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Libido; Everything You Wanted To Know!

Libido, also referred to as sex drive, is a person's overall desire for sexual activity. Libido is often an important factor in the formation and maintenance of relationships, and a libido mismatch between partners can affect relationships negatively.

Why Do We Have A Sex Drive?

Libido is recognised as an important force in the Darwinian theory of natural selection. Libido’s evolutionary purpose is to get the species to procreate, therefore passing genetic material to the next generation. From an evolutionary perspective, any mechanism that can increase the frequency of sexual intercourse during fertile days of a woman’s menstrual cycle, has a selective advantage by improving the chance of conception. And that’s why women have highly fluctuating sex drives, with a high urge to engage sexually just before ovulation in each menstrual cycle. Men’s sex drives remain relatively stable.

Neurobiology Of Libido

Libido is governed primarily by activity in the mesolimbic dopamine pathway. So what is the mesolimbic pathway? The mesolimbic pathway is also referred to as the reward pathway. The pathway connects an area called the ventral tegmental area in the midbrain to another area called the ventral striatum of the basal ganglia in the forebrain. The ventral striatum includes the nucleus accumbens and the olfactory tubercle.

For simplicity, just understand this: the release of neurochemicals through this pathway gives us pleasure, and that facilitates reinforcement; that is, any activity that gives us pleasure makes us want to keep doing it again and again. The same pathway is also involved in addiction to substances or behaviours. In this pathway, 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 acting on this pathway include:

  • Testosterone (directly correlated)

  • Estrogen (directly correlated)

  • Oxytocin (directly correlated)

  • Progesterone (inversely correlated)

  • Serotonin (inversely correlated)

  • Norepinephrine (inversely correlated)

However, keep in mind that all of them affect sex drive to varying degrees; with Dopamine and Testosterone being the strongest modulators.

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Effects Of Age

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.

Sex Hormone Levels And The Menstrual Cycle

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 and oestrogen levels. In the week following ovulation, the oestrogen and testosterone levels are 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.

Libido During Pregnancy And Lactation

In the first trimester of pregnancy, estrogen and progesterone levels rise. Symptoms in early pregnancy that may lower sexual desire include:

  • hormonal changes

  • exhaustion

  • queasiness

  • breast sensitivity

Around week 10, these increased hormone levels will drop off. At that point, fatigue and nausea decrease significantly. With the loss of those two symptoms may come an increase in sex drive, which peaks in late 1st trimester, and early 2nd trimester. Later in the third trimester, weight gain, back pain, and other symptoms again decrease sexual drive.

Also, during pregnancy and breastfeeding, prolactin levels increase, stimulating the breasts to produce milk. High prolactin levels push down estrogen levels, which in turn dampens sexual desire. Plus, levels of testosterone are also lower in breastfeeding women.

Libido Men Vs. Women

Although not an absolute rule, the following are general patterns derived from surveys and studies that make men and women different when it comes to libido:

1. Men Think More About Sex

The majority of men under 60 think about sex at least once a day, with an average of 15-20 times/day. For women, the number is half that. As men and women age, both fantasise less, but men still fantasise about twice as often. Men have more spontaneous sexual arousal and more frequent and varied fantasies

2. Men Seek Sex More

Men want sex more often than women at the start of a relationship, in the middle of it, and after many years of it. This isn't just true for heterosexuals; gay men also have sex more often than lesbians at all stages of their relationships. Men also want more sex partners in their lifetime, and are more interested in casual sex.

3. Men Masturbate More

According to multiple studies, about two-thirds of men say they masturbate, even though about half also say they feel guilty about it. By contrast, about 40% of women say they masturbate, and the frequency of masturbation is lesser among women. One study found that 58 percent of men entertained sexual fantasies during masturbation, while the figure for women was only 12 percent. Male fantasies contained more actual sex, whereas women’s fantasies were more likely than men’s to feature affection and bonding.

4. Men Take More Risks

Various surveys show men are more likely to seek sex even when it's frowned upon or outlawed. This is probably why prostitution is still mostly a phenomenon of men seeking sex with women, rather than the other way around.

