The year is almost coming to an end, with many of us likely to reflect on the last twelve months. For some, it has been a challenging year due to financial head winds. For others, the surprises of the Brexit and Trump presidential create worries that may pave ways for many unexpected days ahead.

As we look back on the events that may change the world in 2016, many of us also reflect on our own health, and anticipate changes in lifestyle next year for overall improvement. When it comes to the considerations of our sex lives, it is not always easy to reflect, as many changes are subtle and gradual.

This week, I try to address a concern from a reader who realized a downhill deterioration in his desire for sex. Is not having any mood for sex a cause for concern or simply a fact of life for a middle-aged man?

Dear Dr. G,

I don’t consider myself old. But in the past twelve months, I feel like I don’t have the zest in sex as I used to have.

I guess I can be considered as a middle-aged father of two.

When I reached forty years old in 2016, I realized the bedroom activities desires had slowly deteriorated. Two years ago, I seemed to remember having sex about twice a week. To be honest, I really cannot remember when was the last time I had sex with my wife.

My wife is not complaining, as everyone is busy with work and life and sex is not a top priority any more (Sigh!)

I do not consider myself having a large appetite for sex, but my libido is really diminishing to worrying levels.

I really would like to know whether having no mood for sex is normal. Is this a cause for concern, or I just have to wave goodbye to my sex life from now on?

Of course, I also would like to consider what treatment may be available to get me back in the mood for love again.


No Mood

Sexual libido or sex drive in men is a natural phenomenon. The endocrine system in men initiates the thoughts of sexual desires and enhances the appetite for sexual activities. In an evolutionary sense, this increases the chances of mating and creating offspring. Many scientists and clinicians in sexual health medicine consider men as “Sexual automatons” who are hardwired to desire sex. Although, it may not be every seven seconds, postulated by some women magazine, Kinsey Institute estimated that men think about sex at least five times a day.

Therefore it is natural for some men to worry about their own health when their libido does not match that of their younger days. The famous sexual health researcher, Irwin Goldstein postulated that one in five men have low sexual desire to the extent that they would rather do anything else than having sex. In his study, Goldstein also demonstrated that one third of women say they are more interested in sex than their partners.

Testosterone is the main driver in sexual desire for men and therefore it is unsurprising to learn that studies have demonstrated 40% of men over the age of 45 have low testosterone. Although age is the main reason for the decline in the male hormone, other causes such as chronic illnesses, illicit drug abuse and long-term medications, such as hair loss medicine, can also contribute towards the decrease in male hormone. Apart from testosterone, other hormones are also recognized to be important in getting the men in the mood for sex. High levels of the hormone, prolactin in the brain or low levels of thyroid hormone are some of the endocrine causes for the decrease in men’s sexual needs.

The biggest sexual organ in a human is the brain. Hence, psychological issues may also be a significant cause of decrease in sex drives in men. Anxiety at work, strains in relationship, mental disorders and depressions are all well documented to affect sexual needs in men.

Of course, the healthy sexual appetite in men is a good barometer for good overall health. Needless to say, poor bodily functions such as cardiac disease, hypertension, dyslipidemia and obesity also dampen that healthy sexual libido.

The first step to recover diminishing sex drive in men is visiting the doctor for open discussions and assessments. Healthier lifestyle choices are keys to rejuvenate that loving feeling. This can achieve by getting regular exercise, ensuring enough sleep, reduce stress, improve diet and cut down on the cigarette and alcohol.

Counseling may also be necessary for couples. In many cases, a low libido is an indicator of the differences in expectations. Talking through the issues with a therapist often opens up awkward subjects of sexual needs. This can often encourages changes in priorities in lives to enhance the bedroom experiences. Anti-depression may be necessary to treat men with depression. However, such medication is also associated with further lowering of sexual desires.

Testosterone replacement therapy (TRT) is the treatment for some men with consistently low testosterone due to late onset hypogonadism. Although this may be a quick fix for men with low sex drives, the exact dosage and interval of intervention should be determined.

In reality, sexual desire in men vary enormously. Some men may have unbearable appetite for sex; other may have very low drives. In reality, there is no real definition of a norm. For the men whose quality of life is affected by the lack of desire, it is definitely worthwhile to seek help in regaining that mood for love again.

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