Rose walked into the consultation room with her husband Gabriel and wasted no time. “Our sex life has gone to the dogs,” she declared. They had lost interest in each other, she explained, and intimacy had become rare.
“We hardly have sex,” Rose continued. “We just want to know if this is what to expect at our age.”
Like many men in such situations, Gabriel said little, urging Rose to speak instead. This is a familiar scene in the Sexology Clinic. Men often remain silent about sexual problems, turning instead to destructive coping mechanisms such as alcohol, affairs, or burying themselves in work. Women, by contrast, tend to voice concerns more openly and often become the saviours of struggling relationships.
I began by assessing the couple for possible causes of low libido. Relationship difficulties are among the most common reasons. Some couples live in cold wars, projecting unity in public while quietly waging battles of manipulation and hurt. Others are in open conflict, trading insults or even resorting to violence. Rose and Gabriel showed none of these signs.
“To tell you the truth, we are the best of friends,” Gabriel said, finally finding his voice. “We have never doubted that we were made for each other.”
With their relationship intact, I turned to sexual values. Negative attitudes toward sex, often absorbed during childhood, can shape intimacy for life. But Rose and Gabriel’s upbringing had instilled positive values, leaving no clues to explain their struggles.
That led me to medical causes. Rose had long been treated for depression, while Gabriel was managing hypertension. Both conditions and their treatments are known to affect sexual function.
Depression robs people of interest in life. Feelings of hopelessness, sadness, and worthlessness often extend to sex. Rose had been on medication for seven months, a drug that increases serotonin in the brain. While serotonin helps lift mood, it also dampens sexual desire by blocking pathways that trigger arousal. In her case, the illness itself reduced libido, and the treatment compounded the problem.
Gabriel’s hypertension medication posed its own challenge. He was taking beta-blockers, a class of drugs notorious for impairing erections. When sexual stimulation becomes difficult, men often withdraw from intimacy altogether.
Many medicines can affect sexual health. Some may enhance desire, but many suppress it. Side effects range from loss of libido and erectile dysfunction in men to vaginal dryness, pain during sex, and even difficulty achieving orgasm in women. And these are not obscure drugs—they include common treatments such as oral contraceptives, allergy medications, and painkillers.
It is important to ask about the sexual side effects of any medicine before starting treatment. Alternatives often exist.
For Rose and Gabriel, their prescriptions were changed to drugs with no impact on libido. It took three months for the old medicines to clear from their systems, during which time the clinic guided them through sex coaching to help them rediscover intimacy.
