Quick answer
Sexual health is an area collectively influenced by the vascular system, hormones, the nervous system, sleep, metabolic health, medications used, psychological state, and relationship dynamics. In cases of low libido, erectile dysfunction, menopause-related complaints, and changes in sexual function, the most appropriate approach is to evaluate the underlying factors together, rather than focusing on a single hormone or a single intervention.
Key points
- Low libido cannot be explained by testosterone alone; sleep, stress, depression, medications, relationship dynamics, and metabolic factors can also be influential.
- In some individuals, erectile dysfunction can be an early indicator of vascular and cardiometabolic risks.
- During menopause, vaginal dryness, burning, pain, and urinary complaints may be part of the genitourinary syndrome of menopause and can be treated.
- Testosterone therapy is planned by evaluating symptoms together with laboratory measurements repeated at appropriate times.
- Research on complementary/regenerative approaches such as PRP, shockwave therapy, energy-based modalities, and ozone is evolving; they can be evaluated as adjunct options to the main treatment plan in suitable candidates.
Why is sexual health a part of overall health?
Sexual function is closely related to vascular health, hormonal balance, the nervous system, sleep, and psychological well-being. Therefore, complaints regarding erection, sexual desire, or pain during intercourse can sometimes provide important clues for assessing a broader health picture, not just sexual life.
How is low libido evaluated?
Low sexual desire may be associated with testosterone and other hormonal changes, as well as chronic stress, inadequate sleep, depression, certain medications, alcohol, relationship problems, obesity, and metabolic diseases. For this reason, rather than a single laboratory value, the onset and duration of the symptom, accompanying signs, and the individual’s overall health status are important.
For a detailed evaluation, you can review the Low Libido and Lack of Sexual Desire guide.
Erectile dysfunction
Erectile dysfunction can stem from vascular, neurological, hormonal, psychological, or medication-related causes. Cardiometabolic risks such as diabetes, hypertension, dyslipidemia, smoking, sleep disorders, and obesity can affect erectile function. Evaluating these risks is especially important in newly emerging or persistent complaints.
Detailed information: Erectile Dysfunction and Erection Problems.
PDE5 inhibitors
Sildenafil, tadalafil, and other medications in the same class are frequently used options in the treatment of erectile dysfunction in appropriate individuals. Efficacy may be influenced by proper use, adequate sexual stimulation, dosage, comorbid conditions, and other medications. In individuals using nitrates, PDE5 inhibitors must not be used concomitantly due to the risk of severe hypotension. In individuals with cardiovascular disease, the safety of sexual activity and pharmacotherapy is evaluated separately.
When is testosterone evaluated?
Low testosterone can affect libido, energy, muscle strength, bone health, and certain sexual functions. A diagnosis is not made based solely on a single low laboratory result; clinical symptoms and morning testosterone measurements repeated under appropriate conditions are evaluated together. When a low value is detected, obesity, sleep apnea, medications, the pituitary-testicular axis, and other possible causes are reviewed.
When treatment is considered, fertility plans, hematocrit, prostate evaluation, and cardiometabolic status become part of the monitoring plan. Detailed guide: Low Testosterone and Men’s Health.
Sexual health in women
In women, sexual desire, arousal, and comfort are evaluated together with hormonal changes, relationship dynamics, psychological status, medications, pain, vaginal dryness, and overall health. Especially during the menopause period, vaginal dryness, burning, irritation, recurrent urinary complaints, and pain during intercourse can affect daily life and sexual function.
Menopause and genitourinary syndrome of menopause
In genitourinary syndrome of menopause, vaginal moisturizers, lubricants, local hormonal options, and other therapies suitable for the individual’s risk profile can be evaluated. The goal is to improve not only sexual activity, but also daily comfort and urinary complaints. For the metabolic, bone, and sleep dimensions of menopause, you can visit the Menopause and Healthy Aging page.
Low sexual desire and HSDD
In the evaluation of hypoactive sexual desire disorder, not only the level of libido, but also the distress the symptoms cause the individual and biopsychosocial factors are taken into consideration. In women, pharmacological or hormonal options may be considered in specific patient groups; the selection is made according to menopausal status, comorbidities, and personal preferences.
PRP, shock wave, and regenerative approaches
PRP, low-intensity shock wave, and various energy-based applications are being investigated in the field of sexual function. Positive clinical signals have been reported in some early and medium-scale studies. Due to differences in protocol, device, application dose, and patient selection, results may vary from person to person; larger studies continue to clarify which approach provides greater benefit in which patient group.
Ozone and sexual health
The potential effects of ozone applications on sexual function through circulation, redox balance, and tissue responses are being investigated. Human data are still at an earlier stage. For this reason, in the appropriate individual, ozone may be considered as a complementary option within a broader evaluation of erectile function or general sexual health goals; the evaluation of underlying vascular, hormonal, or metabolic causes retains priority.
Related guides: Ozone Therapy and Male Reproductive Health and Ozone.
Metabolic health and sexual function
Obesity, insulin resistance, diabetes, hypertension, and dyslipidemia can contribute to both hormonal and vascular sexual function problems. Therefore, in some individuals, weight management, evaluation of sleep apnea, regular exercise, and improvement of cardiometabolic risks become an important part of the sexual health plan.
Related page: Weight Management and Metabolic Health.
Our approach at our Bodrum clinic
We do not evaluate sexual health complaints solely through testosterone or a single application. Vascular health, metabolic risk, sleep, medications, hormones, menopause, psychological, and relational factors are addressed together. The primary goal is to identify the issue that bothers the person most and its possible causes.
In the appropriate individual, lifestyle modifications, medical treatments, hormonal options, and complementary/regenerative applications can be compared together. We keep the plan as simple, measurable, and aligned with personal goals as possible.
Frequently asked questions
Is low libido a testosterone deficiency?
Not always. Testosterone is one of the important factors; however, sleep, stress, relationship problems, depression, medications, and metabolic status can also affect sexual desire.
Can erectile dysfunction be related to cardiovascular health?
Yes. Especially in new-onset or persistent erectile dysfunction, the evaluation of cardiometabolic risk factors can be beneficial.
Can PRP or shock wave help?
Positive results have been reported in some studies. The expected contribution may vary depending on the cause of erectile dysfunction, the protocol used, and the individual’s baseline status.
Can vaginal dryness during menopause be treated?
Yes. Moisturizers, lubricants, local hormonal options, and other individually tailored treatments can significantly reduce symptoms.
Related content
- Erectile dysfunction and potency issues
- Low libido and lack of sexual desire
- Low testosterone and men’s health
- Menopause and healthy aging
- Male infertility and ozone
- Weight management and metabolic health
- Healthy aging and Longevity
- Ozone therapy
References
- European Association of Urology. Guidelines on Sexual and Reproductive Health.
- International Menopause Society. Recommendations and key messages on women’s midlife health and menopause. 2025.
- AUA/SUFU/AUGS. Guideline on Genitourinary Syndrome of Menopause. 2025.
- ISSWSH. Clinical Practice Guideline for Systemic Testosterone for HSDD in Women. 2021.
Written and medically reviewed by: Dr. Kerem Çağlayan
Last medical review: September 10, 2026
Visual note: The page visual is a representative clinical image created with artificial intelligence.
Disclaimer: This content is for general medical informational purposes only; it does not replace personal diagnosis or treatment recommendations.
Clinical evaluation in Bodrum: To discuss whether the procedure is suitable for you, you can use the Bodrum Clinic and Appointment and Contact pages.