5. Women's Sexual Turn-ons Are More Complicated Than Men's

Straight men are more turned on by depictions of male-female sex and female-female sex. Gay men are turned on by male-male sex. For women, things are a little more complicated. Women show about the same genital reaction to male-female, male-male, and female-female sex. That’s because men are very rigid and specific about who they become aroused by, who they want to have sex with, and who they fall in love with. In contrast, women may be more open to same-sex relationships thanks to their less-directed sex drives. Women probably have the capacity to become sexually interested in and fall in love with their own sex more than men do.

6. Women's Sex Drives Are More Influenced By Social And Cultural Factors

Women's sexual attitudes, desires, and practices are more influenced by their environment than men’s.

This means that:

  • Women's attitudes towards, and willingness to perform various sexual acts are more likely than men's to change over time.

  • Women are more influenced by the attitudes of their peer group in their decisions about sex.

  • Women with higher education levels are more likely to have performed a wider variety of sexual practices (such as oral sex); education makes less of a difference with men.

7. Women Take A Less Direct Route To Sexual Satisfaction

Men and women travel slightly different paths to arrive at sexual desire. Sex is simpler and more straightforward for men. That doesn't mean men don't seek intimacy, love, and connection in a relationship, just as women do. They just view the role of sex differently. Women want to talk first, connect first, then have sex. For men, sex is the connection. Sex is the language men use to express their tender, loving, vulnerable side. It is their language of intimacy.

8. Women's Libidos Seem To Be Less Responsive To Drugs

There is a hormonal factor in sex drive, but it is much more important in men than women. While the treatments are effective, they're not as effective in women as in men. Testosterone has been linked to sex drive in both men and women. But testosterone works much faster in men with low libidos than women. A testosterone patch for women called Intrinsa has been approved in Europe but was rejected by the FDA due to concerns about long-term safety.

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1. Is Libido The Same As Sexual Arousal?

Not really, but they can be related. Libido is what’s going on in your mind (like when you’re lost in a hot fantasy) while sexual arousal is what’s happening in your body (like getting wet if you have a vagina or getting an erection if you have a penis).

The confusion comes in because libido and sexual arousal often rise and dip together. But arousal and libido aren’t always connected. You may experience high levels of libido without the physical signs of arousal (like when you feel really turned on but aren’t getting wet). Or you may experience physical signs of arousal (like increased lubrication or erection) even if you’re not really mentally in the mood. This is known as arousal non-concordance.

2. What Counts As A “Normal” Libido?

There is NO normal. Each individual has their own baseline of what feels good, natural, and satisfying libido-wise. You might have no noticeable libido to speak of and feel perfectly fine with that. You might feel some level of sexual attraction multiple times every day and be fine with that too.

Many of us have been fed the lie that men think about sex 24/7 and that women can basically take it or leave it. This kind of reductive thinking is oppressive to people of all genders. The important thing to remember is that there’s a ton of room for what counts as a “normal” libido, no matter what your sex, gender identity, or sexual orientation.

3. How Normal Is It For My Libido To Yo-Yo?

Extremely; If you're human, you're going to have fluctuations in your sexual desire. Like energy and appetite, your libido can be in constant flux as it responds to the many variables in your brain, body, relationships, and environment.

4. What If My Partner’s Libido Is Higher Or Lower Than Mine?

This is called a sexual desire discrepancy, and is not inherently a problem. Think about how you and your partner likely need or desire different amounts of sleep, food, and exercise. But it can create relationship tension when one person gets blamed for having what the other perceives as too-low or too-high a libido. (You never/always want to have sex, what’s wrong with you?) It can also become a problem when one person takes the imbalance personally. (He doesn’t want to have sex because he doesn’t find me attractive). It’s important for couples with sexual desire discrepancies to talk openly about it, try to meet in the middle, and find ways other than sex to satisfy each other’s intimate needs.

5. Is There Such A Thing As Libido Being Too High?

Yes, your libido can be too high or low for you if it’s persistently deviating from your norm or bothering you in some way. Compulsive sexual behaviour disorder (CSBD) only became a recognised condition in the mental health field in 2018. Called nymphomania in women, and satyriasis in men, the signs of sexual compulsion often include:

  • Sexual behaviour having a negative impact on other areas of life such as your health, relationships, work, etc.

