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{{short description|Person's overall sexual drive or desire for sexual activity}} {{Short description|Psychological or sexual drive or energy}}
{{other uses}} {{other uses}}
{{redirect|Sex drive|other uses|Sex Drive (disambiguation)}} {{redirect|Sex drive|other uses|Sex Drive (disambiguation)}}
In ], '''libido''' ({{IPAc-en|l|ɪ|ˈ|b|iː|d|oʊ}}; from the ] {{Lang|la|libīdō}}, 'desire') is ] drive or energy, usually conceived of as ] in nature, but sometimes conceived of as including other forms of ].<ref>{{Cite book| url= https://www.oed.com/view/Entry/107907|title=Oxford English Dictionary (OED Online)|publisher=Oxford University Press| year=1989| edition= 2nd| location= Oxford |url-access= subscription| access-date=28 March 2021}}</ref> The term ''libido'' was originally developed by ], the pioneering originator of ]. With direct reference to Plato's Eros, the term initially referred only to specific ], later expanded to the concept of a universal psychic energy that drives all instincts and whose '']''.<ref>{{cite book |last1=Platon |title=Symposion}}</ref><ref>{{cite book |last1=Freud |first1=Sigmund |title=Massenpsychologie und Ich-Analyse |pages=99}}</ref><ref>Sigmund Freud, ''The Ego and the Id'', ''On Metapsychology'' (Penguin Freud Library 11) p. 369.</ref> The libido - in its abstract core differentiated partly according to its synthesising, partly to its analytical aspect called ''life-'' and ''death-drive'' - thus becomes the source of all natural forms of expression: the behaviour of sexuality as well as striving for social commitment (''maternal love instinct'' etc.), skin ], food, knowledge and victory in the areas of species- and ].<ref>{{cite web |title=Libido |url= https://dictionary.apa.org/libido |work= APA Dictionary of Psychology |publisher=American Psychological Association |access-date=19 April 2023}}</ref><ref>{{cite book |last1=Akhtar |first1=Salman |title=A Comprehensive Dictionary of Psychoanalysis |date=2009 |publisher=Karnac |location=London |page=159}}</ref>
'''Libido''' ({{IPAc-en|l|ɪ|ˈ|b|iː|d|oʊ}}; ]: '''sex drive''') is a person's overall sexual drive or ] for ]. Libido is influenced by ], ], and social factors. Biologically, the ]s and associated neurotransmitters that act upon the ] (primarily ] and ], respectively) regulate libido in humans.<ref name="MEDRS review" /> Social factors, such as work and family, and internal psychological factors, such as personality and stress, can affect libido. Libido can also be affected by medical conditions, medications, lifestyle and relationship issues, and age (e.g., ]). A person who has extremely frequent sexual urges, or a suddenly increased sex drive may be experiencing ], while the opposite condition is ]. In ], libido is psychic drive or energy, particularly associated with sexual ], but also present in other instinctive desires and drives.<ref>{{Cite book|url=https://www.oed.com/view/Entry/107907|title=Oxford English Dictionary (OED Online)|publisher=Oxford University Press|year=1989|edition=2nd|location=Oxford, UK|url-access=subscription|access-date=28 March 2021}}</ref>


In common or ] usage, a person's overall sexual drive is often referred to as that person's "libido". In this sense, libido is influenced by biological, psychological, and social factors. Biologically, the ]s and associated neurotransmitters that act upon the ] (primarily ], ], and ], respectively) regulate sex drive in humans.<ref name="MEDRS review" /> Sexual drive can be affected by social factors such as work and family; psychological factors such as personality and stress; also by medical conditions, medications, lifestyle, relationship issues, and age.
A person may have a desire for sex, but not have the opportunity to act on that desire, or may on personal, moral or religious reasons ]. Psychologically, a person's urge can be ] or ]. Conversely, a person can engage in sexual activity without an actual desire for it. Multiple factors affect human sex drive, including stress, illness, pregnancy, and others. A 2001 review found that, on average, men have a higher desire for sex than women.<ref>{{cite news|author1=Roy F. Baumeister, Kathleen R. Catanese, and Kathleen D. Vohs|title=Is There a Gender Difference in Strength of Sex Drive? Theoretical Views, Conceptual Distinctions, and a Review of Relevant Evidence|url=http://assets.csom.umn.edu/assets/71520.pdf|work=Department of Psychology Case Western Reserve University|publisher=Lawrence Erlbaum Associates, Inc.|quote=All the evidence we have reviewed points toward the conclusion that men desire sex more than women. Although some of the findings were more methodologically rigorous than others, the unanimous convergence across all measures and findings increases confidence. We did not find a single study, on any of nearly a dozen different measures, that found women had a stronger sex drive than men. We think that the combined quantity, quality, diversity, and convergence of the evidence render the conclusion indisputable}}</ref>

]s are often an important factor in the formation and maintenance of ]s in humans. A lack or loss of sexual desire can adversely affect relationships. Changes in the sexual desires of any partner in a sexual relationship, if sustained and unresolved, may cause ]. The ] of a partner may be an indication that a partner's changing sexual desires can no longer be satisfied within the current relationship. Problems can arise from disparity of sexual desires between partners, or poor communication between partners of sexual needs and preferences.<ref name="B">{{cite web|url=http://www.mayoclinic.com/health/low-sex-drive-in-women/DS01043/DSECTION=causes |title=Low sex drive in women |access-date=July 28, 2010}}</ref>

There is no widely accepted measure of what is a healthy level for sex desire. Some people want to have sex every day, or more than once a day; others once a year or not at all. However, a person who lacks a desire for sexual activity for some period of time may be experiencing a ] or may be ].


== Psychological perspectives == == Psychological perspectives ==
===Psychoanalysis=== ===Freud===
{{Psychoanalysis |Concepts}} {{Psychoanalysis |Concepts}}
]]] ]]]
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], who is considered the originator of the modern use of the term,<ref>{{Cite book|title=Sex and Society|last1=Crowe|first1=Felicity|last2=Hill|first2=Emily|last3=Hollingum|first3=Ben|publisher=Marshall Cavendish|year=2010|isbn=9780761479055|location=New York|pages=462}}</ref> defined libido as "the energy, regarded as a quantitative magnitude... of those instincts which have to do with all that may be comprised under the word 'love'."<ref>S. Freud, ], 1959</ref> It is the instinctual energy or force, contained in what Freud called the ], the strictly unconscious structure of the ]. He also explained that it is analogous to hunger, the will to power, and so on<ref>{{Cite book|title=The New Wounded: From Neurosis to Brain Damage|last=Malabou|first=Catherine|date=2012|publisher=Fordham University Press|isbn=9780823239672|location=New York|pages=103}}</ref> insisting that it is a fundamental instinct that is innate in all humans.<ref>{{Cite book|title=Literary Theory: The Complete Guide|last=Klages|first=Mary|publisher=Bloomsbury Publishing|year=2017|isbn=9781472592767|location=London|pages=245}}</ref> ], who is considered the originator of the modern use of the term,<ref>{{Cite book|title=Sex and Society|last1=Crowe|first1=Felicity|last2=Hill|first2=Emily|last3=Hollingum|first3=Ben|publisher=Marshall Cavendish|year=2010|isbn=9780761479055|location=New York|pages=462}}</ref> defined libido as "the energy, regarded as a quantitative magnitude... of those instincts which have to do with all that may be comprised under the word 'love'."<ref>S. Freud, ], 1959</ref> It is the instinctual energy or force, contained in what Freud called the ], the strictly unconscious structure of the ]. He also explained that it is analogous to hunger, the will to power, and so on<ref>{{Cite book|title=The New Wounded: From Neurosis to Brain Damage|last=Malabou|first=Catherine|date=2012|publisher=Fordham University Press|isbn=9780823239672|location=New York|pages=103}}</ref> insisting that it is a fundamental instinct that is innate in all humans.<ref>{{Cite book|title=Literary Theory: The Complete Guide|last=Klages|first=Mary|publisher=Bloomsbury Publishing|year=2017|isbn=9781472592767|location=London|pages=245}}</ref>


Freud pointed out that these libidinal drives can conflict with the conventions of civilised behavior, represented in the psyche by the ]. It is this need to conform to society and control the libido that leads to tension and anxiety in the individual, prompting the use of ] which channel the psychic energy of the unconscious drives into forms that are acceptable to the ego and superego. Excessive use of ego defenses results in ], so a primary goal of ] is to make the drives accessible to ], allowing them to be addressed directly, thus reducing the patient's automatic resort to ego defenses.<ref>{{cite book
Freud developed the idea of a series of developmental phases in which the libido fixates on different erogenous zones—first in the ] (exemplified by an infant's pleasure in nursing), then in the ] (exemplified by a toddler's pleasure in controlling his or her bowels), then in the ], through a ] in which the libido is dormant, to its reemergence at puberty in the ].<ref>Sigmund Freud, ''New Introductory Lectures on Psychoanalysis'' (PFL 2) p. 131</ref> (] would later add subdivisions in both oral and anal stages.)<ref>], ''The Psychoanalytic Theory of Neurosis'' (1946)p. 101</ref>

Freud pointed out that these libidinal drives can conflict with the conventions of civilised behavior, represented in the psyche by the ]. It is this need to conform to society and control the libido that leads to tension and disturbance in the individual, prompting the use of ] to dissipate the psychic energy of these unmet and mostly unconscious needs into other forms. Excessive use of ego defenses results in ]. A primary goal of ] is to bring the drives of the id into ], allowing them to be met directly and thus reducing the patient's reliance on ego defenses.<ref>{{cite book
| last = Reber | last = Reber
| first = Arthur S. | first = Arthur S.
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</ref> </ref>


Freud viewed libido as passing through a series of ] within the individual. Failure to adequately adapt to the demands of these different stages could result in libidinal energy becoming 'dammed up' or ] in these stages, producing certain pathological character traits in adulthood. Thus the psychopathologized individual for Freud was an immature individual, and the goal of psychoanalysis was to bring these fixations to conscious awareness so that the libido energy would be freed up and available for conscious use in some sort of constructive ]. Freud viewed libido as passing through a series of ] in the individual, in which the libido fixates on different erogenous zones: first the ] (exemplified by an infant's pleasure in nursing), then the ] (exemplified by a toddler's pleasure in controlling his or her bowels), then the ], through a ] in which the libido is dormant, to its reemergence at puberty in the ]<ref>Sigmund Freud, ''New Introductory Lectures on Psychoanalysis'' (PFL 2) p. 131</ref> (] would later add subdivisions in both oral and anal stages.).<ref>], ''The Psychoanalytic Theory of Neurosis'' (1946)p. 101</ref> Failure to adequately adapt to the demands of these different stages could result in libidinal energy becoming 'dammed up' or ] in these stages, producing certain pathological character traits in adulthood.


