Men. High sex drive. Panting sexual animals. We know what they want. And we know when they want it: right now.
Even doctors tend to see men as "sexual automatons," hardwired always to want sex, says pioneering sex researcher Irwin Goldstein, MD, director of sexual medicine at San Diego’s Alvarado Hospital and editor in chief of The Journal of Sexual Medicine. "But that is not the case at all," Goldstein tells WebMD Magazine. "Many, many men -- about one in five --have such low sexual desire they’d rather do almost anything else than have sex."
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One in five men doesn't want sex? How can that be true? And why haven't we heard about it? Actually, many women have -- the ones hearing the phrase "Not tonight, dear." Goldstein says most people think that is a rare occurrence. "But in fact, almost 30% of women say they have more interest in sex than their partner has."
The causes of low sex drive
So what's behind low sexual desire? Aging plays a role, though many older men have a robust interest in sex, Goldstein points out. Like most other human traits, the sex drive varies. Most men are in the normal range; some are extraordinarily driven toward addiction-like sexual behavior. At the other end of the scale are men with very low sexual interest. These are men who suffer from hypoactive sexual desire disorder (HSDD).
"There are always men on both sides of the normal curve," Goldstein says. "And a certain percentage -- perhaps up to a quarter -- will be considered to have HSDD for a whole host of reasons." These include:
Psychological issues. Stress and anxiety from the strain of daily life, relationship or family problems, depression, and mental disorders are among the many factors that can affect sexual desire.
Medical problems. Diseases such as diabetes; conditions such as obesity, high blood pressure, and high cholesterol; and HIV drugs, some hair-loss remedies, and other medications can negatively affect sexual desire.
Hormonal causes. "Testosterone is the hormone of desire, arguably for women as well as for men,” Goldstein says. Low testosterone levels usually mean low sexual desire. Levels dip as men age; other causes include chronic disease, medications, and other drug use. Other hormones can play a role, too, such as low levels of thyroid hormone or, rarely, high levels of prolactin, a hormone produced in a gland at the base of the brain.
Low dopamine levels. Sexual desire obviously involves the brain -- and the brain's chemical messaging system is intimately linked to sexual desire. One of those messengers is dopamine. Doctors have noted that Parkinson's disease patients treated with dopamine-stimulating drugs had increased sexual desire. Goldstein says these drugs help some men with HSDD.
Each cause of low sexual desire has its own treatment. When the root cause is psychological, sex therapy can offer men specific techniques and strategies for regaining their enjoyment of sex. "It is not psychotherapy; it is psychology counseling focused on sexual issues," Goldstein explains.