Men always want sex. Right? Wrong. I have often heard the sexual partner of a man say, “My mate doesn’t want to have sex. What’s wrong with him? Don’t all men want sex?” That’s a common misunderstanding and it’s based on the mistaken belief that men are wired to want sex most times they can get it.

Here’s a list of ten common reasons why men may not want sex:

Medications. Antidepressants (SSRI-type) and antihypertensives (blood pressure medication) are often the culprit when a man has a lowered interest in sexual activity. These can also cause sexual dysfunction. Lack of sleep. When a man is in his teens or twenties, the opportunity to have sex will often overwhelm the desire to sleep. This is often true also when a relationship is brand new. But, as people and relationships age, sex can lose its compelling nature and a good night’s rest can be quite tempting. Hormonal levels. The most important physiological stimulant of sexual desire is testosterone. Many men are mistakenly sent to have a blood test for total testosterone when low libido is the issue. While that information might be interesting to know to have a full picture of a man’s hormonal levels, knowing the free testosterone level is much more relevant to how much sex he desires. Also, too much prolactin and SHBG (sex hormone binding globulin) can suppress sexual desire. So when a hormonal reason is suspected, these are the blood tests to have (in order of importance): free testosterone, prolactin, SHBG, and total testosterone. Identity issues. When men feel uncertain about their role in the world, their desire for sex can dwindle. Depression may be linked to this, but isn’t always. Identity issues can crop up when: he has issues at work or is out of work, faces the death of an important family member, becomes disheartened about a formerly held strong belief, and questions his understanding of his own sexual orientation — to name a few. Turn-off to aspects of the sex. Some men will turn away from sex rather than have sex that is not fulfilling to them. Lack of fulfillment can be related to specific things that his partner does during sex or how he experiences his partner’s body. He may feel criticized or treated unfairly. It may just seem like too much “work.” He may have sexual interests that he knows or fears his partner may not share. Disagreements with one’s mate. When there are interpersonal difficulties between the members of a couple, many men will avoid sex or just plain refuse their partner’s advances. Some men punish their partner by withholding sex, but for others it’s not a matter of punishment, they just cannot muster sexual feelings when there are unresolved conflicts. Stress. Stress comes in many forms and may stem from: financial difficulties, personal or family member illness, challenges at work, parenting dilemmas, and issues involving extended family members. Of course, there are many more sources of stress. Masturbation that replaces partnered sex. This is a hot topic since the advent of the Internet. It seems to some researchers in this field that many men who might not have sought out other sources of visual sexual stimulation (magazines, videos, movies) have found their way to locate sexual imagery online. For some couples, this can be a dilemma, particularly when the viewing of the images leads to masturbation, that then leads to less partnered sex. Less partnered sex feels like a blessing to some, but to others it is a frustrating and disappointing outcome. Fear of intimacy. Some men have relationships with their romantic partner that resemble that of siblings. The contact that they experience in their relationship takes the intimacy level up so high that adding sexual intimacy on top of that feels like an overload. Though it may be difficult to imagine that a person could have too much intimacy, it is the hunch of many sex experts today that this is a very common cause of declining sexual frequency in couples. Difficulties functioning sexually. Many men who have an erection dysfunction or believe that they ejaculate too soon — or too late (if at all), will avoid having sex with their partner. Rather than face what feels like another experience of “failure” in our performance-obssessed culture, these men choose to avoid being sexual at all.

When partnered with a man who does not want sex, the optimal path does not include criticism, belittling, or slurs on his manhood. Armed with accurate information and professional help, most of these causes of sexual avoidance can be greatly improved and in many cases removed altogether.