"I still love my wife and want our family to be stable, but whenever intimacy comes up, I avoid it, making her suspect I no longer love her," Thanh told Doctor Tra Anh Duy, a specialist at the Men's Health Center, during his consultation.
Many months prior, Thanh maintained his routine: going to work, picking up his children, remembering anniversaries, and caring for his wife as usual. Only their intimate life changed. Whenever his wife initiated intimacy, he made excuses like being tired, sleepy, or busy. His avoidance led to his wife's sadness and suspicion that he no longer loved her or was seeing someone else.
Examination results showed a 98 cm waist circumference, a BMI of 27,9 kg/m2, and blood pressure of 138/86 mmHg. Lab tests revealed slightly elevated blood sugar and lipids. Morning testosterone levels were at the lower end of the normal range, compounded by insomnia, stress, and increased abdominal circumference.
According to Doctor Duy, Thanh's decreased libido resulted from a combination of factors: metabolic disorder, sleep deprivation, and psychosexual pressure. Thanh experienced prolonged work stress, slept an average of 5-6 hours nightly, gained weight, had little physical activity, experienced reduced morning erections, and began feeling anxious about sexual activity.
This condition is not uncommon. Research published in JAMA indicates that about 15% of men report this issue, which does not necessarily mean the husband no longer loves his wife. According to Doctor Duy, love, responsibility, and sexual desire do not always align. A man can still love his wife and want to preserve his family, but his body and mind may lack the energy for intimacy.
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Doctor Duy consults a patient. Photo: Lam Anh |
Libido is influenced by various factors: hormones, brain function, sleep, stress, medical conditions, medications, body image, and relationship quality. A decline in one or more of these factors can lead to decreased libido. Prolonged stress, financial pressure, sleep deprivation, depression, anxiety, abdominal obesity, diabetes, hypertension, dyslipidemia, alcohol, tobacco, erectile dysfunction, or performance anxiety can all contribute to reduced desire.
A study by Leproult and Van Cauter published in JAMA revealed that healthy men sleeping only 5 hours per night for one week experienced a 10-15% decrease in daytime testosterone levels. This indicates that sleep deprivation not only causes fatigue but also affects endocrine function and sexual desire. Additionally, depression and certain medications can reduce libido. Many men do not recognize they have psychological issues, instead experiencing a loss of interest, difficulty sleeping, irritability, fatigue, and a lack of desire for sexual activity.
Conversely, silence can widen the gap between spouses. The husband avoids intimacy due to shame or fear of disappointing his wife, while the wife interprets it as rejection or a sign of no longer being attractive. Increased tension makes it harder for desire to return.
According to Doctor Duy, a husband's decreased libido should not be automatically assumed to be a sign of infidelity, loss of love, or "weak physiology." When the condition persists, affects marital happiness, or leads to misunderstandings, men should seek specialist consultation for a comprehensive evaluation. Attributing avoidance solely to the husband being tired of his wife or having another partner could lead to missing opportunities for proper treatment.
For Thanh's case, the treatment approach involved more than just medication or testosterone tests. Doctor Duy developed a plan to improve sleep, reduce alcohol consumption, increase physical activity, control weight, and manage metabolic disorders. Doctor Duy also counseled him to communicate more openly and intimately with his wife about their sexual life, addressing the issues he faced directly.
Le Phuong
