Can you shed some light on the most common causes of low to no sex drive in men? My hubby and I haven't had sex for three months. We've only been married for two-and-a-half years. He never really demonstrated a high sex drive except when we were dating. He never initiates, and I find it hard to believe any man can have NO desire. I would like your opinion. Our marriage is okay. We have small arguments, but no matter whether we are happy or sad, it's always the same. No sex! I used to make an effort, but not now. My main question is: what would your opinion be on a man making no effort? Hold nothing back, please!
When men with low sex drives come into my office, I always refer them to a sex-positive physician to get a complete physical that includes tests of their hormone levels. Sometimes it helps to take a little testosterone to boost the libido. Sexual functioning can be impaired by some medications for depression, high blood pressure, or diabetes. (It can also be impaired by depression, however, so a physician may have to be very knowledgeable about medication for this condition to come up with a combo that won't leave your husband with a wobbly rubber dick and no desire for sex.)
After checking for depression, I ask my low-libido male clients about the state of their relationships. Is their partner still physically attractive to them? Do they feel uncomfortable with certain behavior or attitudes that they believe their wife can't or won't change? A spouse who is alcoholic, spends excessively, criticizes others too much, or is angry all the time can kill desire.
I also take a sex history. How did my client learn about sexuality? What were some of the early messages he got about his own body? What were his first sexual experiences like? If he was raised with a harsh fundamentalist religion that preached against sensuality and the flesh, he may have some deeply implanted taboos against being sexually free. Traumatic experiences with child abuse can also impact on adult sexual functioning and negatively affect the ability to be intimate.
We also have some talks about the nature of his desire. Does he want to be heterosexual? Is he content with vanilla sex? A man who is hiding his homosexuality in a sexless marriage may be very ashamed of himself and unable to confront the coming-out process. But he can't reasonably expect a healthy woman with her own needs to put up with that. The same holds true with a man who has some kind of fetish or need for a variant form of sexual behavior. Many men lead double lives, seeking out sex workers to gratify their real sexuality while preserving a "pure" and "normal" marriage that is driving their wives crazy with frustration. But many wives are able to incorporate fetishes into marital sexuality as long as they are also getting their own needs met, and it is wrong to keep such a big secret in any close relationship.
Finally, we have to ask if this hypothetical man is actually happy about being a man. Is he a cross-dresser? Is he unable to get it up unless he can wear women's clothing? Or does he have an unexpressed need to transition from male to female? Gender conflicts are complex issues that need to be handled with a knowledgeable professional.
As you can see, this is a lengthy checklist. There are many reasons why a man might have a low sex drive. But my last question is, why doesn't your husband seem to care about the lack of sex in his life? If he doesn't want to fix this and doesn't see it as a problem, you are left with only two options: accept a life of celibate marriage, or have sex with somebody else. It isn't humane for him to expect you to be monogamous if there is no sex inside the relationship. But I don't recommend cheating either. Presenting him with the bald fact that you are not going to remain faithful if he won't put out may be what it takes to motivate him to deal with his issues.