QUESTION
Lately, I haven't been able to get it up when I'm with my partner. He has been very supportive and understanding. I have been under a lot of stress and I understand this can affect my erections, but this is starting to worry me. Is it normal for a 22-year-old to have a very low sex drive? Is there anything I can do?

ANSWER
It is normal for sex drives (libido) and sexual performance or the ability to have an erection to vary over time related to many, many things including stress, depression, diet, exercise, medical conditions and commonly, drug use -- both prescription and otherwise.

Libido is the desire to have sex and very dependent on psychological state and cues from the environment -- smells, tastes, physical attraction, etc.

Performance is the ability to have and maintain an erection and is more physiologically driven, dependent on adequate blood flow to the penis. Obviously, this can be effected by the mind as well since some people at some times can just dream themselves hard and others need more "cues" to get the blood flowing.

Unless there are medical conditions or new substances affecting your desire and ability, it is likely that as your life circumstances improve, your desire and performance will return. What's important right now is not too worry too much about it because that can make things even more stressful. Try to engage in sexual activities that involve pleasing your partner without putting too much pressure on yourself.

To your health,
Dr. K