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Male Sexual Response: But, What if It’s Not the Woman???

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

One woman writes to Mental Help Net:

I have heard so many comments about the woman having no sex drive, but what if it’s the man? My husband’s sex drive has considerably lowered in the past two years or so, and talking about it has made it worse. He used to work away from home and told me multiple times he sometimes masturbated as many as three times a day. Now, living back at home daily, he no longer masturbates, yet, we rarely have sex. I feel constantly rejected but, while I do not want to seek other companionship, I can’t help but worry that it’s my fault. My husband is unbelievably honest and trustworthy. He is home every night and we spend every second together during the weekends. He’s not gay, that’s a cop out bad answer…what is it???

This woman raises an important question and makes a very good point. The point she makes is that it is not necessarily the woman who has a low sexual drive. There are many men who experience low libidinal drive or who want to avoid engaging in sexual relations with their partner. Although this contradicts the commonly held view that the male sexual appetite is endless, the fact is that many men have either a low sex drive or none at all. This writer then wants to know what is the problem with her husband? He is not homosexual, he does not have sexual affairs and there appears to be no reason for his lack of sexual interest in her. Typical of many people in this situation, whether it is the male or female sexual partner, she becomes anxious that her partner’s problem may be her fault.

What does cause male sexual problems?

There are many problems that can cause a male to experience a low sexual drive or a wish to avoid sex. Some of them are listed here:

Possible causes of male sexual problems:

1. The problem that usually comes to mind first is ED or Erectile Dysfunction, the inability to maintain an erection long enough to have sex. However, this is far from the only problem that can exist.

2. Another well known problem is premature ejaculation. In other words, ejaculation occurs prior to penetration. This is frustrating for both the male and female partner.

3. On the opposite end of the spectrum is delayed or inhibited orgasm. In this case, it takes an extremely long time before the male achieves orgasm or it may not occur at all.

4. Problems in the relationship can cause each of the partners to avoid sexual relations. Constant arguing, distrust or other types of conflicts and difficulties lead to avoidance.

5. Low levels of testosterone, the male sex hormone, can cause the male to experience a lack of or a low desire to have sex. In actuality, the aging male does experience a variation of the menopause that women experience during middle age, but not as suddenly or abruptly as experienced by women. As with women, there is a lowering of sexual hormone levels leading to a decline in interest.

6. Many types of medications can cause complications in the sexual response in both men and women. For example, many types of anti depressant medications have a dampening effect on the sexual urge and can cause men to experience delayed orgasm. In addition, blood pressure medications can also have this dampening effect.

7. Arterial disease, such as hardening of the arteries, whereby, blood flow is partially blocked and diminished to many parts of the body, negatively impacts the male sexual response.

8. Alcohol addiction as well as addiction to other drugs interferes with sexuality.

9. Diabetes, which leads to arterial disease, dampens sexual desire.

10. Depressive and anxiety disorders lead to decreased libido in both men and women.

I am certain that this is not a thorough list of all the possible problems, both emotional and physical, that lead to sexual dysfunction in men.


Men of all ages do not like to go to the doctor. When the problem is sexual in nature they are even more discouraged from seeking medical help because of feelings of embarrassment and shame that there may be something wrong with their "masculinity."

These issues do not reflect negatively on a man’s masculinity at all. In fact, there is now treatment and relief for the conditions that cause sexual dysfunction.

Some treatments are as follows:

1. If there are problems in the relationship between partners both couples and individual psychotherapy are extremely helpful in removing barriers to a happier sexual life together.

2. There is treatment for depression and anxiety that may not require the use of medications. Cognitive Behavioral Therapy (CBT) has been found extremely effective in relieving both sets of symptoms.

However, in those cases where medication is necessary, the Psychiatrist can make adjustments in the dosages of an anti depressant or make a change in medicine in order to relieve the sexual side effects that are causing problems.

3. There are prescription medications for ED or Erectile Dysfunction that are effective in relieving that problem.

4. Hormonal treatments can boost libido or desire for those men who, for a variety of reasons, may have lowered testosterone levels.

5. Quitting smoking can relieve many breathing problems that have a dampening effect on sexuality.

6. Exercise rather than being a "couch potato," can increase libido.

7. Sometimes surgery is necessary and successful in bringing about a cure if there is something organically wrong the male sexual organs.

The point is that there is help available and there is no reason to continue suffering, except for feelings of shame in connection with these issues.

If you or the male partner you are with experiences these types of problems it is important to consult a urologist or endocrinologist to identify and treat the problem. If the issue is psychological or relational then seeing a psychotherapist is the way to go.

Your comments are welcome and encouraged.

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