===Jung===
] stated that ''libido'' can be revisioned as "emotional drives, impulses, needs or passions" to determine ].<ref>{{cite book
Swiss psychiatrist ] identified the libido with psychic energy in general. According to Jung, 'energy', in its subjective and psychological sense, is 'desire', of which sexual desire is just one aspect.<ref>P. Gay, ''Freud'' (1989) p. 397</ref><ref>{{cite web |url=http://frithluton.com/articles/libido/ |title=Libido |last=Sharp |first=Daryl |website=frithluton.com|date=15 October 2011 }}</ref> Libido thus denotes "a desire or impulse which is unchecked by any kind of authority, moral or otherwise. Libido is appetite in its natural state. From the genetic point of view it is bodily needs like hunger, thirst, sleep, and sex, and emotional states or affects, which constitute the essence of libido."<ref>“The Concept of Libido” Collected Works Vol. 5, par. 194.</ref> It is "the energy that manifests itself in the life process and is perceived subjectively as striving and desire."<ref>{{cite book |last1=Ellenberger |first1=Henri |title=The Discovery of the Unconscious |date=1970 |publisher=Basic Books |location=New York |page=697}}</ref> Duality (opposition) creates the energy (or libido) of the psyche, which Jung asserts expresses itself only through symbols. These symbols may manifest as "fantasy-images" in the process of psychoanalysis, giving subjective expression to the contents of the libido, which otherwise lacks any definite form.<ref>“The Technique of Differentiation,” Collected Works Vol. 7, par. 345.</ref> Desire, conceived generally as a psychic longing, movement, displacement and structuring, manifests itself in definable forms which are apprehended through analysis.
|last=Karen
|first=Horney
|author-link=Karen Horney
|date=1939
|title=New Ways in Psychoanalysis
|publisher=W. W. Norton & Company
|page=24
|isbn=978-0-393-31230-0
|quote=If, however, we discard these theoretical aspects, and for "libido" substitute emotional drives, impulses, needs or passions, we see the essential kernel of the assumption and can appreciate its value in creating an understanding of personality.}}</ref>


=== Other psychological and social perspectives ===
===Analytical psychology===
A person may have a desire for sex, but not have the opportunity to act on that desire, or may on personal, moral or religious reasons ]. Psychologically, a person's urge can be ] or ]. Conversely, a person can engage in sexual activity without an actual desire for it. Multiple factors affect human sex drive, including stress, illness, pregnancy, and others. A 2001 review found that, on average, men have a higher desire for sex than women.<ref>{{cite news|author1=Roy F. Baumeister, Kathleen R. Catanese, and Kathleen D. Vohs|title=Is There a Gender Difference in Strength of Sex Drive? Theoretical Views, Conceptual Distinctions, and a Review of Relevant Evidence|url=http://assets.csom.umn.edu/assets/71520.pdf|work=Department of Psychology Case Western Reserve University|publisher=Lawrence Erlbaum Associates, Inc.|quote=All the evidence we have reviewed points toward the conclusion that men desire sex more than women. Although some of the findings were more methodologically rigorous than others, the unanimous convergence across all measures and findings increases confidence. We did not find a single study, on any of nearly a dozen different measures, that found women had a stronger sex drive than men. We think that the combined quantity, quality, diversity, and convergence of the evidence render the conclusion indisputable}}</ref>
According to Swiss psychiatrist ], the libido is identified as the totality of psychic energy, not limited to sexual desire.<ref>P. Gay, ''Freud'' (1989) p. 397</ref><ref>{{cite web |url=http://frithluton.com/articles/libido/ |title=Libido |last=Sharp |first=Daryl |website=frithluton.com|date=15 October 2011 }}</ref> As Jung states in "The Concept of Libido,"<ref>“The Concept of Libido,” Collected Works Vol. 5, par. 194.</ref> " denotes a desire or impulse which is unchecked by any kind of authority, moral or otherwise. Libido is appetite in its natural state. From the genetic point of view it is bodily needs like hunger, thirst, sleep, and sex, and emotional states or affects, which constitute the essence of libido." The Duality (opposition) creates the energy (or libido) of the psyche, which Jung asserts expresses itself only through symbols: "It is the energy that manifests itself in the life process and is perceived subjectively as striving and desire." (Ellenberger, 697) These symbols may manifest as "fantasy-images" in the process of psychoanalysis which embody the contents of the libido, otherwise lacking in any definite form.<ref>“The Technique of Differentiation,” Collected Works Vol. 7, par. 345.</ref> Desire, conceived generally as a psychic longing, movement, displacement and structuring, manifests itself in definable forms which are apprehended through analysis.


Certain psychological or social factors can reduce the desire for sex. These factors can include lack of privacy or ], ] or ], distraction, or depression. Environmental stress, such as prolonged exposure to ] or ], can also affect libido. Other causes include experience of sexual abuse, assault, trauma, or neglect, body image issues, and anxiety about engaging in sexual activity.<ref>], ''Love's Executioner and Other Tales of Psychotherapy''. New York: Basic Books, 1989. {{ISBN|0-06-097334-X}}.</ref>
Defined more narrowly, libido also refers to an individual's urge to engage in ], and its ] is the force of destruction termed ] or ].<ref>Eric Berne, ''A Layman's Guide to Psychiatry and Psychoanalysis'' (1976) p. 69 and 101</ref>


Individuals with ] (PTSD) may find themselves with reduced sexual desire. Struggling to find pleasure, as well as having trust issues, many with PTSD experience feelings of vulnerability, rage and anger, and emotional shutdowns, which have been shown to inhibit sexual desire in those with PTSD.<ref>{{Cite journal|last1=Yehuda|first1=Rachel|last2=Lehrner|first2=Amy|last3=Rosenbaum|first3=Talli Y.|date=2015|title=PTSD and Sexual Dysfunction in Men and Women|journal=The Journal of Sexual Medicine|volume=12|issue=5|pages=1107–1119|doi=10.1111/jsm.12856|pmid=25847589|s2cid=1746180|issn=1743-6109}}</ref> Reduced sex drive may also be present in trauma victims due to issues arising in sexual function. For women, it has been found that treatment can improve sexual function, thus helping restore sexual desire.<ref>{{Cite journal|last1=Wells|first1=Stephanie Y.|last2=Glassman|first2=Lisa H.|last3=Talkovsky|first3=Alexander M.|last4=Chatfield|first4=Miranda A.|last5=Sohn|first5=Min Ji|last6=Morland|first6=Leslie A.|last7=Mackintosh|first7=Margaret-Anne|date=2019-01-01|title=Examining Changes in Sexual Functioning after Cognitive Processing Therapy in a Sample of Women Trauma Survivors|url=https://www.whijournal.com/article/S1049-3867(18)30101-4/abstract|journal=Women's Health Issues|language=en|volume=29|issue=1|pages=72–79|doi=10.1016/j.whi.2018.10.003|issn=1049-3867|pmid=30455090|s2cid=53871527|doi-access=free}}</ref> Depression and libido decline often coincide, with reduced sex drive being one of the symptoms of ].<ref name=":12">{{Cite journal|last1=Robert L. Phillips|first1=Jr|last2=Slaughter|first2=James R.|date=2000-08-15|title=Depression and Sexual Desire|url=https://www.aafp.org/afp/2000/0815/p782.html|journal=American Family Physician|volume=62|issue=4|pages=782–786|pmid=10969857|issn=0002-838X}}</ref> Those with depression often report the decline in libido to be far reaching and more noticeable than other symptoms.<ref name=":12" /> In addition, those with depression often are reluctant to report their reduced sex drive, often normalizing it with cultural/social values, or by the failure of the physician to inquire about it.
== Factors that affect libido ==

]s are often an important factor in the formation and maintenance of ]s in humans. A lack or loss of sexual desire can adversely affect relationships. Changes in the sexual desires of any partner in a sexual relationship, if sustained and unresolved, may cause ]. The ] of a partner may be an indication that a partner's changing sexual desires can no longer be satisfied within the current relationship. Problems can arise from disparity of sexual desires between partners, or poor communication between partners of sexual needs and preferences.<ref name="B">{{cite web|url=http://www.mayoclinic.com/health/low-sex-drive-in-women/DS01043/DSECTION=causes |title=Low sex drive in women|website=Mayo Clinic|publisher=Mayo Foundation for Medical Education and Research|access-date=July 28, 2010}}</ref>

== Biological perspectives ==
=== Endogenous compounds === === Endogenous compounds ===
{{See also|Sexual motivation and hormones}} {{See also|Sexual motivation and hormones}}
Libido is governed primarily by activity in the ] (] and ]).<ref name="MEDRS review" /> Consequently, ] and related ]s (primarily ])<ref name="Miller">{{cite journal | author = Miller GM | title = The emerging role of trace amine-associated receptor 1 in the functional regulation of monoamine transporters and dopaminergic activity | journal = J. Neurochem. | volume = 116 | issue = 2 | pages = 164–176 |date=January 2011 | pmid = 21073468 | pmc = 3005101 | doi = 10.1111/j.1471-4159.2010.07109.x }}</ref> that modulate dopamine neurotransmission play a critical role in regulating libido.<ref name="MEDRS review">{{cite journal |vauthors=Fisher HE, Aron A, Brown LL | title = Romantic love: a mammalian brain system for mate choice | journal = Philos. Trans. R. Soc. Lond. B Biol. Sci. | volume = 361 | issue = 1476 | pages = 2173–86 |date=December 2006 | pmid = 17118931 | pmc = 1764845 | doi = 10.1098/rstb.2006.1938 | quote = The sex drive evolved to motivate individuals to seek a range of mating partners; attraction evolved to motivate individuals to prefer and pursue specific partners; and attachment evolved to motivate individuals to remain together long enough to complete species-specific parenting duties. These three behavioural repertoires appear to be based on brain systems that are largely distinct yet interrelated, and they interact in specific ways to orchestrate reproduction, using both hormones and monoamines.&nbsp;... Animal studies indicate that elevated activity of dopaminergic pathways can stimulate a cascade of reactions, including the release of testosterone and oestrogen (Wenkstern et al. 1993; Kawashima &Takagi 1994; Ferrari & Giuliana 1995; Hull et al. 1995, 1997, 2002; Szezypka et al. 1998; Wersinger & Rissman 2000). Likewise, increasing levels of testosterone and oestrogen promote dopamine release&nbsp;...This positive relationship between elevated activity of central dopamine, elevated sex steroids and elevated sexual arousal and sexual performance (Herbert 1996; Fiorino et al. 1997; Liu et al. 1998; Pfaff 2005) also occurs in humans (Walker et al. 1993; Clayton et al. 2000; Heaton 2000).&nbsp;... This parental attachment system has been associated with the activity of the neuropeptides, oxytocin (OT) in the nucleus accumbens and arginine vasopressin (AVP) in the ventral pallidum&nbsp;... The activities of central oxytocin and vasopressin have been associated with both partner preference and attachment behaviours, while dopaminergic pathways have been associated more specifically with partner preference. }}</ref> Libido is governed primarily by activity in the ] (] and ]).<ref name="MEDRS review" /> Consequently, ] and related ]s (primarily ])<ref name="Miller">{{cite journal | author = Miller GM | title = The emerging role of trace amine-associated receptor 1 in the functional regulation of monoamine transporters and dopaminergic activity | journal = J. Neurochem. | volume = 116 | issue = 2 | pages = 164–176 |date=January 2011 | pmid = 21073468 | pmc = 3005101 | doi = 10.1111/j.1471-4159.2010.07109.x }}</ref> that modulate dopamine neurotransmission play a critical role in regulating libido.<ref name="MEDRS review">{{cite journal |vauthors=Fisher HE, Aron A, Brown LL | title = Romantic love: a mammalian brain system for mate choice | journal = Philos. Trans. R. Soc. Lond. B Biol. Sci. | volume = 361 | issue = 1476 | pages = 2173–86 |date=December 2006 | pmid = 17118931 | pmc = 1764845 | doi = 10.1098/rstb.2006.1938 }}</ref>


