Dr. Mezhebovsky is Director of Psychiatry at Boston Clinical Trials. She has conducted over one hundred clinical research studies in the areas of mental health and sexual dysfunctions.
“Not tonight Joséphine.” This is the supposed response by Napoleon Bonaparte when declining sex with Empress Joséphine. Truth to be told, there’s no evidence whatsoever that Napoleon ever uttered these words. But if he did, Josephine should have been seriously concerned. Both because this could’ve been a first sign that their relationships were on the rocks (the couple eventually divorced after multiple infidelities by both partners) and because it could’ve been an early indication of the Emperor’s declining health (he died at the age of 51).
So if you are a woman and you are beginning to hear “not tonight” from the man in your life increasingly frequently, don’t brush it off. It is, of course, possible that, occasionally, he is bone tired. Let’s be honest, it is also possible that he is no longer romantically attracted to you and even, perhaps, having an affair. But what is more likely, his low interest in sex is an early manifestation of a physical or mental disorder. Here’s what you need to know about the reasons why a man may lose interest in sex.
1. Depression. As many as 60% of people with depression experience sexual problems, according to the Cleveland Clinic foundation. Depression is treatable, however some antidepressants, namely selective serotonin reuptake inhibitors (SSRIs) can, in fact, have a negative side effect on libido. Address the issue with the doctor ASAP – finding medication that is effective and has minimal side effects is not a trivial task (New promising anti-depression medications with, hopefully, fewer side effects are being developed by several pharma companies. To learn more about clinical trial of new medications at BCT, click here)
2. High blood pressure. Uncontrolled hypertension damages blood vessels in the body making them less able to transport blood to where it is needed to achieve and maintain erection. Unfortunately, medications that are often prescribed to treat high blood pressure, such as beta blockers and diuretics, are known to worsen erectile dysfunction. Do not stop blood pressure medications on your own, but do discuss the problem with your doctor sooner rather than later.
3. Diabetes. Men with diabetes are two or three times more likely to have erectile dysfunction than healthy men of the same age. In fact, ED is often an early sign of the trouble. Make sure that that appropriate blood test is performed and discussed with the doctor.
4. Other medications. Some antihistamines, non-steroidal anti-inflammatory drugs, muscle relaxants, and even hair loss medications may cause loss of libido. The mechanisms of the impact are complicated. If your man is on one of those medications, do make the doctor aware of the unwanted side effects.
5. Gum disease. According to a recent study published in the Journal of Sexual Medicine (JSM), there could be a link between erectile dysfunction and chronically inflamed gums – both symptoms likely caused by a common underlying problem with unsufficient blood flow
6. Sports. It’s hard to argue against any kind of physical activity, particularly as pleasant as bicycling. Studies after studies have proven beneficial effect of exercise on sexual health. Yet when it comes to bicycling, it is probably best done in moderation. According to JSM, 4% of male bicyclists who spent at least three hours per week in the saddle experienced moderate to severe erectile dysfunction, while only 1% of runners of the same age reported similar conditions.
Interestingly, the preeminent 19th century French ruler had many of the described conditions. He was known to have periods of aggressiveness and moodiness, which are strong indications of a possible bi-polar disorder. He was quite portly and, indeed, spent many hours in the saddle, which, anecdotally, may have similar effect as bicycling.
So, could it be that “Not tonight Joséphine” was actually a true story? Could be, but it doesn’t really matter. What does matter, however, is that by better understanding your Napoleon, you can both live a happier, healthier, and longer life!