Doctor, I don’t feel like having sex with my partner. She is young and attractive but I don’t know what is wrong with me.
I am worried and my partner even more.
These words taken from a query are much more common than it might seem to us and represent a social and couple stigma. In a study conducted in 374 men with a mean age of 48.8 years, 30% had a lack of sexual desire. Of these, 47% also had an erectile dysfunction disorder.
What do we understand by lack of desire?
It would be the absence of sexual fantasies and sexual activity that causes great anguish and a disorder in the couple’s relationship; It should not be due to a major mental disorder (except other sexual dysfunction), and it’s not solely due to the effects of a substance or a general medical condition.
The main problem with this definition is that the concept of sexual desire is not yet well defined in the current literature and is based on the traditional model of human sexual response derived from Masters & Johnson and Helen Singer Kaplan.
To begin with, we must be careful to distinguish whether the disorder has always been present, or is recent. If it is presented with any couple or only with one.
Sexual desire is the result of positive interaction between internal cognitive processes (thoughts, fantasy, and imagination), neurophysiological mechanisms (central arousal), and affective components (emotional state), although the biological basis remains almost unknown in humans.
Some hormones such as prolactin, estrogens, cortisol, and in particular testosterone modulate sexual desire, acting on androgen receptors that are present in different areas of the human brain.
The causes of the lack of desire would be determined by biological and psychological factors and relationship problems.
We must emphasize that hypogonadism is a cause of lack of desire, as well as hyperprolactinemia.
Hypothyroidism is another endocrine condition associated with the lack of male desire, in addition to several categories of medications such as Antidepressants, Antipsychotics, Lithium, Antiepileptic, Clonidine, Reserpine, opiates.
What to do in the face of a lack of desire?
The first thing to do is go to a sexologist in Delhi who will conduct a complete medical history in addition to a rigorous physical examination. You will see a possible decrease in testicular and prostate size that makes us suspect hypogonadism. Lack of desire is sometimes the only symptom of a prolactin-secreting pituitary adenoma. Other symptoms such as gynecomastia and galactorrhoea. A hormonal problem must be ruled out, measuring Testosterone, Prolactin, and TSH, or even other tests whenever a systemic disease is suspected.
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