Striking a balance in a marriage is something all couples try to achieve.  Juggling commitments at work, home and with the kids is a common thread of most couples.  A strong bond between both spouses can see them through the most trying of times. 

But, what happens when one spouse seems disinterested in the other?  Those who have experienced this say it leads to questions, anxiety and often depression.

Diminished desire for intimacy can take many marriages down a rocky path.  Many studies have been done on a low sex drive in women.  But now men are starting to speak up, too.  A lack of desire in either spouse can cause frustration and low self-esteem, further complicating the problem. 

What defines a low libido varies with each individual.  If a decline in the interest level of either spouse is noticed for a lengthy period of time, it should cause concern.  When it continues for months and years, many spouses begin to feel rejected, alone and their self esteem drops.  As one woman explained, “It’s difficult to be married to a wonderful guy whom I love and respect, and accept the fact that he has little interest in intimacy.  I can’t help but wonder, ‘What is wrong with me?’” 

“When low sex drive is mentioned, most people automatically think of the wife as having the problem,” said John R. Enright, MD, urologist with the Urology Center of Southwest Louisiana.  “However, there are many husbands who have reported a low sex drive.  It’s difficult for them to discuss it, but once they do, we can work on correcting the problem.”

Low libido and impotence in men are two different things, explained Dr. Enright, although impotence can cause a man to avoid or lose interest in sex.  “Impotence refers to erectile dysfunction, which is a treatable physical problem generally caused by reduced blood flow and nerve damage. And while impotence may be a male health problem, women are affected too.  According to Ben Darby, MD, obstetrician and gynecologist with OBG-1, many female patients discuss problems with their partner’s impotence when talking with their ob/gyn’s about intimacy problems.  “These women are concerned, and want to know what they can do to get their partner’s to seek help or even to talk about their problems.  It’s important for them to understand the causes of the problem, so they can encourage their partner to see their doctor.”

If impotence is not the problem, then there are other factors that may be the cause of a decreased sex drive for both men and women.  These include:

Illness.  Any medical problem or chronic illness can reduce sex drive.  Of course, a diagnosis of a major illness such as cancer will cause any thought of sex to go out the window for a time.  But even minor sickness can diminish sexual interest.

 
Drugs.  Many prescription anti-depressants can diminish sex drive in both men and women.  Other medications with this side effect include tranquilizers and blood pressure medications.  There are alternatives to consider if one medication disrupts the sex drive.  Dr. Enright recommends talking with your physician about the possibility of changing a prescription to one without such side effects.  “It may not be possible, but it’s certainly worth looking in to,” he said.

Stress.  We all balance many things in everyday life.  But when we take on too much, it causes problems.  Any kind of serious stress can cause a decrease in sex drive.  Once the stress is dealt with, most people will notice a return to normal. 

On the female side of the bed, problems with sex drive can also be caused by different things.  Many women have reported a decline in sexual interest a few years before menopause begins.  A new study suggests that it’s not necessarily reduced testosterone that causes women to lose interest, but fluctuation of it instead.  This study found that women who reported decreased libido typically had testosterone levels similar to those of women with sustained desire.  However, women who showed the greatest variation in hormone levels were three times more likely to be sexually disinterested. 

“Testosterone is commonly considered a ‘male’ hormone,” explained Ben Darby, MD, obstetrician and gynecologist with OBG-1.  “Women also produce a small amount of testosterone in their ovaries and adrenal glands to help maintain muscle strength as well as contribute to sex drive.  Upon menopause, testosterone production drops.”

In dealing with loss of libido, communication is critical in resolving the problem.   Experts agree that keeping it “under the covers” only complicates the problems.  “This is problem that affects both people in the relationship, regardless of which person is experiencing the symptoms.  Ignoring the problem will fuel the fire of doubts,” said Dr. Darby.  “Those doubts will multiply quickly and the neglected spouse may assume they aren’t desirable anymore or that their spouses’ feelings toward them have changed.  By facing the problem directly, they will address the fears they both have and handle them together.”

Because there are physical problems that can be addressed, Dr. Enright recommends talking with a physician.  “Women are often more willing to talk about these types of problems, so they may go to their doctor first when intimacy problems are experienced.  Men should do the same.  There are a variety of ways to treat a low sex drive for men and women.  No one should let shame or embarrassment keep them from finding a way through this problem.”