Ask Dr. Jane: Frustrated wife wants advice on low-libido husband

Dear Dr. Jane,

I’m married to a great guy. We’re both late 40s, no kids, both working good jobs, both in shape and financially secure. We get along well in almost every area except the bedroom.I love any kind of affection, touch or intimacy. My husband says that he loves me but he never wants to have sex with me. His testosterone is normal. He says that he almost never watches porn or masturbates. He says that he just has a low libido. We haven’t had sex for over a year now. Why is this happening?

– Frustrated wife in Bend

Dear Frustrated,

I’m so glad that you connected with me here. You’re describing something very common — libido discrepancy, also known as uneven desire in couples. Lots of people think that all or most men have higher libidos than their female partners, but that’s not necessarily true.

Many men come to me for help in my practice because they are struggling with this issue. Some are married. Some are in long-term committed relationships. Sorry that you’re going through this. The lack of physical connection must be very difficult for you.

There are lots of reasons why your husband may be experiencing low libido. Libido is influenced by a combination of physical, psychological and lifestyle factors.

Here are some things that might be in the way of your husband’s sexual interest::

Hormonal Imbalances: It’s good that he has had his testosterone checked. Testosterone is the primary hormone responsible for sexual drive. A decrease in testosterone levels can lead to a reduced libido. Other hormonal changes that can decrease libido are prolactin and thyroid. It’s important for your husband to make sure that his hormones are at a healthy level as you work on this issue in your relationship. Note: The range for “normal” testosterone is very wide. For example, for men in their 40s and 50s the range is 250 – 915. What is normal for one man, may be very low for your husband.

Problems with stress or mental health: Things like high stress levels, anxiety and depression can lead to physical and emotional exhaustion, which in turn can reduce interest in sex. Depression often leads to a general lack of interest in many activities, including sex. How has he been feeling about his life these days? Does he have a lot of stress or mental health problems?

Unknown relationship issues: Emotional distance and communication problems impact openness to sex. Unresolved conflicts, or lack of emotional intimacy can also lead to decreased libido. Sometimes there are unspoken concerns that impact a partner’s sexual interest. Couples’ counseling can get to the bottom of this concern.

Pornography usage: You mention that your partner doesn’t watch porn. Admitting to porn use can be very challenging and embarrassing. Porn often creates unrealistic sexual expectations and can decrease interest in partnered sex. When you discuss pornography, try to do it in a nonjudgmental way so that your partner doesn’t feel criticized by you for using pornography. Get help to work through this problem.

Physical health issues: Diabetes, obesity, high blood pressure or heart disease impact sexual desire. Does he have these kinds of problems? Also, certain medications impact libido – especially anti-depressants and some anti-hypertensives. This doesn’t mean he can’t take these types of medications. He should talk to his doctor about this.

Lifestyle factors: A lack of exercise: weight gain, fatigue and reduced blood circulation can lower desire. Even a poor diet with deficiencies (like low zinc or vitamin D) can impact libido. Alcohol, drugs and smoking reduce libido by affecting hormone levels, circulation and overall physical health.

Sleep issues: Sleep apnea or poor sleep quality can lead to fatigue and hormonal imbalances, both of which may contribute to low libido.

Aging: As men age, testosterone levels typically drop, which can lead to reduction in desire. You’re both only in your 40s so this isn’t what’s happening with you, but it’s a common concern for lots of people.

Get started on a conversation that will lead you both to a better connection in the bedroom!

You got this.

— Dr. Jane