My husband has no sex drive: what should I know?

Sexual desire naturally changes, but a persistent or distressing change deserves attention. Fatigue, depression, anxiety, alcohol, conflict, erectile or ejaculation problems, pain, and medicines can all affect interest. Low testosterone or another medical condition may also contribute, but desire alone cannot identify the cause.

If you are asking because sex has become uncomfortable for you, vaginal dryness and genitourinary syndrome of menopause may affect closeness and desire. Menopause and perimenopause can also bring sleep disruption, mood changes and hot flushes. These are possible contributors, not a diagnosis of either partner.

Choose a private, calm moment and describe the change without blame: say that you miss closeness and want to understand how he feels. Ask whether he has pain, low mood, sleep problems, medicine changes or worries about sexual performance. Avoid pressure for sex; agree on forms of affection that feel comfortable to both of you.

Encourage him to arrange a primary-care appointment if the change persists or causes distress. A clinician can review health history, medicines and symptoms before considering tests or treatment. Couples counselling or sex therapy can help when communication or anxiety is part of the problem.

Seek prompt medical advice for sudden loss of desire with severe depression, thoughts of self-harm, chest pain, fainting, severe pain, or other alarming symptoms. Arrange a routine review for persistent change, erectile difficulties, pain during sex, marked tiredness, mood changes, or symptoms that began after a medicine change.

Ask: What physical or emotional factors could be affecting desire? Could a medicine or sleep problem contribute? Do symptoms suggest hormone or mood assessment? What treatment or counselling options fit our situation?