There are a number of reasons men may not want sex, including certain medications (antidepressant and blood pressure pills), a host of medical conditions, depression, fear of sexual failure, too much prolactin, or too little testosterone.
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There's a popular myth that men want sex as often as they can get it. The truth is that low sexual desire in men is more common than we think. We don't know the actual prevalence of this under-reported phenomenon, because men are usually too ashamed to admit it, but the number of couples in my practice with hypoactive sexual desire has sky-rocketed over the past few years. It seems ironic that as women embrace their pleasure zones and finally get the courage to claim their orgasms, many men are saying, "Not tonight, dear -- I have a headache!"
I recently received this letter:
Dear Dr. Scantling,
Is it possible for a man not to have sexual desire? My husband, age 48, and I have been married nearly 20 years. During that time, we have sex on our anniversary and sometimes on New Year's Eve at my initiative after months of begging and complaining from me. When we finally have sex, he mechanically accommodates me. He kisses me with closed lips, doesn't look at me, touches my breasts and genitals quickly, and then "mounts" me. The whole thing is over in less than five minutes! I have tried to tell him and show him what I like in bed, I've suggested we see a therapist, I've pleaded and I've threatened -- nothing works. I'm completely out of ideas. I don't want a divorce -- I just want a better marriage! Do you think testosterone would help him? I've discussed this with my doctors, but they just look at me in amazement and don't appear to have any direct reference for my situation. I'd really appreciate your help.
Signed -- Neglected
There are a number of reasons men may not want sex, including certain medications (antidepressant and blood pressure pills), a host of medical conditions, depression, fear of sexual failure, too much prolactin, or too little testosterone. Research shows that although we can improve motivation and sexual drive by giving hypogonadal men testosterone it may not necessarily increase desire for sexual activity with one's partner.
The more challenging issues are emotional. Withholding sexual affection may be a sign of ambivalence about intimacy or an indirect way to express hostility under the guise of immobilization. "I'd reach out if I could -- I just don't know why I don't show you that I love you more often."
Whatever the causes, reduced sexual desire plays havoc with a relationship. Women tend to blame themselves for their partner's disinterest -- many get plastic surgery, go on diets and do just about everything and anything to get their partner's interest -- even threaten an affair to prove their desirability. As resentment builds, the "hurt" one can become the "hurtful" one as the dynamics are played out.
When I meet with these couples, I often see openly disgruntled women and more quietly perplexed men. Many of the men are described as the consummate "nice" guys -- successful in their careers -- loving fathers. On interview, some secretly admit to sexually neglecting their partners, but self-stimulate regularly while viewing erotic images on the Internet. They tell me that they'd rather "take care of business alone -- it's simpler that way" than "deal with the drama." What they feel more ashamed about, however, is hurting the women they profess to love.
And what about the women? The less sexual attention they receive, the more rejected they feel. Instead of appreciating his efforts at home or at work, they become hostile, critical, suspicious or blaming. Instead of saying, "I miss spending time with you," they make caustic remarks about the infrequent unimaginative sex they have together. Hearing some of these wives complain reminds me of the Queen of Hearts in "Alice's Adventures in Wonderland" who is quick to deliver her most famous line, "Off with their heads!" Although she's more bark than bite, her tirades take a toll. Being bitchy never engenders intimacy.
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Whether low sexual desire begins with the man or his partner is the classic chicken and egg argument. The net result is that both partners are disadvantaged. The husband doesn't feel like a "real" man, and the wife feels unloved -- unwanted, unattractive -- "un" you name it. As the distance and hostility grow, so may the threats of divorce in a deepening downward spiral.
So what's a couple to do? If you wait for passion to return, you may be waiting a lifetime. The best way to change a pattern is to begin -- somewhere. You know you can take all the "fat burner" pills on the market but you won't get rid of your belly fat until you actually hit the gym and curb those vanilla soy lattes. Period. The same is true for creating sexual passion. Behavior is meaningful, not promises. As the French say, "The appetite comes with the eating."
If you're a woman attracted to a man who doesn't want sex, it might be helpful to do some introspection. Do you have an extreme need to be needed? Do you long to be the one who finally breaks through your man's wall of isolation to reach the passion buried inside? Unfortunately, all that you may unearth is your own exhaustion and fury.
But don't be hard on yourself when you ask, "Why didn't I see this at the beginning?" He probably means it when he says he loves you, but what he may not be telling you (because he doesn't know it yet) is that he's placed you into the role of his mother and unconsciously resents you for it. Once you understand that, you might understand why he's had to separate sex from intimacy.
If you're ready to give up your anger and are interested in improving things, answer the following questions honestly: Have I become self-righteously vindictive or punitive? Have I unknowingly turned into my partner's controlling caretaker or competitive sister? Do I spend more time criticizing what he does wrong than appreciating what he does right?
I'm not blaming you for his lack of passion, but it's important to take responsibility for your piece of the problem.
And what about the man who withholds sex because of unresolved conflicts while he claims to love his partner? If you're one of these men, ask yourself: How do I feel about women in general? Who are the women I can have sex with or fantasize about and are they the same women I would marry? Am I in touch with the control and power I feel when I deprive my partner of what she wants the most? Do I understand why intimacy is difficult for me? How can I express my passion without feeling like I'm giving something up?
Low sexual desire is a complex problem that creates suffering for both of you. Understanding your partner's perspective is the key to improvement. If you don't believe that, you're not going to get anywhere.
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I can hear you saying, "I don't want to understand him (or her), I just want them to change," to which I say "sorry." You selected each other for a host of reasons. Either you thought you could "change" your partner or something in your marriage has gone off kilter. Whatever it is, if you approach one another as lovers, not as an angry mother or recalcitrant son, you'll have a better chance of getting the sexual passion you both so richly deserve.
To Ask A Question
Our intimate relationships and sexual health are intensely personal concerns that many people find difficult to discuss. Please think of this as a safe place to have those concerns addressed. Write to me in confidence at: AskDrScantling@aol.com.
Feel free to ask me whatever is on your mind regarding sexual wellness, health, intimacy and relationship --- mind, body or spirit. Some readers' letters will be chosen for publication and reply in the column. They will be edited to eliminate names and other personal identifying information.
This content is to be considered informational and is not intended as a substitute for professional, medical, or psychological advice, diagnosis or treatment. Please consult your own medical doctor or therapist before adhering to any information or recommendations. Case material used in Dr. Scantling's columns are composites and not intended to represent any actual couple or individual. Dr. Sandra Scantling is a licensed clinical psychologist, advanced practice registered nurse and certified sex therapist. She practices in Farmington. Her website is www.drsandy.com. Her archived columns are available at www.courant.com/ne.
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