Other neurotransmitters, neuropeptides, and sex hormones that affect sex drive by modulating activity in or acting upon this pathway include: Other neurotransmitters, neuropeptides, and sex hormones that affect sex drive by modulating activity in or acting upon this pathway include:
* ]<ref name="MEDRS review" /> (directly correlated) – and other ]s<ref name="Lichterman" /><ref name="pmid20920505">{{cite journal |vauthors=Harding SM, Velotta JP | title = Comparing the relative amount of testosterone required to restore sexual arousal, motivation, and performance in male rats | journal = Horm Behav | volume = 59 | issue = 5 | pages = 666–73 |date=May 2011 | pmid = 20920505 | doi = 10.1016/j.yhbeh.2010.09.009 | s2cid = 1577450 }}</ref><ref name="Davis_2008">{{cite journal |vauthors=Davis SR, Moreau M, Kroll R, Bouchard C, Panay N, Gass M, Braunstein GD, Hirschberg AL, Rodenberg C, Pack S, Koch H, Moufarege A, Studd J | title = Testosterone for low libido in postmenopausal women not taking estrogen | journal = N. Engl. J. Med. | volume = 359 | issue = 19 | pages = 2005–17 |date=November 2008 | pmid = 18987368 | doi = 10.1056/NEJMoa0707302 | s2cid = 181727 | url = https://semanticscholar.org/paper/7e57304da9d1a2979b386ca57794ca016b09e110 }}</ref><ref>{{cite journal |last = Renneboog B |title = |journal = ] |volume = 33 |pages = 443–9 |year = 2012 |pmid=23091954 |issue = 4}}</ref> * ]<ref name="MEDRS review" /> (directly correlated) – and other ]s<ref name="Lichterman" /><ref name="pmid20920505">{{cite journal |vauthors=Harding SM, Velotta JP | title = Comparing the relative amount of testosterone required to restore sexual arousal, motivation, and performance in male rats | journal = Horm Behav | volume = 59 | issue = 5 | pages = 666–73 |date=May 2011 | pmid = 20920505 | doi = 10.1016/j.yhbeh.2010.09.009 | s2cid = 1577450 }}</ref><ref name="Davis_2008">{{cite journal |vauthors=Davis SR, Moreau M, Kroll R, Bouchard C, Panay N, Gass M, Braunstein GD, Hirschberg AL, Rodenberg C, Pack S, Koch H, Moufarege A, Studd J | title = Testosterone for low libido in postmenopausal women not taking estrogen | journal = N. Engl. J. Med. | volume = 359 | issue = 19 | pages = 2005–17 |date=November 2008 | pmid = 18987368 | doi = 10.1056/NEJMoa0707302 | s2cid = 181727 | doi-access = free }}</ref><ref>{{cite journal |last = Renneboog B |title = |journal = ] |volume = 33 |pages = 443–9 |year = 2012 |pmid=23091954 |issue = 4}}</ref>
* ]<ref name="MEDRS review" /> (directly correlated) – and related female sex hormones<ref name = "DeLamater&Sill2005">{{cite journal |last1= DeLamater|first1=J.D. |last2=Sill |first2=M.|year=2005 |title=Sexual Desire in Later Life |journal=The Journal of Sex Research |volume=42 |issue=2 |pages=138–149 |doi=10.1080/00224490509552267|pmid=16123844 |s2cid=15894788 |url=https://semanticscholar.org/paper/9c1d78d89aedc7e4be52a402c4d9a8bb6f86bdd4 }}</ref><ref name="pmid21514299">{{cite journal |vauthors=Heiman JR, Rupp H, Janssen E, Newhouse SK, Brauer M, Laan E | title = Sexual desire, sexual arousal and hormonal differences in premenopausal US and Dutch women with and without low sexual desire | journal = Horm. Behav. | volume = 59 | issue = 5 | pages = 772–779 |date=May 2011 | pmid = 21514299 | doi = 10.1016/j.yhbeh.2011.03.013| s2cid = 20807391 }}</ref><ref name="pmid16037752">{{cite journal |vauthors=Warnock JK, Swanson SG, Borel RW, Zipfel LM, Brennan JJ | title = Combined esterified estrogens and methyltestosterone versus esterified estrogens alone in the treatment of loss of sexual interest in surgically menopausal women | journal = Menopause | volume = 12 | issue = 4 | pages = 359–60 | year = 2005 | pmid = 16037752 | doi = 10.1097/01.GME.0000153933.50860.FD | s2cid = 24557071 }}</ref><ref name="Ziegler-51-p1-2" /><ref>{{cite journal|last=Simerly |first=Richard B. |title=Wired for reproduction: organization and development of sexually dimorphic circuits in the mammalian forebrain |journal=Annu. Rev. Neurosci. |volume=25 |pages=507–536 |date=2002-03-27 |url=http://www.healthsystem.virginia.edu/internet/neuroscience/BehavioralNeuroscience/Simerley-EFR-1-4.pdf |archive-url=https://web.archive.org/web/20081001223447/http://www.healthsystem.virginia.edu/internet/neuroscience/BehavioralNeuroscience/Simerley-EFR-1-4.pdf |url-status=dead |archive-date=2008-10-01 |doi=10.1146/annurev.neuro.25.112701.142745 |pmid=12052919 |access-date=2007-03-07 }}</ref> * ]<ref name="MEDRS review" /> (directly correlated) – and related female sex hormones<ref name = "DeLamater&Sill2005">{{cite journal |last1= DeLamater|first1=J.D. |last2=Sill |first2=M.|year=2005 |title=Sexual Desire in Later Life |journal=The Journal of Sex Research |volume=42 |issue=2 |pages=138–149 |doi=10.1080/00224490509552267|pmid=16123844 |s2cid=15894788 }}</ref><ref name="pmid21514299">{{cite journal |vauthors=Heiman JR, Rupp H, Janssen E, Newhouse SK, Brauer M, Laan E | title = Sexual desire, sexual arousal and hormonal differences in premenopausal US and Dutch women with and without low sexual desire | journal = Horm. Behav. | volume = 59 | issue = 5 | pages = 772–779 |date=May 2011 | pmid = 21514299 | doi = 10.1016/j.yhbeh.2011.03.013| s2cid = 20807391 }}</ref><ref name= "pmid16037752">{{cite journal |vauthors=Warnock JK, Swanson SG, Borel RW, Zipfel LM, Brennan JJ | title = Combined esterified estrogens and methyltestosterone versus esterified estrogens alone in the treatment of loss of sexual interest in surgically menopausal women | journal = Menopause | volume = 12 | issue = 4 | pages = 359–60 | year = 2005 | pmid = 16037752 | doi = 10.1097/01.GME.0000153933.50860.FD | s2cid = 24557071 }}</ref><ref name="Ziegler-51-p1-2" /><ref>{{cite journal|last=Simerly |first=Richard B. |title=Wired for reproduction: organization and development of sexually dimorphic circuits in the mammalian forebrain |journal=Annu. Rev. Neurosci. |volume=25 |pages=507–536 |date=2002-03-27 |url=http://www.healthsystem.virginia.edu/internet/neuroscience/BehavioralNeuroscience/Simerley-EFR-1-4.pdf |archive-url=https://web.archive.org/web/20081001223447/http://www.healthsystem.virginia.edu/internet/neuroscience/BehavioralNeuroscience/Simerley-EFR-1-4.pdf |url-status=dead |archive-date= 2008-10-01 |doi= 10.1146/annurev.neuro.25.112701.142745 |pmid=12052919 |access-date= 2007-03-07 }}</ref>
* ]<ref name="Ziegler-51-p1-2">Ziegler, T. E. (2007). Female sexual motivation during non-fertile periods: a primate phenomenon. Hormones and Behavior, 51(1), 1–2</ref> (inversely correlated) * ]<ref name="Ziegler-51-p1-2">Ziegler, T. E. (2007). Female sexual motivation during non-fertile periods: a primate phenomenon. Hormones and Behavior, 51(1), 1–2</ref> (inversely correlated)
* ]<ref name="Oxytocinergic circuit">{{cite journal |vauthors=McGregor IS, Callaghan PD, Hunt GE | title = From ultrasocial to antisocial: a role for oxytocin in the acute reinforcing effects and long-term adverse consequences of drug use? | journal = Br. J. Pharmacol. | volume = 154 | issue = 2 | pages = 358–368 |date=May 2008 | pmid = 18475254 | pmc = 2442436 | doi = 10.1038/bjp.2008.132 | quote = Recent evidence suggests that popular party drugs such as MDMA and gamma-hydroxybutyrate (GHB) may preferentially activate brain oxytocin systems to produce their characteristic prosocial and prosexual effects. Oxytocin interacts with the mesolimbic dopamine system to facilitate sexual and social behaviour, and this oxytocin-dopamine interaction may also influence the acquisition and expression of drug-seeking behaviour.}}</ref> (directly correlated) * ]<ref name= "Oxytocinergic circuit">{{cite journal |vauthors=McGregor IS, Callaghan PD, Hunt GE | title = From ultrasocial to antisocial: a role for oxytocin in the acute reinforcing effects and long-term adverse consequences of drug use? | journal = Br. J. Pharmacol. | volume = 154 | issue = 2 | pages = 358–368 |date=May 2008 | pmid = 18475254 | pmc = 2442436 | doi = 10.1038/bjp.2008.132 | quote = Recent evidence suggests that popular party drugs such as MDMA and gamma-hydroxybutyrate (GHB) may preferentially activate brain oxytocin systems to produce their characteristic prosocial and prosexual effects. Oxytocin interacts with the mesolimbic dopamine system to facilitate sexual and social behaviour, and this oxytocin-dopamine interaction may also influence the acquisition and expression of drug-seeking behaviour.}}</ref> (directly correlated)
* ]<ref name="dop and nor"/><ref>{{Cite journal |vauthors=Hu XH, Bull SA, Hunkeler EM, etal |title=Incidence and duration of side effects and those rated as bothersome with selective serotonin reuptake inhibitor treatment for depression: patient report versus physician estimate |journal=The Journal of Clinical Psychiatry |volume=65 |issue=7 |pages=959–65 |date=July 2004 |pmid=15291685 |doi=10.4088/JCP.v65n0712}}</ref><ref>{{Cite journal|vauthors=Landén M, Högberg P, Thase ME |title=Incidence of sexual side effects in refractory depression during treatment with citalopram or paroxetine |journal=The Journal of Clinical Psychiatry |volume=66 |issue=1 |pages=100–6 |date=January 2005 |pmid=15669895 |doi=10.4088/JCP.v66n0114}}</ref> (inversely correlated) * ]<ref name="dop and nor"/><ref>{{Cite journal |vauthors=Hu XH, Bull SA, Hunkeler EM, etal |title=Incidence and duration of side effects and those rated as bothersome with selective serotonin reuptake inhibitor treatment for depression: patient report versus physician estimate |journal=The Journal of Clinical Psychiatry |volume=65 |issue=7 |pages= 959–65 |date=July 2004 |pmid= 15291685 |doi= 10.4088/JCP.v65n0712}}</ref><ref>{{Cite journal|vauthors=Landén M, Högberg P, Thase ME |title=Incidence of sexual side effects in refractory depression during treatment with citalopram or paroxetine |journal=The Journal of Clinical Psychiatry |volume=66 |issue=1 |pages=100–6 |date=January 2005 |pmid=15669895 |doi=10.4088/JCP.v66n0114}}</ref> (inversely correlated)
* ]<ref name="dop and nor">{{cite journal |author=Clayton AH |title=The pathophysiology of hypoactive sexual desire disorder in women |journal=Int J Gynaecol Obstet |volume=110 |issue=1 |pages=7–11 |date=July 2010 |pmid=20434725 |doi=10.1016/j.ijgo.2010.02.014 |s2cid=29172936 }}</ref> (directly correlated) * ]<ref name="dop and nor">{{cite journal |author=Clayton AH |title=The pathophysiology of hypoactive sexual desire disorder in women |journal=Int J Gynaecol Obstet |volume=110 |issue=1 |pages=7–11 |date=July 2010 |pmid=20434725 |doi=10.1016/j.ijgo.2010.02.014 |s2cid=29172936 }}</ref> (directly correlated)
* ]<ref>''Int J Impot Res''. 2000 Oct;12 Suppl 4:S26-33.</ref> * ]<ref>''Int J Impot Res''. 2000 Oct;12 Suppl 4:S26-33.</ref>


