He's Just Not Up for It Anymore (22 page)

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When HSDD is used as a catchall term for little or no sex, it may be the result of so many factors that it can be difficult to pinpoint the causative reasons. It may be psychological in origin, linked to anger, stress, or fear; physiological, caused by hormonal imbalances, such as a low level of testosterone; or the unintended result of medication for a wide variety of diseases including diabetes and vascular issues. Depression can result in a lack of desire, and, as we previously mentioned, so can antidepressants. It may be true HSDD and biological in origin, simply the way an individual functions; just as one man may have an unusually high sex drive, another may have one unusually low. And sometimes a man with a weak level of desire marries a female with a libido that falls into a range that is average or above, a situation perhaps masked in the early days of courtship when his passion was able to soar to a temporary high before it peaked and declined back to what is “normal” for him.

“Normal,” when discussing sexual appetite, is a complex, delicate, and misleading term. It suggests there is something wrong, or abnormal, about a low libido, and there is not. Let us state again, there is a very wide range of normalcy when it comes to desire, and even that is fluid, changing with age, health, opportunity, partner, and state of mind. It can morph from quiet, occasional yearning to immense, wild, uncontrollable passion and back again. To quantify passion is to put a figure on the unique.

Problems arise when a couple’s level of desire is disparate. When we discuss HSDD in this chapter, we are talking primarily about biological and hormonal issues, things beyond the sphere of anger, psychogenic wounds leading to fear of intimacy or even touch, religious-based causatives that inhibit deeply sexual feelings of any type deemed “wrong,” or a simple lack of attraction. We are also eliminat-ing those men who prefer, for whatever reason, solitary sex. That leaves us with men who rarely or never fantasize or desire partnered sex.

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ASEXUALS HAVE OTHER THINGS

ON THEIR MINDS

It is difficult to imagine a man without fantasies of a sexual nature or history of solitary or partnered sex, and in fact such a man would be hard to find. Asexuality is a rare condition, and even rarer among men than women, but it does exist.

In 2004, researcher Anthony Bogaert published a national study on asexuality. One percent of adults self-identified as asexual, which is defined as having no attraction to males or females. Women are more likely to be asexual than men. A minority of both men and women (but more women) who said they were asexual reported that they were currently in long-term cohabiting or marital relationships.

It isn’t sexy to be asexual; and some asexuals allege discrimination. Members of AVEN (Asexuality Visibility and Education) believe that the American Psychological Association should allow for four sexual preference possibilities instead of three, adding asexual to their current list of heterosexual, homosexual, and bisexual. The isolation asexuals once experienced has been alleviated somewhat by the Internet, where there are now support groups and websites. The AVEN site has a store that sells T-shirts with sayings like “Asexuality.

It’s not just for amoebas anymore,” and, for those in partnered relationships, “I’m Asexual and So Is My Significant Other!” There is talk of “A-Pride.”

Clearly, two people with no sexual desire at all can be happily married, as long as it’s to each other. It is also clear that if an asexual marries someone with an average libido, whatever that may be, problems will arise that are likely to be insurmountable.

Having said that, such a tiny portion of the extremely small male asexual population marries, that it is very unlikely that this is the reason that a married man stops having sex. It can seem comforting to think that one’s partner is asexual (the responsibility for maybe he’s gay? asexual?

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the problem falls entirely on him, and at least there’s no other person involved), but this is usually not the case—the odds are simply against it.

LESS THAN TEN TIMES A YEAR

I believe my husband just has a low libido, but I was unaware of this when we got engaged. We pretty much stopped having sex about three months after moving in together, and four years ago we stopped completely. He has no interest in even finding out why he isn’t interested. (Female, 38) HSDD is usually quantified as wanting to make love ten times a year or less. It is possible that a man may be happy; healthy; free of stress, intimacy issues, and anger; not suffering from erectile dysfunction or on libido-reducing medication; not drug dependent or obese; not spending time watching online porn or engaging in other types of masturbatory fantasy; not having an affair, bisexual leaning toward gay, or gay; a good husband, father, in love and content with his life and wife; and still not want to have sex very often.

It’s possible, but extremely unlikely, because HSDD is usually not a stand-alone issue. If you really believe that with your partner it is, and everything else in the relationship is fine, look a little harder, talk a little longer, and listen a lot closer. If you still are convinced it is not related to anything else, you have to decide how to deal with the fact that your partner loves you and finds you desirable; he just doesn’t, or can’t, show it in a sexual way. Unfortunately, he’s in control, whether he wants to be or not. The person with lower desire always is. Many self-help books (and therapists we have interviewed over the years) suggest some type of compromise: he can watch you masturbate, or perform oral sex with no need for you to reciprocate. To be realistic, most men will be awkward about admitting their libido is so much 188

HE’S JUST NOT UP FOR IT ANYMORE

lower than their partner’s, and/or not interested in the servicing aspect. It may also be embarrassing for a woman to do these acts in front of a disinterested party. However, if he is willing and participates with love and enthusiasm, this might be an interim solution.

Often, those who suffer from HSDD (as opposed to those who are asexual) find enjoyment in sex once they actually start doing it. They don’t have the fantasies and general feelings of desire, but they can experience great pleasure once they start making love if they can allow themselves to get lost in the moment.

WHAT ABOUT LOW TESTOSTERONE?

The Massachusetts Male Aging Study assessed the sex drive and hormonal levels of 1,632 men between the ages of 40 and 70 years old. At each of three points in time during a fifteen-year period (1987–1989, 1995–1997, 2002–2004), the men were asked to complete self-administered questionnaires about the frequency of sexual thoughts, desires, and fantasies, and their level of testosterone was measured.

