Men's Sex Issues: Low or No Sex Drive?

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It's a common myth that all men have a raging, constant sex drive (also called desire or libido). Popular culture emphasizes this and perpetuates the myth that all men want sex all of the time. But this is simply not so. Many men experience a sex drive that fluctuates. Some experience none at all. This can go on for days, weeks, months or years at a time. And in addition to low and no sex drive, guys can experience feelings of anxiety, sadness and often worst of all, shame around this. Shame because our culture tells us that this shouldn't be happening, that as a man you should always have sex on your mind and be ready to go.

It can be hard to talk about having a low sex drive and not easy to figure out what to do about it. To complicate matters, your sex drive is influenced by many different factors. This can make it hard to pin down one cause. In fact, often a mix of factors lead to diminished or absent desire in men.

One note: there is a difference between low sex drive and asexuality. Individuals who identify as asexual experience no or low sexual desire but also have no distress about it. In my work with men with low sex drive, there is usually distress and a desire to change things.

If you are concerned about your sex drive, it can be helpful to consider some of the following factors that are often involved.

Medical / Health Issues

A variety of health issues can contribute to low libido, including several endocrine disorders, cardiovascular issues, cancer, as well as some medications. Of note, one class of drugs used to treat depression and anxiety, SSRIs (selective serotonin reuptake inhibitors), often have an impact on desire in men.

Psychological Issues

There are a number of psychological issues that can have a direct effect on your libido. Stress is a frequent contributor. Difficult work conditions, a miserable commute, money problems and other stressors can all lead to a decrease in sexual desire. Depression can lead to a loss of interest in many positive and pleasurable activities, including sex. Anxiety can also contribute, especially when there are negative beliefs about yourself or inaccurate beliefs about sex (I should be able to perform better, I should be a better lover, I never seem to get things right with my partner, etc.).

Other psychological issues can also contribute to low desire. If you struggle with sexual issues such as premature ejaculation or erectile dysfunction, you may notice desire diminishing as a result of these separate challenges. Finally, trauma such as childhood sexual abuse can have a significant effect on sexual desire in men when they are adults.

Relationship Issues

While different levels of desire are often seen in sexual partners and aren't necessarily an indication of low libido problems, significant relationship issues can have a direct effect on desire levels. Conflict in the relationship, as well as feelings of anger, frustration and resentment toward your partner can negatively effect desire. Also, problems in sexual communication between partners can have a negative effect on your libido. If you feel that you must always play a certain role or that you have certain things expected of you (I must always initiate sex, I can't ever have foreplay, sex always must start and end the same) you may see interest in sex diminish.

What can you do about it?

Working with a therapist can be a good way to address the issues mentioned above, especially since often there are a complicating set of factors that contribute to low sex drive.

One important intervention is to get checked out by a physician. A complete physical can rule out any health issues that may be contributing. Often when I work with men around low libido, this is the first step we take in moving forward.

Identifying stressors that may be contributing, as well as coping mechanisms to deal with these can also be helpful. While you may not be able to change your job, your commute, or quickly improve stressful financial issues, you can learn new ways to deal with these things so that you feel more in control of your life. Addressing symptoms of depression and anxiety can also be helpful and have a direct effect on your libido.

Finally, if relationship issues are contributing to your low libido, both individual and couple therapy can be helpful to resolve conflicts, improve communication, and move forward with a healthy sex life.

Often, individuals I work with note that a variety of factors contribute to their low sexual desire and it can take some work to untangle the causes and identify solutions. The good news is that there are a variety of approaches that can help.