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My friend Lisa complained to me about her husband’s feeling rejected sexually. Suspected her husband might be sexually apathetic.

When it comes to frigidity, people first think of female frigidity. In fact, with the acceleration of the pace of modern work and life and the increase of pressure, more and more men will also appear the situation of sexual apathy, which is called low sexual desire or hypersexual desire in medicine. Low sexual desire in men generally refers to adult men’s lack of sexual interest or lack of sexual life requirements for at least 3 months. Low sexual desire is one of the common male sexual dysfunction, which is different from the lack of sexual pleasure. The two concepts can appear at the same time, mainly for the lack of sexual fantasy, the lack of subjective desire and consciousness to participate in sexual activities, the reduction of the demand for active sexual behaviour, and the low frequency of sexual activities.

It is estimated that about 15% of adult men are suffering from this problem. The reasons for low libido are very complex, which can be divided into the following categories.

1Bad living habits in life habits, although alcohol can make people have the impulsive desire, in fact, it is more damage to men’s sexual ability, long-term drinking will lead to chronic liver poisoning, make the blood estrogen level rise, androgen level is low, resulting in low sexual desire. The same is true of long-term smoking. Nicotine in tobacco, like alcohol in wine, is absorbed by the body, which inhibits androgen production in the body and blocks the pathway of nerve reflex in sexual life, resulting in decreased sexual function, sexual sensory disturbance and sexual apathy. However, the effects of smoking and alcohol on sexual function are reversible, and most of the human functions can gradually return to a normal level after giving up smoking and alcohol.

2Mental and psychological pressure, the fast pace of modern life, fierce competition, work pressure, complex interpersonal relationships, which cause great psychological pressure to adult men, especially the psychological quality of the more vulnerable, nervous, anxiety and depression interweaved, repeated psychological disorders, interfere with the function of the cerebral cortex, resulting in low libido. For this kind of patients, we should give more spiritual care, and emphasize the positive role of female spouses in the treatment. Some patients are suffering from serious mental stress.

3Age, low androgen level, age is also one of the causes of sexual apathy. With the growth of age, men’s demand for sexuality will be lower and lower, which is the objective law of sexual ageing. Especially after the age of 50, the male genitals are gradually ageing and shrinking, and the demand for sexual desire is lower, which may be related to the increase of estrogen level and the decrease of androgen in the elderly men. Androgen can not only maintain male spermatogenesis and secondary sexual characteristics but also improve the excitability, sexual desire and sexual response of the cortical sexual center. Low androgen levels can also directly lead to low sexual desire in men, sometimes accompanied by erectile dysfunction. For this kind of patient, we need to carry out the corresponding sex hormone determination, if necessary, give androgen replacement therapy, to let patients return to normal sex life.

4Men with chronic diseases such as hypertension, diabetes, chronic hepatitis, liver cirrhosis, chronic renal insufficiency and other chronic diseases will lead to the decline of male sexual function, such as impotence, premature ejaculation and so on, which will affect the quality of sexual life. Over time, it will affect the subjective desire and consciousness of sexual activity, leading to the decline of sexual desire. For such patients, we need to give active treatment to the primary disease, but also pay attention to the level of androgen, if necessary, the use of androgen replacement therapy can effectively improve the sexual dysfunction of patients.

5A variety of clinical drugs are directly related to low sexual desire, such as antipsychotics, antihypertensive drugs (reserpine, propranolol, etc.), hormone drugs (estrogen, antiandrogen drugs), long-term or large-scale use may lead to decreased sexual function, and even cause male impotence, further leading to low sexual desire. Long term radiotherapy can also lead to decreased libido. If necessary, we can communicate with relevant specialists to adjust the type and dosage of drugs.

6The relationship between husband and wife. For the relationship between husband and wife, making love every day does not necessarily improve the quality of sexual life. We need to create some romance to increase sexual attraction. In many cases, seeing familiar faces often will make the husband lose his libido. As the saying goes, parting is better than getting married. Keeping a proper distance is also a good way to avoid sexual apathy. At the same time, the unharmonious relationship between husband and wife or the disharmony of sexual life are both dangerous signals, because the generation of human sexual desire is not a simple biological instinct, which is mostly caused by love. There are emotional barriers between husband and wife, mutual boredom, and sexual desire mostly decline. Therefore, the harmonious relationship between husband and wife is the foundation of harmonious sex life.

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