==== Sex hormone levels and the menstrual cycle ==== ==== Sex hormone levels and the menstrual cycle ====
A woman's desire for sex is correlated to her ], with many women experiencing a heightened sexual desire in the several days immediately before ],<ref>{{cite journal|author1=Susan B. Bullivant |author2=Sarah A. Sellergren |author3=Kathleen Stern |title=Women's sexual experience during the menstrual cycle: identification of the sexual phase by noninvasive measurement of luteinizing hormone |journal=Journal of Sex Research |date=February 2004 |volume=41 |issue=1 |pages=82–93 (in online article, see pp.14–15, 18–22) |url=https://dx.doi.org/10.1080%2F00224490409552216 |pmid=15216427 |doi=10.1080/00224490409552216 |s2cid=40401379 |display-authors=etal |url-status=dead |archive-url=https://web.archive.org/web/20070923001735/http://findarticles.com/p/articles/mi_m2372/is_1_41/ai_n6032944 |archive-date=2007-09-23 }}</ref> which is her peak fertility period, which normally occurs two days before and until two days after the ovulation.<ref>{{cite web|url=http://www.duofertility.com/en/my-body/my-cycle/my-fertile-period.html |title=My Fertile Period &#124; DuoFertility |access-date=2008-09-22 |url-status=dead |archive-url=https://web.archive.org/web/20081221225600/http://www.duofertility.com/en/my-body/my-cycle/my-fertile-period.html |archive-date=2008-12-21 }}</ref> This cycle has been associated with changes in a woman's ] levels during the menstrual cycle. According to Gabrielle Lichterman, testosterone levels have a direct impact on a woman's interest in sex. According to her, testosterone levels rise gradually from about the 24th day of a woman's menstrual cycle until ovulation on about the 14th day of the next cycle, and during this period the woman's desire for sex increases consistently. The 13th day is generally the day with the highest testosterone levels. In the week following ovulation, the testosterone level is the lowest and as a result women will experience less interest in sex.<ref name="Lichterman">{{cite book|title=28 Days: What Your Cycle Reveals about Your Love Life, Moods, and Potential|first=Gabrielle|last=Lichterman|isbn=978-1-59337-345-0|date=November 2004}}</ref>{{better source needed|date=October 2015}} A woman's desire for sex is correlated to her ], with many women experiencing a heightened sexual desire in the several days immediately before ],<ref>{{cite journal| first1=Susan B. | last1= Bullivant |first2= Sarah A.| last2= Sellergren | first3= Kathleen |last3= Stern |title=Women's sexual experience during the menstrual cycle: identification of the sexual phase by noninvasive measurement of luteinizing hormone |journal=Journal of Sex Research |date=February 2004 |volume=41 |issue=1 |pages=82–93 (in online article, see pp.14–15, 18–22) |url=https://dx.doi.org/10.1080%2F00224490409552216 |pmid=15216427 |doi=10.1080/00224490409552216 |s2cid=40401379 |display-authors=etal |url-status=dead |archive-url= https://web.archive.org/web/20070923001735/http://findarticles.com/p/articles/mi_m2372/is_1_41/ai_n6032944 |archive-date=2007-09-23 }}</ref> which is her peak fertility period, which normally occurs two days before and until two days after the ovulation.<ref>{{cite web| url=http://www.duofertility.com/en/my-body/my-cycle/my-fertile-period.html |title=My Fertile Period| website= DuoFertility.com| date= | publisher= |access-date= 2008-09-22 |url-status=dead |archive-url=https://web.archive.org/web/20081221225600/http://www.duofertility.com/en/my-body/my-cycle/my-fertile-period.html |archive-date=2008-12-21 }}</ref> This cycle has been associated with changes in a woman's ] levels during the menstrual cycle. According to Gabrielle Lichterman, testosterone levels have a direct impact on a woman's interest in sex. According to her, testosterone levels rise gradually from about the 24th day of a woman's menstrual cycle until ovulation on about the 14th day of the next cycle, and during this period the woman's desire for sex increases consistently. The 13th day is generally the day with the highest testosterone levels. In the week following ovulation, the testosterone level is the lowest and as a result women will experience less interest in sex.<ref name= "Lichterman">{{cite book| title=28 Days: What Your Cycle Reveals about Your Love Life, Moods, and Potential| first= Gabrielle|last=Lichterman| isbn= 978-1-59337-345-0| date= November 2004| publisher= Adams Media Corporation}}</ref>{{better source needed|date=October 2015}}


Also, during the week following ovulation, ] levels increase, resulting in a woman experiencing difficulty achieving ]. Although the last days of the menstrual cycle are marked by a constant testosterone level, women's libido may get a boost as a result of the thickening of the ] which stimulates ] and makes a woman feel aroused.<ref name="C">{{cite web |url=http://www.emaxhealth.com/48/4247.html |title=Women Can Now Predict When They Will Have The Best Sex |access-date=July 28, 2010 |archive-date=July 5, 2019 |archive-url=https://web.archive.org/web/20190705133933/https://www.emaxhealth.com/48/4247.html |url-status=dead }}</ref> Also, during these days, ] levels decline, resulting in a decrease of ]. Also, during the week following ovulation, ] levels increase, resulting in a woman experiencing difficulty achieving ]. Although the last days of the menstrual cycle are marked by a constant testosterone level, women's libido may get a boost as a result of the thickening of the ] which stimulates ] and makes a woman feel aroused.<ref name="C">{{cite web |url=http://www.emaxhealth.com/48/4247.html |title=Women Can Now Predict When They Will Have The Best Sex | website= emaxhealth.com |access-date=July 28, 2010 |archive-date=July 5, 2019 |archive-url=https://web.archive.org/web/20190705133933/https://www.emaxhealth.com/48/4247.html |url-status=dead }}</ref> Also, during these days, ] levels decline, resulting in a decrease of ].

Although some specialists disagree with this theory, ] is still considered by the majority a factor that can cause decreased sexual desire in women. The levels of ] decrease at menopause and this usually causes a lower interest in sex and vaginal dryness which makes sex painful. However, the levels of ] increase at menopause and this may be why some women may experience a contrary effect of an increased libido.<ref>{{Cite journal|last1=Shearer|first1=Jasmin L|last2=Salmons|first2=Nabeel|last3=Murphy|first3=Damian J|last4=Gama|first4=Rousseau|date=January 2017|title=Postmenopausal hyperandrogenism: the under-recognized value of inhibins|journal=Annals of Clinical Biochemistry|language=en-US|volume=54|issue=1|pages=174–177|doi=10.1177/0004563216656873|pmid=27278937|issn=0004-5632|doi-access=free}}</ref>

=== Psychological and social factors ===
Certain psychological or social factors can reduce the desire for sex. These factors can include lack of privacy or ], ] or ], distraction, or depression. Environmental stress, such as prolonged exposure to ] or ], can also affect libido. Other causes include experience of sexual abuse, assault, trauma, or neglect, body image issues, and anxiety about engaging in sexual activity.<ref>], ''Love's Executioner and Other Tales of Psychotherapy''. New York: Basic Books, 1989. {{ISBN|0-06-097334-X}}.</ref>


