress, the connection held strong: men with no sexual interest were nearly 70% more likely to die during the follow-up period (Sakurada et al., 2022).
This wasn’t a pattern seen in women, which raises important questions about how sexual desire functions not just in relationships, but as a possible marker of biological resilience—especially in men, where reduced libido may reflect changes in vascular health, hormone levels, or mental health—areas strongly linked to long-term outcomes.
The Yamagata Study
The study enrolled 20,969 adults (8,558 men and 12,411 women), asking a single yes/no question about current interest in people of the opposite sex. Over a median of 7.1 years, 503 participants died, with 162 deaths from cancer and 67 from cardiovascular causes (Sakurada et al., 2022). Even after rigorous statistical adjustment, men without libido remained at significantly higher mortality risk—a finding that elevates sexual desire from a mere quality-of-life measure to a potentially vital sign of health.
Notably, cancer-related mortality was initially elevated but lost statistical significance in fully adjusted models. Yet the persistent association with all-cause mortality signals something biologically meaningful is unfolding, though researchers caution against leaping to causal conclusions.
Distinguishing Low Libido from Erectile Dysfunction
Many readers may conflate libido loss with erectile dysfunction (ED), yet these are interconnected yet distinct concerns. Libido reflects internal drive—its absence may stem from hormonal imbalances, stress, low mood, or fatigue. ED, by contrast, often originates from circulatory or neurological dysfunction, especially atherosclerosis. While both can coexist, each plays a different role as a health indicator.
Studies consistently warn that ED often serves as an early warning sign of cardiovascular disease. Plaque-induced damage to penile arteries can precede or coincide with coronary artery disease, and ED has been linked with higher rates of heart attack, stroke, and death (Mayo Clinic Staff, n.d.)
The Link Between Sex Drive and Health Problems
What might explain the Yamagata findings? Several interrelated mechanisms emerge:
- Lifestyle & Chronic Disease
Men lacking libido in the Japanese study were more likely to smoke and have diabetes—factors that predispose to cardiovascular and metabolic disease (Sakurada et al., 2022). These lifestyle-related illnesses are themselves associated with early mortality, suggesting that libido loss may be an early symptom of broader health decline.
- Hormonal Dysfunction & Aging
Testosterone plays a central role in regulating sexual desire, mood, muscle mass, and metabolic function. As men age, natural testosterone levels often decline, which can lead to symptoms such as low libido and fatigue. While earlier observational studies raised concerns about possible cardiovascular risks associated with testosterone replacement therapy (TRT), more recent large-scale trials—such as the TRAVERSE study—have found no significant increase in heart attacks or strokes among men with symptomatic hypogonadism (Hackett, 2025). However, the long-term safety profile remains under active investigation. Some evidence still points to potential risks, including atrial fibrillation, blood clots, and the possibility of stimulating latent prostate disease (Grech, Breck, & Heidelbaugh, 2014). These mixed findings highlight the need for individualized treatment decisions and further high-quality research to fully establish TRT’s safety across diverse populations and risk profiles.
- Endothelial Dysfunction and Vascular Health
Atherosclerosis and endothelial dysfunction compromise blood flow, not just in the heart but in penile tissue. Impaired nitric oxide signaling may diminish erection quality and libido, even before overt cardiovascular symptoms arise. Libido and erection quality may thus both reflect the health of blood vessels.
- Psychological & Social Well-Being
The Yamagata study linked low libido with low frequencies of laughter, high psychological distress, and lower social engagement—factors that may precede or accompany mental health issues (Sakurada et al., 2022). Such psychosocial decline not only dims sexual desire but also correlates with higher mortality.
A Man’s Journey
Imagine John, a 52-year-old with stable blood pressure and cholesterol, but less energy. Lately, he finds himself drifting through his days and losing interest in intimacy. His general practitioner attributes it to stress and aging and suggests Viagra. However, the Yamagata findings prompt a deeper inquiry.
The doctor tests John’s testosterone—revealing borderline low levels—and flags mild insulin resistance. They discuss his sleep quality, stress levels, diet, activity patterns, and mood. This conversation unearths midlife anxiety, deteriorating sleep due to work demands, and social isolation.
A comprehensive plan emerges: a structured exercise regime, nightly wind-down routine, stress management, dietary tweaks, and if needed, testosterone supplementation. His libido gradually returns alongside improved mood, energy, and metabolic markers. He might never need ED medication, but if erectile problems arise, their presence would add another warning signal that underlines the importance of cardiovascular screening (Johns Hopkins Medicine, 2018).
This narrative shows that libido loss often signals a turning point—an invitation to transform health habits, seek medical guidance, and prevent further deterioration.
Related Reading:
Treating Low-Libido (Hypogonadism) In Men: Viagra Is Not a Suitable Prescription
How Are Doctors Treating Low Libido in Women?
UNC Researchers Make an Antiviral Contraceptive Gel That Stimulates the Male Libido
FAQs
What did the Yamagata study find?
Men over 40 with no sexual interest had a 69% higher risk of dying over 7 years.
How many people were in the study?
20,969 adults—8,558 men and 12,411 women.
How was libido measured?
One yes/no question about current interest in the opposite sex.
