Q: My man has no sex drive. He is awesome in every other way, but I'm struggling with the lack of intimacy. I'm thinking of leaving him, but scared of being alone. He knows how I feel. He's tried taking vitamins and so on, but nothing has helped. It's become a sensitive subject, which is a bit of a passion killer. I'm at my wits end. Any advice please?

A: In around 15 percent of couples, the man exhibits a lower level of desire for sex than their partner. When their man has a lower libido, women take it personally; feeling desperate, unsexy, unloved and unwanted, or they suspect an affair. This can be soul destroying for most women.

There can be many reasons that cause a man to experience low desire. If your partner is on any medication for depression, this will certainly affect his libido. However, I do not recommend stopping the medication without consulting your GP. He could try different medications and see if they have different side-effects.

Stress also plays a major role in lack of desire as this depletes testosterone, the male hormone. Usually when a man's testosterone levels are low, lack of desire and tiredness are the most common symptoms. Others signs include irritability, poor concentration, reduced muscle strength, decreased energy or a loss of body or facial hair.

One in 200 men in Australia suffers from testosterone deficiency and although there are no specific statistics for South Africa, most doctors say that the number is probably similar here. It can affect men of all ages. The condition may be caused by many things but generally the symptoms result from hypogonadism (the under-secretion of testosterone by the testes).

If your partner is willing, he should visit his GP or consult with an urologist. A simple blood test can determine if low testosterone levels and other hormones are affecting his libido.

Open communication in a relationship is extremely important especially when one partner is experiencing low libido. I often find that men withdraw physically and emotionally when there is a failure in the bedroom.

Because men are “fix it” people they see failure in the bedroom as traumatic, making them feel less of a man, which is obviously not true. They may withdraw emotionally and physically from the bedroom, stop giving kisses, hugging or just cuddling. This is because he may fear that any affection may be read as an invitation to sexual intimacy.

It seems that the problem has already affected the relationship between you and your partner, and if you think that this guy is worth holding on to, I would recommend seeing a sexologist or relationship counsellor to help you get your relationship and intimacy back on track.

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