Although some specialists disagree with this theory, ] is still considered by the majority a factor that can cause decreased sexual desire in women. The levels of estrogen decrease at menopause and this usually causes a lower interest in sex and vaginal dryness which makes sex painful. However, the levels of testosterone increase at menopause and this may be why some women may experience a contrary effect of an increased libido.<ref>{{Cite journal |last1=Shearer|first1=Jasmin L|last2= Salmons|first2=Nabeel|last3=Murphy|first3=Damian J|last4= Gama|first4= Rousseau|date=January 2017| title= Postmenopausal hyperandrogenism: the under-recognized value of inhibins| journal=Annals of Clinical Biochemistry| language=en-US| volume= 54| issue= 1|pages=174–177| doi= 10.1177/0004563216656873|pmid=27278937|issn=0004-5632|doi-access= free}}</ref>
Individuals with ] (PTSD) may find themselves with reduced sexual desire. Struggling to find pleasure, as well as having trust issues, many with PTSD experience feelings of vulnerability, rage and anger, and emotional shutdowns, which have been shown to inhibit sexual desire in those with PTSD.<ref>{{Cite journal|last1=Yehuda|first1=Rachel|last2=Lehrner|first2=Amy|last3=Rosenbaum|first3=Talli Y.|date=2015|title=PTSD and Sexual Dysfunction in Men and Women|journal=The Journal of Sexual Medicine|volume=12|issue=5|pages=1107–1119|doi=10.1111/jsm.12856|pmid=25847589|s2cid=1746180|issn=1743-6109|url=https://semanticscholar.org/paper/804a6278b60c3615b66b25dc6645f7ee2e1c7b79}}</ref> Reduced sex drive may also be present in trauma victims due to issues arising in sexual function. For women, it has been found that treatment can improve sexual function, thus helping restore sexual desire.<ref>{{Cite journal|last1=Wells|first1=Stephanie Y.|last2=Glassman|first2=Lisa H.|last3=Talkovsky|first3=Alexander M.|last4=Chatfield|first4=Miranda A.|last5=Sohn|first5=Min Ji|last6=Morland|first6=Leslie A.|last7=Mackintosh|first7=Margaret-Anne|date=2019-01-01|title=Examining Changes in Sexual Functioning after Cognitive Processing Therapy in a Sample of Women Trauma Survivors|url=https://www.whijournal.com/article/S1049-3867(18)30101-4/abstract|journal=Women's Health Issues|language=en|volume=29|issue=1|pages=72–79|doi=10.1016/j.whi.2018.10.003|issn=1049-3867|pmid=30455090|s2cid=53871527}}</ref> Depression and libido decline often coincide, with reduced sex drive being one of the symptoms of ].<ref name=":12">{{Cite journal|last1=Robert L. Phillips|first1=Jr|last2=Slaughter|first2=James R.|date=2000-08-15|title=Depression and Sexual Desire|url=https://www.aafp.org/afp/2000/0815/p782.html|journal=American Family Physician|volume=62|issue=4|pages=782–786|pmid=10969857|issn=0002-838X}}</ref> Those with depression often report the decline in libido to be far reaching and more noticeable than other symptoms.<ref name=":12" /> In addition, those with depression often are reluctant to report their reduced sex drive, often normalizing it with cultural/social values, or by the failure of the physician to inquire about it.


=== Physical factors === === Physical factors ===
Physical factors that can affect libido include ] issues such as ], the effect of certain prescription medications (for example ]), and the attractiveness and biological fitness of one's partner, among various other lifestyle factors.<ref> {{webarchive|url=https://web.archive.org/web/20071002134500/http://www.psychologytoday.com/articles/pto-19960101-000028.html |date=2007-10-02 }}</ref> Physical factors that can affect libido include ] issues such as ], the effect of certain prescription medications (for example ]), and the attractiveness and biological fitness of one's partner, among various other lifestyle factors.<ref>{{cite web| url= https://www.psychologytoday.com/us/articles/199612/the-orgasm-wars| work= ] | title=The Orgasm Wars |date= December 31, 1996| access-date=August 19, 2023}}</ref>


] is a cause of lack of libido in women due to the loss of ] during the period.<ref name="A">{{cite web|url=http://www.netdoctor.co.uk/sex_relationships/facts/lackingsexdrive.htm |title=Lack of sex drive in men (lack of libido) |access-date=July 28, 2010}}</ref> ] is a cause of lack of libido in women due to the loss of ] during the period.<ref name="A">{{cite web | url=http://www.netdoctor.co.uk/sex_relationships/facts/lackingsexdrive.htm | title=Lack of sex drive in men (lack of libido) | website=netdoctor.co.uk | publisher= | date= | access-date=July 28, 2010 | archive-date=October 16, 2015 | archive-url=https://web.archive.org/web/20151016134757/http://www.netdoctor.co.uk/sex_relationships/facts/lackingsexdrive.htm | url-status=dead }}</ref>


], ], and the use of certain drugs can also lead to a decreased libido.<ref>{{cite web |last1=Mayo Clinic |title=Low sex drive in women |url=https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/symptoms-causes/syc-20374554 |publisher=Mayo Foundation for Medical Education and Research (MFMER) |access-date=14 January 2020 |ref=Feb. 15, 2018}}</ref> Moreover, specialists suggest that several lifestyle changes such as ], ], lowering consumption of alcohol or using prescription drugs may help increase one's sexual desire.<ref>{{cite journal |last1=Finley |first1=Nicola |title=Lifestyle Choices Can Augment Female Sexual Well-Being |volume=12 |issue=1 |pages=38–41 |journal=American Journal of Lifestyle Medicine |pmc=6125014 |year=2017 |pmid=30283244 |doi=10.1177/1559827617740823 }}</ref><ref>{{cite web |last1=Mayo Clinic |title=Low sex drive in women: Diagnosis and Treatment |url=https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/diagnosis-treatment/drc-20374561 |publisher=Mayo Foundation for Medical Education and Research (MFMER) |access-date=14 January 2020}}</ref> ] tobacco, ], and the use of certain drugs can also lead to a decreased libido.<ref>{{cite web |last1= |title=Low sex drive in women: symptoms and causes| website= mayoclinic.org| url= https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/symptoms-causes/syc-20374554 |publisher=Mayo Foundation for Medical Education and Research (MFMER) |access-date=14 January 2020 |ref=Feb. 15, 2018}}</ref> Moreover, specialists suggest that several lifestyle changes such as exercising, ], lowering consumption of alcohol or using prescription drugs may help increase one's sexual desire.<ref>{{cite journal |last1=Finley |first1=Nicola |title=Lifestyle Choices Can Augment Female Sexual Well-Being |volume=12 |issue=1 |pages=38–41 |journal= American Journal of Lifestyle Medicine |pmc=6125014 |year=2017 |pmid= 30283244 |doi= 10.1177/1559827617740823 }}</ref><ref>{{cite web |last1= |title=Low sex drive in women: Diagnosis and Treatment |website= mayoclinic.org| url= https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/diagnosis-treatment/drc-20374561 |publisher=Mayo Foundation for Medical Education and Research (MFMER) |access-date=14 January 2020}}</ref>


==== Medications ==== ==== Medications ====
Some people purposefully attempt to decrease their libido through the usage of ]s.<ref>Rebal Jr, Ronald F., Robert A. Faguet, and Sherwyn M. Woods. "Unusual sexual syndromes." Extraordinary Disorders of Human Behavior. Springer US, 1982. 121-154.</ref> Aphrodisiacs, such as ] psychostimulants, are a class of drugs which can increase libido. On the other hand, a reduced libido is also often ] and can be caused by many medications, such as ], ]s and other ], ]s, ]s, ]s and ]. Some people purposefully attempt to decrease their libido through the usage of ]s.<ref>Rebal Jr, Ronald F., Robert A. Faguet, and Sherwyn M. Woods. "Unusual sexual syndromes." ''Extraordinary Disorders of Human Behavior''. Springer US, 1982. 121-154.</ref> Aphrodisiacs, such as ] psychostimulants, are a class of drugs which can increase libido. On the other hand, a reduced libido is also often ] and can be caused by many medications, such as ], ]s and other ], ]s, ]s, ]s and ].


], ] and many ] uncommonly can cause a long-term decrease in libido and overall sexual function, sometimes lasting for months or years after users of these drugs have stopped taking them. These long-lasting effects have been classified as ] medical disorders, respectively termed post-retinoid sexual dysfunction/post-Accutane syndrome (PRSD/PAS), post-finasteride syndrome (PFS) and ].<ref name=":12"/><ref name=":3">{{Cite journal|last1=Bala|first1=Areeg|last2=Nguyen|first2=Hoang Minh Tue|last3=Hellstrom|first3=Wayne J. G.|date=2018-01-01|title=Post-SSRI Sexual Dysfunction: A Literature Review|journal=Sexual Medicine Reviews|volume=6|issue=1|pages=29–34|doi=10.1016/j.sxmr.2017.07.002|pmid=28778697|issn=2050-0521}}</ref> These three disorders share many overlapping symptoms in addition to reduced libido, and are thought to share a common etiology, but collectively remain poorly-understood and lack effective treatments. Isotretinoin, ] and many SSRIs uncommonly can cause a long-term decrease in libido and overall sexual function, sometimes lasting for months or years after users of these drugs have stopped taking them. These long-lasting effects have been classified as iatrogenic medical disorders, respectively termed post-retinoid sexual dysfunction/post-Accutane syndrome (PRSD/PAS), post-finasteride syndrome (PFS) and ].<ref name=":12"/><ref name=":3">{{Cite journal|last1=Bala|first1=Areeg|last2=Nguyen|first2=Hoang Minh Tue| last3= Hellstrom|first3=Wayne J. G.| date= 2018-01-01|title=Post-SSRI Sexual Dysfunction: A Literature Review| journal=Sexual Medicine Reviews |volume=6|issue=1|pages=29–34| doi=10.1016/j.sxmr.2017.07.002|pmid=28778697|issn=2050-0521}}</ref> These three disorders share many overlapping symptoms in addition to reduced libido, and are thought to share a common etiology, but collectively remain poorly-understood and lack effective treatments.


Multiple studies have shown that with the exception of ] (Wellbutrin), ] (Desyrel) and ] (Serzone), antidepressants generally will lead to lowered libido.<ref name=":12" /> SSRIs that typically lead to decreased libido are ] (Prozac), ] (Paxil), ] (Luvox), ] (Celexa) and ] (Zoloft).<ref name=":12" /> Some antidepressant users have tried decreasing their dosage in the hopes of maintaining an adequate sex drive.{{Example needed|s|date=February 2022}}{{Citation needed|date=February 2022}} Other users try enrolling in psychotherapy to solve depression-related issues of libido. However, the effectiveness of this therapy is mixed, with many reporting that it had no or little effect on sexual drive.<ref name=":12" /> Multiple studies have shown that with the exception of ] (Wellbutrin), ] (Desyrel) and ] (Serzone), antidepressants generally will lead to lowered libido.<ref name=":12" /> SSRIs that typically lead to decreased libido are ] (Prozac), ] (Paxil), ] (Luvox), ] (Celexa) and ] (Zoloft).<ref name=":12" /> Lowering the dosage of SSRI medications has been shown to improve libido in some patients.<ref name="Gonzales_1997">{{cite journal |last1=Montejo-González |first1=A L |last2=Llorca |first2=G |last3=Izquierdo |first3=J A |date=Fall 1997 |title=SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients |url=https://pubmed.ncbi.nlm.nih.gov/9292833/ |journal=J Sex Marital Ther |volume=23 |issue=3 |pages=176–194 |doi=10.1080/00926239708403923 |pmid=9292833 |access-date=2024-09-27}}</ref> Other users try enrolling in psychotherapy to solve depression-related issues of libido. However, the effectiveness of this therapy is mixed, with many reporting that it had no or little effect on sexual drive.<ref name=":12" />


