Sexual Reluctance in Men

Applications with complaints of sexual reluctance in men are very rare. The most important reason for this is that the decrease in sexual desire and interest often causes erectile dysfunction and men mostly apply with the complaint of erectile insufficiency (inability to get an erection). In addition, another factor that reduces the frequency of applications is the sexual myth that “men are always ready for sexuality under all conditions”. Such false, exaggerated information and expectations prevent men from engaging in help-seeking behavior.

Sexual interest and desire disorders manifest themselves in the form of “decreased sexual desire” in men. It is the situation where there is no desire for sexual activity despite having a strong sexual ability. In addition, since the need for sexual intercourse and satisfaction varies greatly between individuals, each individual and couple should be evaluated individually. People with desire problems generally have strong egos and try to protect them from unconscious sexual conflicts by inhibiting their desires. However, aversion is often used to mask another sexual dysfunction.

Factors that ensure that the level of desire is sufficient in the evaluation of sexual desire; biological drive, sufficient self-esteem, positive past experiences with sexuality, and good communication with the partner other than sexuality. If any of these factors is impaired, sexual desire will also be impaired.

Types

  • Primary Decreased Sexual Interest and Desire

It is a state of reluctance that starts from adolescence and continues throughout life. First of all, endocrine, that is, hormonal disorder, is investigated. However, it is highly related to intrapsychic processes. It is common in conservative societies and cultures where sexuality is prohibited. As a natural result of sexual prohibitions and pressures applied from an early age, feelings of guilt and guilt about sexuality, suppression of sexual instincts, and gradually alienation from sexuality and even from one’s own body are in question.

  • Secondary Decreased Sexual Interest and Desire

It is the lack of sexual desire that occurs later in a period of an individual’s sexual life. It can mostly be explained by the fact that the general relationship of the individual with his partner is not satisfactory. It is often due to other causes as well. The most common among them are; stress, incompatibility and conflicts with the spouse, anxiety and other psychiatric disorders, some chronic diseases, drugs used, alcohol and drug use, andropause period, sexual violence and trauma, sexual dysfunctions in the spouse or himself can be counted.

Incidence Frequency

Sexual interest and desire disorders were found in 25% of 500 men who applied to the Institute of Sexual Health in different ways. Sexual interest and desire disorders are often seen with other sexual dysfunction and most often with erectile dysfunction. The incidence of sexual interest and desire disorders together with erectile dysfunction was found to be 50%.

Reasons

  • Medical Disorders

  • cardiovascular

  • Cancer

  • Epilepsy

  • Genetic

  • Testicular (primary hypogonadism, mumps, trauma, undescended testis)

  • Secondary hypogonadism (cushing’s syndrome, diabetes)

  • hyperprolactinemia

  • Multisystem disease (chronic kidney failure, chronic liver failure, AIDS)

  • Psychiatric Disorders

  • major depression

  • Bipolar disorder

  • Schizophrenia

  • anxiety disorder

  • Medicines

  • antipsychotics

  • sedatives (especially alprozolam)

  • antidepressants

  • mood stabilizers (especially lithium)

  • Some drugs used in urology practice

  • cardiovascular drugs

  • Drugs taken for pleasure (alcohol, nicotine, heroin, marijuana)

  • sexual identity disorder

  • andropause

  • Intimacy problem in relationship

  • Madonna/whore syndrome

  • disharmony in relationship

  • Other sexual dysfunctions

  • paraphilia

  • sexual dysfunction in partner

  • Chronic and serious illness in partner

  • child sexual abuse

  • Psychosocial problems (cheating, strict religious beliefs, obsessive-compulsive personality traits)

Treatment

Treatment approaches for male sexual desire disorders include sexual therapy, medications, and hormones. A multifaceted approach is imperative.

The basis of treatment in cases of secondary sexual reluctance lies in solving the underlying problem. This is sometimes the replacement of a currently used drug with sexual side effects with another that does not have side effects, sometimes the treatment of the underlying disease, sometimes the detection and treatment of depression, and sometimes the treatment of sexual dysfunction in the partner.

The treatment of primary sexual aversion cases is usually difficult. They need regular sexual therapy and their therapy often takes time.

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