Low Libido & Desire Issues
Specialty
What it is
Low libido is a persistent drop in your interest in sex — with a partner, on your own, or both. It's not the occasional off week; it's the "I used to want this and I don't anymore" pattern that's stuck around long enough for you or someone in your life to notice. The cultural script says men should want sex constantly, so when desire dips, most men either panic about it or bury it. Neither one moves the needle.
Desire is a system, not a switch. Chronic stress, poor sleep, alcohol, certain medications (antidepressants, blood-pressure drugs, opioids), low testosterone, thyroid issues, depression, unresolved conflict in a relationship, and even the way sex has been happening lately all feed into it. When one input shifts, the whole system responds — usually not in the direction you'd guess.
The Approach
How therapy helps
We start by widening the frame. Instead of asking "why don't I want sex," we ask what the last year of your body, mind, and relationship has actually looked like — sleep, work pressure, mood, medication changes, what sex has meant recently, and what it used to mean. Almost always, patterns emerge that make the desire drop make sense.
If a medical workup makes sense — testosterone, thyroid, sleep study, a review of your medication list — we get that in motion in parallel with the psychological work. I can help you frame the conversation with your PCP or urologist so you don't get brushed off with "everything looks normal, you're just getting older."
The therapy piece rebuilds sexuality with intention rather than autopilot. That means unhooking your worth from the frequency counter, redefining what counts as sex, working on the relationship dynamics that quietly kill desire, and rediscovering what actually turns you on — not what you assume should. Real desire follows real attention.
Low desire is one of the most common concerns men bring to sex therapy — and one of the least talked about outside of it.
You're not alone.
Frequently asked questions
Should I just get my testosterone checked and be done with it?
My partner is upset about this. Can therapy include them?
What if I've just... lost interest and I'm okay with that?
Book a Session
Ready to look at desire honestly?
One 50-minute session is usually enough to see what's actually driving the drop — and what to do about it.
Talk to Paul