] is one of the hormones controlling libido in human beings. Emerging research<ref>{{Cite journal ] is one of the hormones controlling libido in human beings. Emerging research<ref>{{Cite journal
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}}.</ref> }}.</ref>


] lower androgen levels in users, and lowered androgen levels generally lead to a decrease in sexual desire. However, usage of oral contraceptives has shown to typically not have a connection with lowered libido in women.<ref>{{Cite journal|last1=Burrows|first1=Lara J.|last2=Basha|first2=Maureen|last3=Goldstein|first3=Andrew T.|date=2012-09-01|title=The Effects of Hormonal Contraceptives on Female Sexuality: A Review|url=https://www.jsm.jsexmed.org/article/S1743-6095(15)34100-X/abstract|journal=The Journal of Sexual Medicine|language=en|volume=9|issue=9|pages=2213–2223|doi=10.1111/j.1743-6109.2012.02848.x|pmid=22788250|issn=1743-6095}}</ref><ref>{{Cite journal|last1=Davis|first1=Anne R.|last2=Castaño|first2=Paula M.|date=2004|title=Oral contraceptives and libido in women|journal=Annual Review of Sex Research|volume=15|pages=297–320|issn=1053-2528|pmid=16913282}}</ref> ] lower androgen levels in users, and lowered androgen levels generally lead to a decrease in sexual desire. However, usage of oral contraceptives has shown to typically not have a connection with lowered libido in women.<ref>{{Cite journal| last1=Burrows|first1=Lara J.|last2= Basha|first2=Maureen|last3=Goldstein|first3=Andrew T.|date=2012-09-01| title=The Effects of Hormonal Contraceptives on Female Sexuality: A Review|url=https://www.jsm.jsexmed.org/article/S1743-6095(15)34100-X/abstract|journal=The Journal of Sexual Medicine| language=en| volume=9|issue=9|pages=2213–2223| doi=10.1111/j.1743-6109.2012.02848.x| pmid=22788250|issn=1743-6095}}</ref><ref>{{Cite journal| last1= Davis| first1=Anne R.| last2= Castaño| first2=Paula M.|date=2004|title=Oral contraceptives and libido in women| journal=Annual Review of Sex Research|volume=15|pages=297–320| issn=1053-2528|pmid=16913282}}</ref>


==== Effects of age ==== ==== Effects of age ====
Males reach the peak of their sex drive in their teenage years, while females reach it in their thirties.<ref> Marcia Claire Inhorn 2009</ref><ref> Patricia Gauntlett Beare</ref> The surge in testosterone hits the male at puberty resulting in a sudden and extreme sex drive which reaches its peak at age 15–16, then drops slowly over his lifetime. In contrast, a female's libido increases slowly during adolescence and peaks in her mid-thirties.{{why|date=August 2021}}<ref>{{Citation Males reach the peak of their sex drive in their teenage years {{Dubious|reason= Males clearly peak in sex drive in their early 20s|date=May 2023}}, while females reach it in their thirties.<ref>{{cite book | page= | title= Reconceiving the second sex | first=Marcia Claire | last=Inhorn |year= 2009 | publisher=| isbn= |via= Google Books}}</ref><ref>{{cite book | url= https://books.google.com/books?id=I7sQAQAAMAAJ | title=Principles and practice of adult health nursing | first= Patricia | last= Gauntlett Beare | date=1990 | publisher=Mosby| isbn= 9780801603860|via= Google Books}}</ref> The surge in testosterone hits the male at puberty resulting in a sudden and extreme sex drive which reaches its peak at age 15–16, then drops slowly over their lifetime.{{Disputed inline|date=May 2023}} In contrast, a female's libido increases slowly during adolescence and peaks in their mid-thirties.{{why|date=August 2021}}<ref>{{cite book
|publisher = Penguin (Non-Classics) |publisher = Penguin (Non-Classics)
|ol = 7360364M |ol = 7360364M
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|title = Sex, Time, and Power |title = Sex, Time, and Power
|url = https://archive.org/details/sextimepower00leon_0 |url = https://archive.org/details/sextimepower00leon_0
|author = Leonard Shlain |first = Leonard
|last= Shlain
|date = July 27, 2004 |date = July 27, 2004
}}</ref> }}</ref>
Actual testosterone and estrogen levels that affect a person's sex drive vary considerably. Actual testosterone and estrogen levels that affect a person's sex drive vary considerably.


Some boys and girls will start expressing romantic or sexual interest by age 10–12. The romantic feelings are not necessarily sexual, but are more associated with attraction and desire for another. For boys and girls in their preteen years (ages 11–12), at least 25% report "thinking a lot about sex".<ref name=":2">{{Cite journal|last=Fortenberry|first=J. Dennis|date=July 2013|title=Puberty and Adolescent Sexuality|journal=Hormones and Behavior|volume=64|issue=2|pages=280–287|doi=10.1016/j.yhbeh.2013.03.007|issn=0018-506X|pmc=3761219|pmid=23998672}}</ref> By the early teenage years (ages 13–14), however, boys are much more likely to have ] than girls. In addition, boys are much more likely to report an interest in sexual intercourse at this age than girls.<ref name=":2" /> ] among youth is common, with prevalence among the population generally increasing until the late 20s and early 30s. Boys generally start masturbating earlier, with less than 10% boys masturbating around age 10, around half participating by age 11–12, and over a substantial majority by age 13–14.<ref name=":2" /> This is in sharp contrast to girls where virtually none are engaging in masturbation before age 13, and only around 20% by age 13–14.<ref name=":2" /> Some boys and girls will start expressing romantic or sexual interest by age 10–12. The romantic feelings are not necessarily sexual, but are more associated with attraction and desire for another. For boys and girls in their preteen years (ages 11–12), at least 25% report "thinking a lot about sex".<ref name=":2">{{Cite journal| last=Fortenberry|first=J. Dennis| date= July 2013|title=Puberty and Adolescent Sexuality|journal=Hormones and Behavior| volume= 64|issue=2| pages=280–287| doi= 10.1016/j.yhbeh.2013.03.007| issn= 0018-506X| pmc= 3761219| pmid= 23998672}}</ref> By the early teenage years (ages 13–14), however, boys are much more likely to have ] than girls. In addition, boys are much more likely to report an interest in sexual intercourse at this age than girls.<ref name=":2" /> ] among youth is common, with prevalence among the population generally increasing until the late 20s and early 30s. Boys generally start masturbating earlier, with less than 10% boys masturbating around age 10, around half participating by age 11–12, and over a substantial majority by age 13–14.<ref name=":2" /> This is in sharp contrast to girls where virtually none are engaging in masturbation before age 13, and only around 20% by age 13–14.<ref name=":2" />


People in their 60s and early 70s generally retain a healthy sex drive, but this may start to decline in the early to mid-70s.<ref name=":0">{{Cite book|title=The Psychology of Human Sexuality|last=Lehmiller|first=Justin J|publisher=Wiley Blackwell|year=2018|isbn=9781119164692|pages=621–626}}</ref> Older adults generally develop a reduced libido due to declining health and environmental or social factors.<ref name=":0" /> In contrast to common belief, postmenopausal women often report an increase in sexual desire and an increased willingness to satisfy their partner.<ref name=":4">{{Cite journal|last1=Sinković|first1=Matija|last2=Towler|first2=Lauren|date=2018-12-25|title=Sexual Aging: A Systematic Review of Qualitative Research on the Sexuality and Sexual Health of Older Adults|journal=Qualitative Health Research|volume=29|issue=9|pages=1239–1254|doi=10.1177/1049732318819834|pmid=30584788|s2cid=58605636|issn=1049-7323}}</ref> Women often report family responsibilities, health, relationship problems, and well-being as inhibitors to their sexual desires. Aging adults often have more positive attitudes towards sex in older age due to being more relaxed about it, freedom from other responsibilities, and increased self-confidence. Those exhibiting negative attitudes generally cite health as one of the main reasons. Stereotypes about aging adults and sexuality often regard seniors as asexual beings, doing them no favors when they try to talk about sexual interest with caregivers and medical professionals.<ref name=":4" /> Non-western cultures often follow a narrative of older women having a much lower libido, thus not encouraging any sort of sexual behavior for women. Residence in retirement homes has affects on residents' libidos. In these homes, sex occurs, but it is not encouraged by the staff or other residents. Lack of privacy and resident gender imbalance are the main factors lowering desire.<ref name=":4" /> Generally, for older adults, being excited about sex, good health, sexual self-esteem and having a sexually talented partner can be factors.<ref>{{Cite journal|last1=Kontula|first1=Osmo|last2=Haavio-Mannila|first2=Elina|date=2009-02-03|title=The Impact of Aging on Human Sexual Activity and Sexual Desire|journal=The Journal of Sex Research|volume=46|issue=1|pages=46–56|doi=10.1080/00224490802624414|issn=0022-4499|pmid=19090411|s2cid=3161449}}</ref> People in their 60s and early 70s generally retain a healthy sex drive, but this may start to decline in the early to mid-70s.<ref name=":0">{{Cite book|title=The Psychology of Human Sexuality|last=Lehmiller|first=Justin J|publisher=Wiley Blackwell| year= 2018|isbn=9781119164692|pages=621–626}}</ref> Older adults generally develop a reduced libido due to declining health and environmental or social factors.<ref name=":0" /> In contrast to common belief, postmenopausal women often report an increase in sexual desire and an increased willingness to satisfy their partner.<ref name=":4">{{Cite journal| last1=Sinković|first1=Matija|last2=Towler|first2=Lauren|date=2018-12-25| title=Sexual Aging: A Systematic Review of Qualitative Research on the Sexuality and Sexual Health of Older Adults|journal=Qualitative Health Research|volume=29|issue=9|pages=1239–1254| doi= 10.1177/1049732318819834| pmid= 30584788|s2cid=58605636|issn=1049-7323}}</ref> Women often report family responsibilities, health, relationship problems, and well-being as inhibitors to their sexual desires. Aging adults often have more positive attitudes towards sex in older age due to being more relaxed about it, freedom from other responsibilities, and increased self-confidence. Those exhibiting negative attitudes generally cite health as one of the main reasons. Stereotypes about aging adults and sexuality often regard seniors as asexual beings, doing them no favors when they try to talk about sexual interest with caregivers and medical professionals.<ref name=":4" /> Non-western cultures often follow a narrative of older women having a much lower libido, thus not encouraging any sort of sexual behavior for women. Residence in retirement homes has effects on residents' libidos. In these homes, sex occurs, but it is not encouraged by the staff or other residents. Lack of privacy and resident gender imbalance are the main factors lowering desire.<ref name=":4" /> Generally, for older adults, being excited about sex, good health, sexual self-esteem and having a sexually talented partner can be factors.<ref>{{Cite journal |last1=Kontula|first1=Osmo|last2=Haavio-Mannila|first2=Elina|date=2009-02-03|title=The Impact of Aging on Human Sexual Activity and Sexual Desire|journal=The Journal of Sex Research|volume=46|issue=1|pages=46–56|doi=10.1080/00224490802624414|issn=0022-4499|pmid=19090411|s2cid=3161449}}</ref>


