So when is men's low libido problematic? There’s a normal decline in the amount of sex most couples have over time, but if a man is significantly distressed, either personally or in his relationship, in addition to having no desire (or greatly reduced desire) for sexual activities or fantasies, it’s a problem: He may be suffering from hypoactive sexual desire disorder (HSDD). It’s a partner’s frustration that gets many men to seek treatment. When a woman feels undesired, she’s bound to have a ton of questions, like “Does this mean I’m not attractive enough?” or “Is he sleeping with someone else?” But the answer is often not that simple.
Why a Man's Libido Slows Down—Is It Testosterone?
The go-to assumption is that this shift is usually due to age or low testosterone, but this generally doesn’t match the science. There is a strong correlation between low desire and other sexual issues like erectile dysfunction, premature ejaculation, and difficulty with orgasm. (Makes sense: Worrying that you’re sexually inadequate or struggling to perform is not a sexy feeling.) These things can be correlated with myriad medical issues like hypothyroidism, diabetes, heart disease, and cancer as well as side effects of many medications, most notably blood pressure meds and antidepressants. Anxiety, depression, or severe stress may also block desire; smoking and excessive drinking certainly don’t help. This is why a thorough medical examination (which involves, gulp, his actually telling a physician he’s having issues) is smart.
How to Talk About the Problem
Once medical issues are ruled out, the challenges for a woman are to try not to take it personally and to get curious instead of defensive. If your partner feels shamed or emasculated for turning down sex, he’s only going to want it less.
Try to have a conversation while fully clothed to think together about what has changed over time. Has work stress gone up? Have you had kids? Are you fighting a lot? There may be things that need to shift in your relationship before sex can become a priority again.
Then, from a place of collaboration instead of blame, ask each other, “Is the sex we’re having worth wanting?” Humans desire only things that are, well, desirable. It’s never too late for a couple to try a departure from their go-to sexual playbook. (I love the Kindu app for sorting through options both partners may want to try.)
If these conversations don’t go well or if you’re left stumped, consider counselling with a sex therapist. In the end, the more you feel like an intimate team, the better equipped you’ll both be to work toward a mutual and authentic sexual relationship.
This article originally appeared on Prevention US.