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Low Sexual Desire for Men

Male Low Sexual Desire (known diagnostically as Male Hypoactive Sexual Desire Disorder) involves persistent or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and a persistent or recurrently deficient (or absent) desire for sexual activity.  Many men experience periods of temporarily low libido that can be influenced for example by tiredness and fatigue or by preoccupation with life events that require close attention (e.g., an impending job interview or another stress).  Hence, Low Sexual Desire is only considered a disorder if it persists for a minimum of 6 months.  Low Sexual Desire for men can be caused by several factors and it is only diagnosed as a psychological problem if it is not better explained by substance or medication use or another medical condition.

Low Sexual Desire is also only considered a psychological problem if it causes significant emotional distress.  Some men identify as ‘asexual’, which is defined as a lack of interest in sexual activity or a lack of sexual attraction to any particular gender.  Men who self-identify as asexual are perfectly comfortable with their lack of sexual desire (for sex or any particular gender) and in these instances a diagnosis of Low Sexual Desire is not made.

Like many other psychological problems, male low libido can result in mild, moderate or severe levels of emotional distress depending on the individual and couple.  It’s important to note that Low Sexual Desire is only diagnosed if the individual experiences persistent or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and a persistent or recurrently deficient (or absent) desire for sexual activity.  Low Sexual Desire is not diagnosed as a psychological problem if there is simply a discrepancy between a man’s level of desire and that of his partner (i.e., a man may have a lower ‘sex drive’ compared to his partner, but this alone would not constitute a disorder).

Other factors include whether the difficulty is lifelong or acquired.  If the problem has been present since the individual became sexually active it is considered lifelong.  If the problem commenced after some months or years of normal sexual functioning it is considered acquired.  The condition may also be situational or generalised.  If situational, the problem only occurs with specific types of stimulation, situations or partners.  If generalised, the problem is not limited to specific types of stimulation, occurs in different situations and/or with different partners.

What causes Male Low Sexual Desire?

A mix of physical and psychological factors or a combination or both may influence Low Sexual Desire for men.  Symptoms of depression and anxiety are strong predictors of low libido.  Up to half of all men with a history of depression or anxiety also experience a significant loss of desire at some stage of their lives, compared with only 15% of men who have not experienced these symptoms.  Broadly, relationship problems, negative attitudes towards sex, a lack of adequate sex education and the after effects of trauma or abuse in early life may affect sexual desire for men.  Illicit drugs and various medications may also dampen libido.  As with all sexual problems, it is important to discuss your concerns with your GP first to rule out any physical basis for a low sex drive.

Physical causes of Male Low Sexual Desire:

Endocrine disorders including hyperprolactinemia that result in abnormally high levels of prolactin in the blood can strongly influence sexual desire for men.  Various medications including antidepressants, anti-hyperintensive drugs and anti-convulsant drugs may also result in hyperprolactinemia and consequently low libido for men.  The relationship between Testosterone levels and sexual desire is unclear.  Men’s reported sexual desire does not fluctuate linearly with Testosterone levels, however results of some research notes abnormally low levels of Testosterone may correlate with low sexual desire, however further research in this area is needed.  The biological effects of ageing also result in lowered sexual desire for men.

Psychological causes of Male Low Sexual Desire:

Psychological causes of low libido for men include excessive stress and fatigue due to life challenges (e.g., working very long hours), dissatisfaction with and/or stress over the couple’s sex life (which may also be influenced by a partner’s sexual difficulties), feeling inadequate or perceiving their partner as uninterested in them.  Sexual desire can also be worsened if the male feels emotionally disconnected from his partner or if the couple experience recurrent relationship tension, which may or may not be related to their sex life.  Inaccurate or unhelpful beliefs (e.g., “putting pressure on my partner for sex is bad, I should always wait for her to let me know she wants sex”) and being distracted by worries during sexual encounters also negatively impact on sexual desire for men.

Unrealistic expectations on behalf of the man or his partner can also negatively affect a man’s sexual desire.  For example if a man assumes he should always want sex regardless of his level of tiredness or fatigue, or if he assumes he must always be able to give his partner multiple orgasms, or if he assumes he must be able to have sex for very long periods of time, then these unrealistic expectations create worry and tension that makes sex less enjoyable and less enticing.  If unrealistic expectations exist for the couple or man involved then a reduced desire for sex commonly results.  Low libido in men may also occur at the same time as other sexual difficulties such as Erectile Dysfunction (impotence).  These types of difficulties can also cause worry and anxiety about sexual performance that results in a lowered desire for sex.

How common is Male Low Sexual Desire?

Estimates of how common Low Sexual Desire is for men vary depending on cultural factors.  Generally, 6% of young men aged 18-24 experience difficulties with sexual desire (lasting 6 months or more).  This figure increases with age and 41% of men aged 66-74 experience difficulties with desire.  Men from northern Europe report less concerns with low desire (12.5%) while men from East Asian nations report significantly more difficulties (28%).  These differences are thought to be the result of cultural factors, for example guilt over sexual activity (possibly influenced by religious beliefs) may result in lowered desire for sex in East Asian men.

What are the steps in treatment for Male Low Sexual Desire?

Managing Low Sexual Desire may be as simple as changing the types of medication you are prescribed (if this applies).  Some recent research indicates a Testosterone underarm cream may also be useful for men over the age of 45.

Relationship counselling for men and couples is also important to identify the causes of low libido when physical factors have been ruled out.  Once relationship problems such as recurrent arguments or unresolved issues between the couple are worked through, a desire for more frequent sex often results.  Counselling may also involve managing the impact of low sexual desire on the couple in those cases in which it cannot be fully reversed.  This can include focussing on what you enjoy that leads to sexual excitement, modifying unrealistic expectations, or sharing satisfying and enjoyable intimate time together that may not involve intercourse.  Effective relationship communication plays an important role for couples managing the effects of differences in sexual desire.  Relationship counselling will focus to a large extent on communication, as well as on misunderstandings or a lack of knowledge about sexual functioning to help the couple achieve a more satisfying sex life.

Disclaimer:  The information covered on this website is for educational purposes only.  A diagnosis of any psychiatric or medical condition must only be made by a medical or mental health specialist.  Diagnosing a psychiatric concern is a complex process that involves formal training, do not ‘diagnose’ yourself.  If you have concerns that a particular disorder or condition applies to you, please speak with your General Practitioner for further assessment and medical/psychological care.

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