Sometimes the problem is clear and just needs discussing, says Joy Davidson, PhD, a New York City–based psychologist who's on the board of directors of the American Association of Sexuality Educators, Counselors and Therapists. An example of this, she says, would be "the woman gets off on oral sex and the man doesn't like to do it. Not being able to talk about sex is like not being able to discuss what you're having for dinner. And just like any other aspect of a relationship, that's a potential deal-breaker. If there's a sexual problem, you have to deal with it."
Low sex drive, especially in conjunction with erectile dysfunction (ED), could indicate a serious health problem such as heart disease or diabetes.
Even if there is a medical issue afoot, disparate sex drives can create an emotional problem in a relationship. That's why many sexual health doctors take a "bio-psycho-social" approach, says Michael Krychman, MD, executive director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach, Calif. They either make some psychological assessments themselves or work hand-in-hand with certified sex therapists.