Not always up for it? Low sex drive in men

Men always have the drive and ability to perform. And if they can't or don't want to, they're not considered proper men. It's a sexist cliché that sex therapist Dania Schiftan says people still believe. «This way of thinking puts men with little to no sex drive under pressure. It also makes it difficult for them to talk about these issues.»

However, sex expert Dania has seen a surprising development in her practice in the last few years. «More men are coming to me for help with libido problems than before,» explains Dania. «While my clients are still predominantly women looking for advice on low libido, men now seem less inhibited to seek help. Not least because it's a topic increasingly covered in the media.» As a therapist, she sees people who clearly want a sex life and are looking to change something about their current situation. «Everyone is entitled to have a low sex drive. If you don't want a sex life, you shouldn't feel like you need to have one.»

Lack of desire... but desire for what?

According to Dania, the term «desire» is used in a way that's too generic. «When my clients say they don't have any desire or drive to have sex, we need to find out what exactly it is they're not feeling that desire for.» A lot of men get to know their sexuality through masturbation, and they use it as a way to release pressure. «Masturbation is an outlet that can be helpful in a lot of situations.» The expression «jacking off» isn't a coincidence.

Once they add a partner to the mix, men realise that the process changes. «All of a sudden, they want to be considerate and perhaps be more attentive or slower than if they were on their own. They can also ask for a bit of tenderness.» Pleasure comes to the fore. «A change like this is very enjoyable but it can also be demanding physically and emotionally.»

«A lot of my clients who have low libido tell me that they still masturbate. Which means their lack of drive is only linked to their sex life with their partner.» Dania puts this down to the fact they can't get what they need from that moment. Releasing pressure, for instance. «Equally, there are men who say they can't concentrate on getting an erection when they're stressed and that's why they have low libido. While for others, their sex drive hinges on the fear of not being able to maintain an erection.» What's more, having the feeling that sex takes longer with your partner or is more complicated can also have an effect on your libido.

Causes

According to our resident sexologist, desire is cyclic. That means you have phases when you have more sex drive and times when you have less interest in it. So, slight changes in your libido are absolutely normal. But if your sex drive continues to drop, it could be for a number of different reasons.

The causes of low libido can be physical as well as psychological. «Physical triggers include serious illnesses and hormonal imbalance. Various medications, such as antidepressants, can also potentially have an effect on libido.» It's only worth seeing a sex therapist once your doctor has been able to rule out any «mechanical» problems.

One of the psychological causes of low libido is depression. «But depression doesn't necessarily show physical signs. For some people, sexuality even offers them support. Whereas men who have an unstable relationship with their body find that their sex drive depends more on their mood.»

When we're looking for causes of low libido, it'd be a bit premature to point the finger at the first available «suspect». Let me give you an example. If a man has low testosterone levels, he would be forgiven for assuming this was the reason for his lack of sex drive. But when you talk to the urologists, they might tell you that the testosterone levels are low but not low enough to warrant the current libido. Dania explains that there are also cases where men have been administered testosterone but not noticed a change in their sex drive. «Most of the time, clients secretly wish their problem was hormone-related. That way the imbalance could easily be addressed by popping a pill. But when it comes to libido problems, there are usually a number of factors at play.»

Special case: long-term relationships

According to Dania, long-term relationships are a topic in themselves. «Over the years, couples usually end up with a monotonous, repetitive kind of sex life. They then opt for what I call the lowest common denominator. Something that they know both of them like or that both of them are OK with,» explains Dania. In this case, the low sex drive or lack of desire is linked to this default routine. «From research, we know that sex life in a long-term relationship steadily gets worse over the first six years. It then stays at that level for the next 20 to 30 years.»

According to sex therapist Dania, low sex drive in a relationship takes on a role and ensures a certain dynamic. «This means it's usually not enough for the person with low libido to see a therapist. What I often notice is the person who is motivated by the therapy sessions taking the initiative at home but coming up against uncertainty or rejection from their partner.» An example of that is a woman coming to therapy and taking steps in the right direction at home. The man, on the other hand, suddenly realises he actually hadn't expected anything to change, and now he's overwhelmed with the new situation. «You can't just make the problem vanish into thin air. It's still a topic that affects all parties in a relationship.»

When does low sex drive become a problem?

The person who puts the brakes on sex is in control. «This imbalance raises questions: how long do you let a sex drought go on for, and when can the person who wants to have sex demand it?» This is a conflict that couples have to resolve between themselves. Dania goes on to say that another key question is, do you have to take it personally or is it a problem that only affects the person with low libido?

Everyone is different, so the point at which low sex drive becomes a problem varies according to each man. «Someone who's never had to deal with the subject before finds it unsettling and is more likely to seek help sooner than someone else. On the other hand, if it's a man who keeps getting this problem but has a partner who isn't very sexually active, it can be years before he actually identifies it as a problem,» explains Dania. But is it even realistic to find a common denominator in terms of sex drive? «Not always and certainly not one that fulfils our every wish. The aim is always to settle on a denominator that suits both parties. That way, both get what they want.»

«Jump starter» aphrodisiacs

Dania says that men who draw a line at sex therapy like to look for an «easy solution» online in the form of aphrodisiacs. These are substances that are meant to increase libido. They come in various forms, including creams, pills, food and supplements. Dania strongly discourages using illegal or prescription drugs. «The side effects or long-term consequences can be fatal. Drugs can only be prescribed by your doctor, and even then, only after careful consultation. And most of the time, they'll be prescribed alongside therapy. In these cases, medication acts as a sensible crutch in the transition period.»

On the other hand, if you use food to organise a romantic dinner of oysters, you might be able to create a nice atmosphere that later leads to sex. «This isn't necessarily down to the oysters, which are rumoured to have a similar effect, but rather the atmosphere they create.» If you expect a would-be aphrodisiac to magically transform embers into a tingling fire, you'll be waiting in vain. «There isn't any medication or substance on earth that can do that. There's rarely an easy way out.»

This is the third article in a series on sexuality with Dania Schiftan. If you have any questions or points you want us to cover in the coming articles, let me know by e-mail at natalie.hemenguel@digitecgalaxus.ch or in the comments below.

For the last 13 years, Dania Schiftan has been working as a sexologist and psychotherapist from her own practice in Zurich. You can find out more about Dania and her job in this interview: