Hello and welcome to Healthcare Magic. Thanks for your query.

Lack of sexual desire (libido) can be due to a variety of causes - both medical and psychological. Medical causes include:
- diabetes
- low levels of testosterone
- other hormonal imbalances e.g. hypothyroidism, hypopitutarism, etc.
- alcohol or drug abuse or due to certain medication
- certain specific vitamin deficiencies like vit. B12
- spinal cord diseases affecting sexual functioning
- chronic pain or long-standing ailments

However, psychological causes form the majority of the causes for lack of sexual desire. They include:
- Stress - the single most important cause (which is in someway involved in about 80 % of the cases)
- Relationship difficulties, poor communication with the partner
- Psychiatric disorders like depression, PTSD, etc. Now, it is interesting to note that the relationship between depression and lack of sexual desire is two directional; that is, persistent lack of sexual desire can lead to depression and depression itself can lead to decrease in sexual desire.

The first and most important step in the management of sexual desire is a detailed evaluation. This will include a detailed medical, sexual, personal and social history, a thorough physical examination and certain investigations, as per the necessity. In your case, since you are 40 years old, I would recommend that to undergo lab investigations to chech for blood sugars, blood pressure, cholesterol levels, testosterone level, thyroid hormone levels, etc. Especially, in males, this is not the age for a natural decline sexual desire and hence any underlying medical causes have to be first ruled out. Most of these causes are reversible with appropriate treatment and will restore normal libido.

Secondly, you may need to have a psychological assessment to see if there are are any possble psychological factors like stress, depression, relattionship difficulties, etc. which could be contributing to this problem. If so, they need to be addressed and tackled; sometimes counselling sessions for the both partners may be required.

So, I would advise you to have a consultation and detailed evaluation, preferably with a psychiatrist, in order to plan further management of this problem. Don't worry, most cases of sexual desire problems are easily manageable, but the crux is in identifying the probable cause. I would also advise you to exercise regularly, avoid alcohol, smoking or any other substances, and eat a healthy, nutritious diet. Supplementation with a multivitamin - containing B-complex and C vitamins will also be a good idea.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist

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Hello again,

You can consult Dr. XXXXXXX Mittal, Psychiatrist and Sexologist in Delhi. Address: Columbia Asia Clinic, Near sector 9 metro station, Opposite Toyota galaxy mall, Plot 24, Sector-20, Dwarka, New Delhi. Contact : 011-0000(for appointment) .

The time taken to tackle your problem will depend on the findings on evaluation. So, I would advise you to first have a detailed evaluation first (which should take only 2 to 3 days) and then discuss with the doctor about further plans for treatment.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist

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