If you’re like most guys, a huge part of your identity is wrapped up in your sex drive—so noticing that your sex drive is starting to fall apart can be incredibly disconcerting. And for some guys, a decreased sex drive can make it feel like their entire sense of motivation or zest for life is gone.

Some men have sex drives that are naturally on the low end of the spectrum—and that’s perfectly OK. A sudden or noticeable shift in your libido, however, is almost always a sign that something is off.

The good news? Most libido issues can be traced back to a specific cause. Here are the nine usual causes of a decreased libido—and what you can do about them.

1. Stress

Most men with a low sex drive think there must be a medical cause for their dip in libido, but the most common reason for a decreased sex drive is stress. I’d estimate that at least 75% of the libido cases I see in my sex therapy practice boil down to stress. Ironically, sex can be a great stress reliever, but if your stress level is through the roof, you're just not going to be in the mood.

The fix: We all know that we have too much stress in our lives, but so few people actually do anything about it. Take an honest look at your levels of work and personal stress, and make a game plan for taking some things off your plate. Decreasing stress can feel like an impossible task at times, but what better motivation than getting your sex drive back?

2. Bad self-care

If you’re not taking care of your basic physical needs, your libido is going to be one of the first things to disappear. Limited sleep, poor diet, lack of exercise, excess weight, and drug or alcohol abuse—they can all tank your libido.

The fix: If you want your body to perform optimally, you have to treat it right, plain and simple. This is another area where your sex life just may be the motivation you’ve needed to take better care of yourself.

3. Medical issues

Even though medical issues aren’t typically the root cause of sex drive problems, there are a number of medical conditions that can cause your libido to shrink or even disappear altogether. They include: anxiety, depression, diabetes, heart disease, high cholesterol, and thyroid issues.

The fix: It’s a good idea to make an appointment with a doctor for a check-up. He or she can screen you for potential libido-dampening conditions, and give you more suggestions for getting your sex drive back on track.

4. Medications

Now here’s the really frustrating part: Many of the medical conditions that cause low libido need to be treated with medications that can further decrease your libido. Ironic, right?

Some of the common medications that can diminish your sex drive:

- Anti-depressants and anti-anxiety medications
- Antihistamines
- Blood pressure medications
- Finasteride (the hair-loss medication commonly known as Propecia)
- High cholesterol medications
- Painkillers, including opioids

The fix: If you’re already on one of these medications, talk to your doctor about any sexual side effects you notice. Your doctor may recommend options like changing your medication, adjusting your dosage, adding another medication, or taking your meds at a specific time of the day. It’s extremely important not to mess with your medications on your own, so make sure you talk to your doctor first.

5. Hormone levels

Your sex drive is highly related to your testosterone levels. Your hormones can fall out of whack for a variety of reasons, including injuries, illnesses, and medications. It also naturally decreases once you pass the age of 30.

The fix: Ask your doctor to test your hormone levels. Your doctor may prescribe testosterone therapy or other interventions to bring your hormones back into balance.

6. Relationship problems

If you and your partner have been fighting a lot, if there’s a lot of tension in your relationship, or if you’re unsure whether or not you even want to be with her, you’re probably going to notice your sex drive start to fade. It’s hard to feel desire for someone you’re not getting along with. (Angry make-up sex can only get you so far.)

If you still have a healthy libido when it comes to masturbation, that’s a sign that your relationship issues may be playing a bigger role than you realize.

The fix: It’s time to start Googling couples counselors or sex therapists.

7. Sexual expectations

One particular dynamic I often see with couples in my practice is that both partners expect that the man should always be the one to initiate and take the lead when it comes to sex. This is an outdated and unhelpful sexual script that unfortunately persists to this day. It’s a ton of pressure to put on one partner’s shoulders. A lot of men pull away in response to all of the pressure.

The fix: Have an honest conversation with your partner about the dynamics that have cropped up between the two of you. Tell her you’d love it if she initiated sex more often. If she seems shy or hesitant, give her a few specific ideas of ways to initiate sex that you’d really enjoy.

8. Being rejected

Here’s another common dynamic I see in my practice—sometimes the man starts off being the one with the higher sex drive. He tends to initiate more frequently simply because he’s the one who wants it more frequently. He gets turned down because his partner doesn’t have as high of a sex drive as he does. Over time, he starts feeling resentful of her for turning him down. (Because let’s face it, getting turned down for sex always sucks!) Eventually, that resentment starts suffocating his sex drive.

The fix: Talk to your partner and ask her to initiate more often. If things have gotten really tense between the two of you, find a sex therapist to help you through it.

9. Performance issues

If you’ve been struggling with your erection or your orgasmic timing, it may start to feel easier to avoid sex altogether. You don’t even want to run the risk of not being able to get hard, coming too soon, or not coming at all.

The fix: Work with a sex therapist to help you gain more control over your erection and orgasm. I see performance issues as a relationship problem, even if only one person experiences physical symptoms. I always recommend seeing a sex therapist together with your partner. It’s much more effective, and it’s relieving to know it’s a not solely your fault.

Vanessa Marin is a sex therapist. Check out her online orgasm course, Finishing School.