My 49-year-old boyfriend and I have not had sex in over a year. He says he has lost his desire for sex but wishes he could make love to me. He has told me his doctor says it is due to depleted dopamine levels. He used to use drugs and is clean 7 years, during which we have had sex until the past year. I figure the doctor’s poor prognosis is a story, an excuse. Recently he told me that he still enjoys masturbating regularly and insisted it’s not ED. I assume it was his way of telling me he can get erect, just not with me. What’s going on?


  • Michael Castleman says:

    Dopamine is the neurotransmitter that makes new love so exciting, but it’s not the main hormone of libido. That’s testosterone. If he does, in fact, have low dopamine, he should see an endocrinologist. But because he still masturbates regularly and enjoyably, we can infer that he has a functional libido.

    So your question—why does he have the energy to masturbate but no energy for sex with you? It’s possible that he wants to break up. Have you discussed this with him? Sometimes a man loses erotic interest in a woman when he wants to end things. But not always.

    You say you had sex until last year. Did anything significant happen then that may explain his loss of sexual interest in you? An illness? Severe stress?

    I’m struck by the fact that he’s 49. Around age 50, sex changes for men. Erections become less reliable and erotic thoughts no longer raise them. Men need direct penis fondling. That’s not erectile dysfunction. That’s middle-age erection changes. ED involves inability to raise erections even with extended masturbation—and we know he masturbates enjoyably so he doesn’t have ED. In addition, around age 50, men begin to have arousal problems. This comes as a shock to many men, who spent their youth perpetually horny, and now at 50, they have trouble becoming aroused. All of a sudden arousal becomes work, and men may not know how to become aroused, except by masturbation. I suggest that you ask him about his arousal situation. Most older men feel most easily aroused early in the day when they have the most energy. Novel surroundings also help.

    If he wants to remain in the relationship, then I’d suggest that you two consult a sex therapist. In a few months of weekly visits, a sex therapist should be able to explore he arousal issues and your rejection issues. I’m optimistic that sex therapy would help. Studies show that it helps two-thirds of couples who try it. For more about how sex therapy works, read An Intimate Look at Sex Therapy. To find a sex therapist near you, visit the American Association of Sex Educators, Counselors, and Therapists, the Society for Sex Therapy and Research, or the American Board of Sexology.

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