Dear Dr. Kate,

I am in a very happy monogamous relationship and I love my boyfriend very much. When we first got together, the sex was fantastic. We had it all the time and it was good. Then our relationship went into long distance mode for five months; the sex was frequent during visits because we weren't sure the next time we would see each other. Then we moved in together. The sex life slowed down, which is normal I suppose because we see each other all the time. Now here's the problem: my boyfriend really isn't interested in sex. We do still have sex, but not as often as I would like. When we do, it is fantastic, but it is rare when he comes. He does come both during intercourse and oral sex, but not always, and when he masturbates, he does come. Clearly my sex drive is higher, I'm 24 and he is only 23. Last night he said to me sometimes he worries why his sex drive is lower. He swears it isn't me and this has always been the way with girls and he doesn't like that I can't just pounce on and get him turned on. Therefore we always have to go on his schedule because when he is horny, he is ready to go. Am I being totally oblivious and not realizing he has ED? I asked him if he thinks too much about it and if that's the problem, and he thinks maybe that's it, but he isn't sure. He hates that he can't keep up with my needs and I haven't been complaining about it, but sometimes a girl just wants to get laid. I love him and am willing to work through it, but I just don't know what to think. I don't want to worry and I don't want him to worry either, but is it normal for a young guy's sex drive to be so low?

Sexless in the City

Dear SITC,

All my patients--and I think everyone everywhere--wants to know what's normal. I think it comes down to how you feel about...how you feel, who's feeling you, and the sex that you're having. If you're happy with how and how often you have sex, than you're healthy. If you're not happy, on the other hand, that's when it's time to seek help.

If your boyfriend is truly bothered by his sex drive, he should first see an internist. There are medical causes of low libido (such as heart disease, diabetes, hypothyroidism, Parkinson's disease, anemia, chronic pain), but if he's healthy, the likelihood of any of these is low. Same odds of erectile dysfunction- if he's young and healthy, it's not ED (plus it sounds like erections themselves aren't the issue here). Overindulging in alcohol, or any indulging in heroin, cocaine or marijuana, can also kill libido. If your guy is taking any medications, they too could play a role. And stress, fatigue, anger, depression, past abusive relationships--the same culprits for us also affect men. If your boyfriend thinks that depression or anxiety is a factor, talking to a therapist could help.

But the more likely answer is simply a lower libido. Decreased sex drive, while it's usually thought of as a woman's problem, affects up to one in four men. In the end, you and your boyfriend may have sex drives that don't match...requiring a little creativity to figure out what will keep you both happy. What have you all tried when you want it more than your partner does?