Dear Nancy,

I find myself in a rut. When making love to my wife, I get off and don't fell horny at all. It's good sex, then nothing. I need to get back into the swing of things. What do you suggest?

This is something more and more men are experiencing. First question is: How old are you?

The following suggestion is just a hunch (after all, I'm not a medical doctor!)

Men around 40 and above see a gradual shift in sexual behavior, as hormone production settles and the responsibilities and essentials of every-day living become prioritized. Although patterns differ drastically, many men see a tapering off in their sexual activity. Once they reach 40, it's natural for men to experience physical changes as metabolism slows and the body manufactures a lesser amount of testosterone. These obvious changes range from weight gain, hair loss, less physical endurance, longer recovery from injuries, and a waning interest in sex.

Men between the ages of 40 and 55, go through dramatic chemical and physiological changes that affect everything from a man's view on life, feelings of irritability and depression, to low libido resulting in a reduced interest in sex and in more extreme cases, an inability to attain and maintain an erection. Dramatic physical and emotional changes can be triggered by significant irregularities in hormone levels. Because of the similarities to the female traits, these symptoms combined are sometimes identified as “male menopause”; it is more commonly referred to in Europe as viropause or andropause.

Testosterone deficiency is usually misdiagnosed as general depression. My advice: see a doctor and have your testosterone levels checked. Once you find out if this could be the problem, speak with your medical doctor about the next steps.