At the start of the study, based on the questionnaires, 19 percent of the men were classified as low libido. This number increased as the subjects got older, 23 percent at the second time period, when 922 of the original men were still available, and 28 percent at the third, when 623 men remained. A team of scientists evaluated the data in the
Journal of Clinical Endocrinology and Metabolism.
They reported a statistical link between men’s sex drives and testosterone levels, although the difference in levels of men self-reporting as high, average, or low was so small that they concluded: “The value of individual patient reports of reduced libido as indicators of low testosterone is open to question.” In other words, if a man’s sex drive is low, it may not be due to low testosterone. As we have discussed, there are multiple physiological and psychological reasons for a man not wanting to have partnered sex.

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However, it is also possible that an abnormally low level of testosterone, a steroid hormone manufactured in the testes and in minus-cule amounts, the adrenal glands, is the cause. In animal testing, males deprived of testosterone will not initiate or participate in sex with a willing partner, although they can achieve an erection if stimulated. The Massachusetts Male Aging Study estimated that there were about 2.4 million 40- to 69-year-old men in America with a testosterone deficiency. A blood test, usually administered in the morning because testosterone level is highest at that time, can attempt to determine if this is the case. The level is usually higher in autumn and can fluctuate with emotion and stress; therefore, the test is sometimes administered more than once. It is extremely difficult to achieve accuracy when measuring this hormone even with repeated testing, making the number of men with abnormally low testosterone difficult to estimate.

A man’s level of testosterone peaks during adolescence and declines thereafter, dropping about 1 percent a year. Thus, the level is most likely to be lower than normal, and result in diminished sex drive, when a man is over the age of 60. (Some decline might be a good thing for the man’s partner—he may focus more on foreplay and less on his own pleasure.) The range of testosterone considered “normal” is enormous—anything between 300 and 1200 nanograms per deciliter is sufficient. Although it is theoretically possible for levels to drop down so low that libido is diminished, it is unusual for this to actually happen, and it is therefore possible that testosterone may be administered unnecessarily. In a
New York Times
article dealing with middle age, loss of libido, and the “so-called syndrome called andropause,” Dr. Richard A. Friedman states, “the vast majority of men who have these complaints [fatigue, loss of muscle mass, decreased libido] do not have testosterone levels in the deficient range. . . . In fact, many of these so-called testosterone deficient men actually have depression, alcohol problems, or other diseases that have gone undetected.”

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But for men accurately diagnosed with abnormally low levels of testosterone, medication can be life altering. There are a variety of treatments including pills, gels, patches, and injections. Increasing the hormone to normal levels can raise libido and enhance overall feeling of well-being. However,
these are not medications to be tinkered
with in hopes of regaining youth or enhancing sexual prowess
—the side effects can be serious, and include increased risk of stroke, stimulation of undetected prostate cancer cells, and enlargement of the prostate. Your primary care physician will most likely recommend that you visit an endocrinologist if he believes treatment is necessary.

THE BELL CURVE

When we asked clinical psychologist Dr. Julian Slowinski about female respondents who claimed that everything was fine, except that their husbands just didn’t want sex very often, he replied: “That’s possible. You have to think of a bell curve. There will be guys over to one end that are highly sexual, and guys on the other who are fairly nonsexual. And so, it would make sense that if he is one of the guys on the low end of the curve, she would complain about not having sex.

The ideal is for low-sex people to find each other, so they can end up with a loving companion-like relationship instead of a sexual one.”

In that ideal world, people with (permanently) low libidos would find one another and live happily and platonically ever after. As we mentioned, the Internet is helping statistically small groups of people, like asexuals, connect. It may also give those people who do want sex, but not very often, a chance to discover one another. However, if you are currently in a marriage that is wonderful except that your partner is on the low end of the bell curve and the reason is nonhormonal, there are difficult decisions to be made.

We don’t want to appear sanctimonious (this is a second marriage for both of us and we know that a time can come when letting go is maybe he’s gay? asexual?

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We believe in staying together if it is at all possible
to do so—but not at all costs.

the only choice, and that it can lead to better things), but here’s what we believe: in our hearts, we hope that your choice will be to stay together. There are no perfect relationships in this world. We feel that one based on trust, humor, love, caring, support, and friendship, with perhaps a little tender lovemaking mixed in now and then, is worth holding on to and protecting. We are also aware of the “easy for
you
to say” factor here. We said it at the beginning of this book—we believe in staying together if it is at all possible to do so. Not at all costs, not if there is something so unacceptable to one or both of you that staying together is no longer an option. Only you can decide what the breaking point is and if it has been reached.

It just bothers us to think that a marriage that is terrific in every other way would be discarded because one person happens to be born on the low end of the libido curve.

PART III

what couples are

doing about it

twelve

SHOULD I STAY OR

SHOULD I GO?

I am okay with this. We still kiss, hug, snuggle, and cuddle. That is what is important to me and him. (Female, 57) The future of my marriage is not very bright. My husband is a wonderful man, but I just don’t want a companion at this stage of my life. (Female, 46)

Here’s another surprise: the overwhelming majority of our respondents are not divorced, and most of them don’t seem to be thinking about it. Half of all marriages in America end; but only 10 percent of the men and 15 percent of the women who answered our survey are no longer married. That is not to say they are
happily
married, or that some are not considering breaking up in the future.

To be alone can be frightening or exciting—it all depends on one’s point of view and stage of life. For some, any relationship is preferable to none. Children or financial issues may prevent separation or provide an excuse to stay, even if leaving is a better choice. Some were admittedly unhappy, “doing nothing,” and resigned to a future of more of the same. But many respondents seemed satisfied in every 196