Low sex drive is an area of health where knowledge and treatment is expanding rapidly but also an area full of myths, lies and misinformation. It’s a condition that is best assessed by a doctor with an interest and special knowledge in this area and it requires a holistic approach.
There are essentially three different ways that low sex drive can be a problem.
- Innate low sex drive is a low sex drive that has been present for all of somebody’s adult life. These are people who report there sex drive has always been low, its the least common
- Acquired low sex drive is where a person who would have previously considered there sex drive to be normal is bothered by how much there drive for sex has dropped
- Desire discrepancy is where one partner’s sexual desire is much greater than the others and it is the most common way for low sex drive to be a problem because sex drive is something that varies a lot between people
There are some cases where hormones and medications are the answer to a low sexual desire problem but in most cases there are lots of different things that are contributing to the problem.
How common is it?
The answer to this questions depends on a lot on what people think a normal sex life should be like. An average frequency of sex between couples in long term, committed relationships is probably around twice a week for those in their 20s and once a week for those in their 40s and 50s but just like some people are short and some are tall there is a wide variation. The percentage of men who might be diagnosed with hypoactive sexual desire disorder (HSDD the medical term for clinically low sex drive) is probably about 5%. Most men in their 40s and 50s however will report that their interest in sex has dropped significantly compared to when they were younger.
What causes is it?
It is much more common for there to be two or three or more different things that are causing low sex drive. Most of the time the cause will be some combination of the things listed below
- Anxiety related to having sex – men worry that sex will be boring, painful, unsatisfying, or unsuccessful and this worry leads to negative feelings about having sex. This is often the case when men say they “just don’t like having sex”
- Desire discrepancy – one partner is much more interested in sex than the other but there isn’t necessarily anything abnormal about the partner who is less interested in sex
- Behavioural problems – excessive use of pornography and masturbation may be a factor as well as certain styles of masturbation
- Relationship problems – this may vary from couples who simply aren’t attracted to each other or where other personal problems are impacting on intimacy
- Sex awareness and knowledge – the portrayal of sex on the internet and TV is often very different to what sex looks like in real life but this sort of sex education is rarely taught
- Lifestyle causes – being overworked, fatigued, lack of exercise, lack of time, or simply having too much stress will effect sex drive
- Medical conditions – many conditions like diabetes, heart disease and cancer affect sex drive
- Medications and drugs – prescription medications (including pain killers and anti-depressants) as well as illicit drugs like anabolic steroids, cocaine, marijuana and heroin affect sex drive
- Hormonal causes – testosterone, oestrogen, prolactin and thyroid hormones can all affect sex drive and these are often the easiest to treat
How is it treated?
The best treatment involves working out which (of the usually multiple) factors are relevant to the problem and addressing each of them. For those patients who seek treatment with an experienced and holistic doctor then treatment is very likely to be successful.
Treatment involves understanding the patient and their problem and depending on this understanding providing treatment in the form of education, behavioural and psychological strategies to improve how men view and enjoy sex, sometimes sex therapy or couples therapy and treatment of any medical or mental health problems that might be impacting on a man’s drive for sex.