Sex problems are 90% psychological & only 10% are physical. Physical causes are like harmonal imbalance, testosterone deficiency,injury or disorders of scrotum, injury or disorders of lumbar vertebrae, high levels of sugar & cholesterol, liver diseases etc. These causes can be finded & treated by investigations.                                                 Psychological causes include stress between couples, dauts raised by wife over man’s performance, aggressive-dominating nature of wife, dauts about wife’s character, extra marital affairs, depression due personal relations etc. These causes are situational, if situation changes they disappear.  To change we give counselling & some medicines. Counselling includes  appropriate sex education, personal & couple sessions to address relationship concerns,how increase intimacy etc.