== Sexual desire disorders == == Sexual desire disorders ==
{{See also|Hyposexuality|Hypersexuality}} {{See also|Hyposexuality|Hypersexuality}}
A sexual desire disorder is more common in women than in men,<ref>{{Cite journal|last1=Segraves|first1=K. B.|last2=Segraves|first2=R. T.|date=2008|title=Hypoactive Sexual Desire Disorder: Prevalence and Comorbidity in 906 Subjects|journal=Journal of Sex & Marital Therapy|language=en|volume=17|issue=1|pages=55–58|doi=10.1080/00926239108405469|pmid=2072405|issn=0092-623X}}</ref> and women tend to exhibit less frequent and less intense sexual desires than men.<ref>{{Cite journal|last1=Baumeister|first1=Roy F.|last2=Catanese|first2=Kathleen R.|last3=Vohs|first3=Kathleen D.|date=2001|title=Is There a Gender Difference in Strength of Sex Drive? Theoretical Views, Conceptual Distinctions, and a Review of Relevant Evidence|journal=Personality and Social Psychology Review|language=en|volume=5|issue=3|pages=242–273|doi=10.1207/S15327957PSPR0503_5|s2cid=13336463|issn=1088-8683}}</ref> ] may happen to the penis because of lack of sexual desire, but these two should not be confused.<ref name="malelacksexdrive">{{cite web|url=http://www.netdoctor.co.uk/sex_relationships/facts/malelacksexdrive.htm |title=Lack of sex drive in men (lack of libido) |access-date=July 28, 2010}}</ref> For example, large recreational doses of ] or ] can simultaneously cause erectile dysfunction and significantly increase libido.<ref name="Human amph effects">{{cite book | author=Gunne LM | title=Drug Addiction II: Amphetamine, Psychotogen, and Marihuana Dependence | date=2013 | publisher=Springer | location=Berlin, Germany; Heidelberg, Germany | isbn=9783642667091 | pages=247–260 | chapter-url=https://books.google.com/books?id=gb_uCAAAQBAJ&pg=PA247 | access-date=4 December 2015 | chapter=Effects of Amphetamines in Humans }}</ref> However, men can also experience a decrease in their libido as they age. Sexual desire disorders are more common in women than in men,<ref>{{Cite journal|last1=Segraves|first1=K. B.|last2=Segraves|first2=R. T.|date=2008|title=Hypoactive Sexual Desire Disorder: Prevalence and Comorbidity in 906 Subjects|journal=Journal of Sex & Marital Therapy|language=en|volume=17|issue=1|pages=55–58|doi=10.1080/00926239108405469|pmid=2072405|issn=0092-623X}}</ref> and women tend to exhibit less frequent and less intense sexual desires than men.<ref>{{Cite journal|last1=Baumeister|first1=Roy F.|last2=Catanese|first2=Kathleen R.|last3=Vohs|first3=Kathleen D.|date=2001|title=Is There a Gender Difference in Strength of Sex Drive? Theoretical Views, Conceptual Distinctions, and a Review of Relevant Evidence|journal=Personality and Social Psychology Review|language=en|volume=5|issue=3|pages=242–273|doi=10.1207/S15327957PSPR0503_5|s2cid=13336463|issn=1088-8683}}</ref> ] may happen to the penis because of lack of sexual desire, but these two should not be confused since the two can commonly occur simultaneously.<ref name="malelacksexdrive">{{cite web|url=http://www.netdoctor.co.uk/sex_relationships/facts/malelacksexdrive.htm |title=Lack of sex drive in men (lack of libido) |access-date=July 28, 2010}}</ref> For example, moderate to large recreational doses of ], ] or ] can simultaneously cause erectile dysfunction (evidently due to ]) while still significantly increasing libido due to heightened levels of dopamine.<ref name="Human amph effects">{{cite book | author=Gunne LM | title=Drug Addiction II: Amphetamine, Psychotogen, and Marihuana Dependence | date=2013 | publisher=Springer | location=Berlin, Germany; Heidelberg, Germany | isbn=9783642667091 | pages=247–260 | chapter-url=https://books.google.com/books?id=gb_uCAAAQBAJ&pg=PA247 | access-date=4 December 2015 | chapter=Effects of Amphetamines in Humans }}</ref> Although conversely, excessive or very regular/repeated high-dose amphetamine use may damage ] in the male ], potentially leading to markedly lowered sexual desire subsequently due to ]. However, in contrast to this, other ] such as cocaine and even ] appear to lack negative impacts on testosterone levels, and may even increase their concentrations in the body. Studies on ] however seem to be exceptionally mixed, with some claiming decreased levels on testosterone, others reporting increased levels, and with some showing no measurable changes at all. This varying data seems to coincide with the almost equally conflicting data on cannabis' effects on sex drive as well, which may be dosage or frequency-dependent, due to different amounts of distinct ] in the plant, or based on individual enzyme properties responsible for metabolism of the drug. Evidence on ]'s effects on testosterone however invariably show a clear decrease, however (like amphetamine, albeit to a lesser degree); temporary increases in libido and related sexual behavior have long been observed during ] in both sexes, but likely most noticeable with moderation, particularly in males. Additionally, men often also naturally experience a decrease in their libido as they age due to decreased productions in testosterone.


The ] has estimated that several million US women have a ], though arousal is not at all synonymous with desire, so this finding is of limited relevance to the discussion of libido.<ref name="A"/> Some specialists claim that women may experience low libido due to some hormonal abnormalities such as lack of ] or androgenic hormones, although these theories are still controversial. The ] has estimated that several million US women have a ], though arousal is not at all synonymous with desire, so this finding is of limited relevance to the discussion of libido.<ref name="A"/> Some specialists claim that women may experience low libido due to some hormonal abnormalities such as lack of ] or androgenic hormones, although these theories are still controversial.
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== Further reading == == Further reading ==
* ] (1970). '']: The History and Evolution of Dynamic Psychiatry''. New York: Basic Books. Hardcover {{ISBN|0-465-01672-3}}, softcover {{ISBN|0-465-01672-3}}. * ] (1970). '']: The History and Evolution of Dynamic Psychiatry''. New York: Basic Books. Hardcover {{ISBN|0-465-01672-3}}, softcover {{ISBN|0-465-01672-3}}.
* Froböse, Gabriele, and Froböse, Rolf. ''Lust and Love: Is It More than Chemistry?'' Michael Gross (trans. and ed.). Royal Society of Chemistry, {{ISBN|0-85404-867-7}} (2006) * Froböse, Gabriele, and Froböse, Rolf. ''Lust and Love: Is It More than Chemistry?'' Michael Gross (trans. and ed.). Royal Society of Chemistry, {{ISBN|0-85404-867-7}} (2006).
* Giles, James, ''The Nature of Sexual Desire'', Lanham, Maryland: University Press of America, 2008. * Giles, James, ''The Nature of Sexual Desire'', Lanham, Maryland: University Press of America, 2008.



Latest revision as of 17:53, 25 October 2024

Psychological or sexual drive or energy For other uses, see Libido (disambiguation). "Sex drive" redirects here. For other uses, see Sex Drive (disambiguation).

In psychology, libido (/lɪˈbiːdoʊ/; from the Latin libīdō, 'desire') is psychic drive or energy, usually conceived of as sexual in nature, but sometimes conceived of as including other forms of desire. The term libido was originally developed by Sigmund Freud, the pioneering originator of psychoanalysis. With direct reference to Plato's Eros, the term initially referred only to specific sexual desire, later expanded to the concept of a universal psychic energy that drives all instincts and whose great reservoir is the id. The libido - in its abstract core differentiated partly according to its synthesising, partly to its analytical aspect called life- and death-drive - thus becomes the source of all natural forms of expression: the behaviour of sexuality as well as striving for social commitment (maternal love instinct etc.), skin pleasure, food, knowledge and victory in the areas of species- and self-preservation.

In common or colloquial usage, a person's overall sexual drive is often referred to as that person's "libido". In this sense, libido is influenced by biological, psychological, and social factors. Biologically, the sex hormones and associated neurotransmitters that act upon the nucleus accumbens (primarily testosterone, estrogen, and dopamine, respectively) regulate sex drive in humans. Sexual drive can be affected by social factors such as work and family; psychological factors such as personality and stress; also by medical conditions, medications, lifestyle, relationship issues, and age.

Psychological perspectives

Freud

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Sigmund Freud

Sigmund Freud, who is considered the originator of the modern use of the term, defined libido as "the energy, regarded as a quantitative magnitude... of those instincts which have to do with all that may be comprised under the word 'love'." It is the instinctual energy or force, contained in what Freud called the id, the strictly unconscious structure of the psyche. He also explained that it is analogous to hunger, the will to power, and so on insisting that it is a fundamental instinct that is innate in all humans.

Freud pointed out that these libidinal drives can conflict with the conventions of civilised behavior, represented in the psyche by the superego. It is this need to conform to society and control the libido that leads to tension and anxiety in the individual, prompting the use of ego defenses which channel the psychic energy of the unconscious drives into forms that are acceptable to the ego and superego. Excessive use of ego defenses results in neurosis, so a primary goal of psychoanalysis is to make the drives accessible to consciousness, allowing them to be addressed directly, thus reducing the patient's automatic resort to ego defenses.

Freud viewed libido as passing through a series of developmental stages in the individual, in which the libido fixates on different erogenous zones: first the oral stage (exemplified by an infant's pleasure in nursing), then the anal stage (exemplified by a toddler's pleasure in controlling his or her bowels), then the phallic stage, through a latency stage in which the libido is dormant, to its reemergence at puberty in the genital stage (Karl Abraham would later add subdivisions in both oral and anal stages.). Failure to adequately adapt to the demands of these different stages could result in libidinal energy becoming 'dammed up' or fixated in these stages, producing certain pathological character traits in adulthood.

Jung

Swiss psychiatrist Carl Gustav Jung identified the libido with psychic energy in general. According to Jung, 'energy', in its subjective and psychological sense, is 'desire', of which sexual desire is just one aspect. Libido thus denotes "a desire or impulse which is unchecked by any kind of authority, moral or otherwise. Libido is appetite in its natural state. From the genetic point of view it is bodily needs like hunger, thirst, sleep, and sex, and emotional states or affects, which constitute the essence of libido." It is "the energy that manifests itself in the life process and is perceived subjectively as striving and desire." Duality (opposition) creates the energy (or libido) of the psyche, which Jung asserts expresses itself only through symbols. These symbols may manifest as "fantasy-images" in the process of psychoanalysis, giving subjective expression to the contents of the libido, which otherwise lacks any definite form. Desire, conceived generally as a psychic longing, movement, displacement and structuring, manifests itself in definable forms which are apprehended through analysis.