What were the leading causes of death?
Cancer and cardiovascular disease.
Did the study prove libido loss causes death?
No. It showed a strong association, not a direct cause.
What risks did researchers control for?
Age, diabetes, hypertension, smoking, BMI, alcohol, education, marital status, stress, and psychological distress.
Why didn’t women show the same risk?
Possibly due to hormonal differences, cultural reporting bias, or other unknown factors.
Does low libido mean something’s wrong?
Often yes—it may signal early hormone imbalance, stress, heart issues, or mood disorders.
Was cancer risk higher too?
Initially, yes, but that link weakened after adjusting for other factors.
What’s the difference between low libido and ED?
Libido is desire; ED is function. ED often signals vascular problems. Libido loss may reflect hormonal, mental, or lifestyle issues.
Can ED be a sign of heart disease?
Yes—penile arteries are smaller, so vascular disease can show up there first.
Does TRT help with libido?
Yes, in men with low testosterone. But risks like clots, prostate growth, and sleep apnea must be managed.
Is TRT safe for the heart?
Recent trials like TRAVERSE show no major cardiac risk in men with low testosterone, but long-term effects still need study.
Can women benefit from hormone therapy?
Some postmenopausal women may benefit from low-dose testosterone or estrogen, but treatment must be individualized.
What causes low libido in women?
Menopause, antidepressants, chronic stress, unresolved relationship issues, or mental health conditions.
What treatments help women?
Hormone therapy, counseling, medication adjustment, pelvic therapy, and lifestyle changes.
Can SSRIs or birth control reduce desire?
Yes. Some medications affect libido in both sexes.
Does relationship quality affect libido?
Yes—poor communication, conflict, or emotional distance can dampen sexual interest.
Is therapy helpful for libido issues?
Yes. Sex therapy or counseling can uncover and address psychological and relational contributors.
Should low libido be discussed with a doctor?
Absolutely. It can reveal underlying physical or mental health conditions.
What kind of doctor handles libido problems?
Start with a primary care provider. They may refer to a urologist, endocrinologist, gynecologist, or therapist.
Can lifestyle changes improve libido?
Yes—exercise, better sleep, stress management, quitting smoking, and improving diet all help.
Is low libido just part of aging?
Not always. A gradual shift is normal, but sudden or complete loss deserves attention.
Does the study include LGBTQ+ participants?
No. It only asked about interest in the opposite sex, limiting generalization.
Can libido return with treatment?
Often yes—especially when the underlying issue is found and addressed.
Final Thoughts
When a man says his sex drive is gone, it’s often waved off by doctors, by partners, by the man himself. But the Yamagata study makes it clear: that a drop in libido could be the first sign of something bigger.
It might point to low testosterone, early heart disease, insulin resistance, poor sleep, chronic stress, or depression. It’s not just about interest in sex—it’s about what’s going on under the hood.
The mistake is assuming it’s just aging. Yes, libido can change with age, but when it falls off completely or suddenly, that’s not normal. That’s a reason to run labs, check vitals, look at meds, and ask real questions. Libido loss should be treated like any other symptom. Investigate it, don’t ignore it.
Also, don’t confuse libido with ED. One is about desire, the other about function. They can overlap, but they’re not the same. And they have different causes and different implications.
Lifestyle still matters. Bad sleep, no exercise, processed food, high stress—all of it chips away at hormone balance and energy. Fixing those things won’t solve everything, but it gives the body a chance to work again.
And for women, just because this study didn’t show a mortality risk doesn’t mean that libido doesn’t matter. The data might be missing the full picture. Women deal with hormonal shifts, stress, medication effects, and relationship strain, and their symptoms are easier to dismiss or harder to track. We should take their concerns just as seriously.
In short, low libido can be an early sign of an underlying medical issue. Sometimes, it’s the first sign that your system is under pressure—and that’s exactly when you should act.
References
Mayo Clinic Staff. (n.d.). Erectile dysfunction: A sign of heart disease? Mayo Clinic. Retrieved July 4, 2025, from https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/art-20045141
Sakurada, K., Konta, T., Murakami, N., Kosugi, N., Saito, T., Watanabe, M., Ishizawa, K., Ueno, Y., & Kayama, T. (2022). Association between lack of sexual interest and all-cause mortality in a Japanese general population: The Yamagata prospective observational study. PLOS ONE, 17(12), e0277967. https://doi.org/10.1371/journal.pone.0277967
Johns Hopkins Medicine. (2018, June 12). Erectile dysfunction means increased risk for heart disease, regardless of other risk factors. https://www.hopkinsmedicine.org/news/newsroom/news-releases/2018/06/erectile-dysfunction-means-increased-risk-for-heart-disease-regardless-of-other-risk-factors
Hackett, G. I. (2025). Long term cardiovascular safety of testosterone therapy: A review of the TRAVERSE study. World Journal of Men’s Health, 43(2), 282–290. https://doi.org/10.5534/wjmh.240081
Grech, A., Breck, J., & Heidelbaugh, J. (2014). Adverse effects of testosterone replacement therapy: An update on the evidence and controversy. Therapeutic Advances in Drug Safety, 5(5), 190–200. https://doi.org/10.1177/2042098614548680
