Wrong -- one out of five men actually have a low sex drive. We know what they want. And we know when they want it: 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. 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.
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.
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. 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.
Continued 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. In cases where the problem is low testosterone , men can take testosterone supplements if they have measurably low levels. When Goldstein suspects low dopamine levels are at the heart of a man's low sexual desire, he might prescribe dopamine-increasing drugs, though this treatment is not currently approved by the FDA and has risks.
However, a new drug now in clinical trials -- for women -- does increase dopamine levels while decreasing a specific kind of serotonin in the brain. Early clinical studies suggest the drug could help women with low sexual desire. Goldstein thinks this new treatment has promise. And if it's approved for women, he says, it will likely be tested in men. In the end, the choice for men who've lost their desire for sex is not between being a panting sexual animal and being a eunuch.
Instead, the real choice is whether these men are ready to regain a vital source of intimacy with their partners -- and a key part of a healthy life for themselves. International Journal of Andrology, December ; vol suppl 2: Annals of Neurology, December ; vol suppl 2: New England Journal of Medicine, Aug.