Other psychological and social perspectives

A person may have a desire for sex, but not have the opportunity to act on that desire, or may on personal, moral or religious reasons refrain from acting on the urge. Psychologically, a person's urge can be repressed or sublimated. Conversely, a person can engage in sexual activity without an actual desire for it. Multiple factors affect human sex drive, including stress, illness, pregnancy, and others. A 2001 review found that, on average, men have a higher desire for sex than women.

Certain psychological or social factors can reduce the desire for sex. These factors can include lack of privacy or intimacy, stress or fatigue, distraction, or depression. Environmental stress, such as prolonged exposure to elevated sound levels or bright light, can also affect libido. Other causes include experience of sexual abuse, assault, trauma, or neglect, body image issues, and anxiety about engaging in sexual activity.

Individuals with post-traumatic stress disorder (PTSD) may find themselves with reduced sexual desire. Struggling to find pleasure, as well as having trust issues, many with PTSD experience feelings of vulnerability, rage and anger, and emotional shutdowns, which have been shown to inhibit sexual desire in those with PTSD. Reduced sex drive may also be present in trauma victims due to issues arising in sexual function. For women, it has been found that treatment can improve sexual function, thus helping restore sexual desire. Depression and libido decline often coincide, with reduced sex drive being one of the symptoms of depression. Those with depression often report the decline in libido to be far reaching and more noticeable than other symptoms. In addition, those with depression often are reluctant to report their reduced sex drive, often normalizing it with cultural/social values, or by the failure of the physician to inquire about it.

Sexual desires are often an important factor in the formation and maintenance of intimate relationships in humans. A lack or loss of sexual desire can adversely affect relationships. Changes in the sexual desires of any partner in a sexual relationship, if sustained and unresolved, may cause problems in the relationship. The infidelity of a partner may be an indication that a partner's changing sexual desires can no longer be satisfied within the current relationship. Problems can arise from disparity of sexual desires between partners, or poor communication between partners of sexual needs and preferences.

Biological perspectives

Endogenous compounds

See also: Sexual motivation and hormones

Libido is governed primarily by activity in the mesolimbic dopamine pathway (ventral tegmental area and nucleus accumbens). Consequently, dopamine and related trace amines (primarily phenethylamine) that modulate dopamine neurotransmission play a critical role in regulating libido.

Other neurotransmitters, neuropeptides, and sex hormones that affect sex drive by modulating activity in or acting upon this pathway include:

Sex hormone levels and the menstrual cycle

A woman's desire for sex is correlated to her menstrual cycle, with many women experiencing a heightened sexual desire in the several days immediately before ovulation, which is her peak fertility period, which normally occurs two days before and until two days after the ovulation. This cycle has been associated with changes in a woman's testosterone levels during the menstrual cycle. According to Gabrielle Lichterman, testosterone levels have a direct impact on a woman's interest in sex. According to her, testosterone levels rise gradually from about the 24th day of a woman's menstrual cycle until ovulation on about the 14th day of the next cycle, and during this period the woman's desire for sex increases consistently. The 13th day is generally the day with the highest testosterone levels. In the week following ovulation, the testosterone level is the lowest and as a result women will experience less interest in sex.

Also, during the week following ovulation, progesterone levels increase, resulting in a woman experiencing difficulty achieving orgasm. Although the last days of the menstrual cycle are marked by a constant testosterone level, women's libido may get a boost as a result of the thickening of the uterine lining which stimulates nerve endings and makes a woman feel aroused. Also, during these days, estrogen levels decline, resulting in a decrease of natural lubrication.

Although some specialists disagree with this theory, menopause is still considered by the majority a factor that can cause decreased sexual desire in women. The levels of estrogen decrease at menopause and this usually causes a lower interest in sex and vaginal dryness which makes sex painful. However, the levels of testosterone increase at menopause and this may be why some women may experience a contrary effect of an increased libido.

Physical factors

Physical factors that can affect libido include endocrine issues such as hypothyroidism, the effect of certain prescription medications (for example flutamide), and the attractiveness and biological fitness of one's partner, among various other lifestyle factors.

Anemia is a cause of lack of libido in women due to the loss of iron during the period.

Smoking tobacco, alcohol use disorder, and the use of certain drugs can also lead to a decreased libido. Moreover, specialists suggest that several lifestyle changes such as exercising, quitting smoking, lowering consumption of alcohol or using prescription drugs may help increase one's sexual desire.

Medications

Some people purposefully attempt to decrease their libido through the usage of anaphrodisiacs. Aphrodisiacs, such as dopaminergic psychostimulants, are a class of drugs which can increase libido. On the other hand, a reduced libido is also often iatrogenic and can be caused by many medications, such as hormonal contraception, SSRIs and other antidepressants, antipsychotics, opioids, beta blockers and isotretinoin.

Isotretinoin, finasteride and many SSRIs uncommonly can cause a long-term decrease in libido and overall sexual function, sometimes lasting for months or years after users of these drugs have stopped taking them. These long-lasting effects have been classified as iatrogenic medical disorders, respectively termed post-retinoid sexual dysfunction/post-Accutane syndrome (PRSD/PAS), post-finasteride syndrome (PFS) and post-SSRI sexual dysfunction (PSSD). These three disorders share many overlapping symptoms in addition to reduced libido, and are thought to share a common etiology, but collectively remain poorly-understood and lack effective treatments.

Multiple studies have shown that with the exception of bupropion (Wellbutrin), trazodone (Desyrel) and nefazodone (Serzone), antidepressants generally will lead to lowered libido. SSRIs that typically lead to decreased libido are fluoxetine (Prozac), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa) and sertraline (Zoloft). Lowering the dosage of SSRI medications has been shown to improve libido in some patients. Other users try enrolling in psychotherapy to solve depression-related issues of libido. However, the effectiveness of this therapy is mixed, with many reporting that it had no or little effect on sexual drive.

Testosterone is one of the hormones controlling libido in human beings. Emerging research is showing that hormonal contraception methods like oral contraceptive pills (which rely on estrogen and progesterone together) are causing low libido in females by elevating levels of sex hormone-binding globulin (SHBG). SHBG binds to sex hormones, including testosterone, rendering them unavailable. Research is showing that even after ending a hormonal contraceptive method, SHBG levels remain elevated and no reliable data exists to predict when this phenomenon will diminish.

Oral contraceptives lower androgen levels in users, and lowered androgen levels generally lead to a decrease in sexual desire. However, usage of oral contraceptives has shown to typically not have a connection with lowered libido in women.

Effects of age

Males reach the peak of their sex drive in their teenage years , while females reach it in their thirties. The surge in testosterone hits the male at puberty resulting in a sudden and extreme sex drive which reaches its peak at age 15–16, then drops slowly over their lifetime. In contrast, a female's libido increases slowly during adolescence and peaks in their mid-thirties. Actual testosterone and estrogen levels that affect a person's sex drive vary considerably.

Some boys and girls will start expressing romantic or sexual interest by age 10–12. The romantic feelings are not necessarily sexual, but are more associated with attraction and desire for another. For boys and girls in their preteen years (ages 11–12), at least 25% report "thinking a lot about sex". By the early teenage years (ages 13–14), however, boys are much more likely to have sexual fantasies than girls. In addition, boys are much more likely to report an interest in sexual intercourse at this age than girls. Masturbation among youth is common, with prevalence among the population generally increasing until the late 20s and early 30s. Boys generally start masturbating earlier, with less than 10% boys masturbating around age 10, around half participating by age 11–12, and over a substantial majority by age 13–14. This is in sharp contrast to girls where virtually none are engaging in masturbation before age 13, and only around 20% by age 13–14.

People in their 60s and early 70s generally retain a healthy sex drive, but this may start to decline in the early to mid-70s. Older adults generally develop a reduced libido due to declining health and environmental or social factors. In contrast to common belief, postmenopausal women often report an increase in sexual desire and an increased willingness to satisfy their partner. Women often report family responsibilities, health, relationship problems, and well-being as inhibitors to their sexual desires. Aging adults often have more positive attitudes towards sex in older age due to being more relaxed about it, freedom from other responsibilities, and increased self-confidence. Those exhibiting negative attitudes generally cite health as one of the main reasons. Stereotypes about aging adults and sexuality often regard seniors as asexual beings, doing them no favors when they try to talk about sexual interest with caregivers and medical professionals. Non-western cultures often follow a narrative of older women having a much lower libido, thus not encouraging any sort of sexual behavior for women. Residence in retirement homes has effects on residents' libidos. In these homes, sex occurs, but it is not encouraged by the staff or other residents. Lack of privacy and resident gender imbalance are the main factors lowering desire. Generally, for older adults, being excited about sex, good health, sexual self-esteem and having a sexually talented partner can be factors.

Sexual desire disorders

See also: Hyposexuality and Hypersexuality

Sexual desire disorders are more common in women than in men, and women tend to exhibit less frequent and less intense sexual desires than men. Erectile dysfunction may happen to the penis because of lack of sexual desire, but these two should not be confused since the two can commonly occur simultaneously. For example, moderate to large recreational doses of cocaine, amphetamine or methamphetamine can simultaneously cause erectile dysfunction (evidently due to vasoconstriction) while still significantly increasing libido due to heightened levels of dopamine. Although conversely, excessive or very regular/repeated high-dose amphetamine use may damage leydig cells in the male testes, potentially leading to markedly lowered sexual desire subsequently due to hypogonadism. However, in contrast to this, other stimulants such as cocaine and even caffeine appear to lack negative impacts on testosterone levels, and may even increase their concentrations in the body. Studies on cannabis however seem to be exceptionally mixed, with some claiming decreased levels on testosterone, others reporting increased levels, and with some showing no measurable changes at all. This varying data seems to coincide with the almost equally conflicting data on cannabis' effects on sex drive as well, which may be dosage or frequency-dependent, due to different amounts of distinct cannabinoids in the plant, or based on individual enzyme properties responsible for metabolism of the drug. Evidence on alcohol's effects on testosterone however invariably show a clear decrease, however (like amphetamine, albeit to a lesser degree); temporary increases in libido and related sexual behavior have long been observed during alcohol intoxication in both sexes, but likely most noticeable with moderation, particularly in males. Additionally, men often also naturally experience a decrease in their libido as they age due to decreased productions in testosterone.

The American Medical Association has estimated that several million US women have a female sexual arousal disorder, though arousal is not at all synonymous with desire, so this finding is of limited relevance to the discussion of libido. Some specialists claim that women may experience low libido due to some hormonal abnormalities such as lack of luteinising hormone or androgenic hormones, although these theories are still controversial.

See also

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