  • Inability to limit or stop your sexual behaviour

  • Being secretive about your sexual behaviour

  • Feeling dependent on your sexual behaviour

  • Using sexual behaviour to escape from problems, such as anger, stress, depression, loneliness, or anxiety.

  • Having difficulty establishing and maintaining stable, healthy relationships due to your sexual behaviour

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Besides this, Certain drugs can send libido sky-high. Many are the same stimulants that jolt your brain, like cocaine, ecstasy, crystal meth, and high doses of caffeine. For some people, manic episodes of bipolar disorder manifest as having more-than-normal amounts of sex or reckless sex. During a manic episode, a person typically experiences a heightened mood suggesting a drastic, elevated shift in behaviour, and that can include engaging in way more sex than usual.

6. What Causes Low Libido?

Stress, anxiety and exhaustion can have a major impact on your happiness and your sex drive. A person whose sex drive has plummeted may also be experiencing low libido due to clinical depression, which can sap a lot of pleasure from normally enjoyable activities. Also, even if you do mentally want to have sex when you have depression, you might have trouble getting physically aroused or having an orgasm. An imbalance of neurotransmitters in the brain can make it difficult for brain cells to coordinate blood flow to the sex organs.

As part of relationship related issues, a low libido can be the result of:

  • being in a long-term relationship and becoming overfamiliar with your partner

  • loss of sexual attraction

  • unresolved conflict and frequent arguments

  • poor communication

  • difficulty trusting each other

Alcohol and Drugs

Drinking excessive amounts of alcohol over a long period can reduce your sex drive, so it's a good idea not to drink too much. Men and women are advised not to drink more than 14 alcohol units a week on a regular basis. And anything that decreases blood flow to the sex organs, like smoking, is counterproductive. Drug misuse is also linked to a loss of sex drive.

Sexual Problems

A low sex drive can be the result of:

  • ejaculation problems

  • erectile dysfunction

  • vaginal dryness

  • painful sex (dyspareunia)

  • inability to orgasm

  • involuntary tightening of the vagina (vaginismus)

In addition to the physical discomfort, sexual problems can contribute to feelings of distress around the mere thought of sex, further reducing libido.

Underlying Health Conditions

A low libido can be associated with:

Age Related Issues

  • falling levels of sex hormones just before, during and after menopause in women

  • falling levels of sex hormones in men

Medication and Contraception

Certain medicines can sometimes reduce libido, including:

  • medication for high blood pressure

  • many types of antidepressant medication

  • medications for fits (seizures)

  • medications called antipsychotics

  • medication for an enlarged prostate

  • medication for prostate cancer

  • hormonal contraception

Lastly, there’s also a lot of medical interest around what has come to be known as hypoactive sexual desire disorder (HSDD). If you’ve been disturbed by a chronically low or absent libido for at least six months and you’re able to rule out all other factors, then you could have HSDD.

7. Can I Increase My Libido?

Increasing your libido really depends on why it was low in the first place. Find out the underlying cause, physical or psychological, and treatment becomes easier.

We need to redefine aphrodisiac foods. There is a lot of buzz around certain foods and herb supplements as being natural libido boosters. Although there is no evidence to suggest that they directly affect libido, there is a common string. And the common string is that all of these so called “aphrodisiacs” are also foods very rich in antioxidants, anti-inflammatory compounds, cholesterol lowering properties and they also increase blood supply to your sex organs through L Arginine, which is found in them in copious amounts. If you are looking for specifics, just look at the Mediterranean diet. In addition, herb supplements with similar properties will be prescribed to you by your healthcare professional. They won’t harm you, and will likely result in benefit.

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For men, testosterone treatment has shown promise, since low testosterone levels are associated with low libido.

Along with counselling, your doctor may prescribe a medication to boost your libido. Food and Drug Administration (FDA)-approved options for premenopausal women include:

  • Flibanserin, a pill that you take once a day at bedtime. Side effects include low blood pressure, dizziness, nausea and fatigue. Drinking alcohol or taking fluconazole, a common medication to treat vaginal yeast infections, can make these side effects worse

  • Bremelanotide, an injection you give yourself just under the skin in the belly or thigh before anticipated sexual activity, for a maximum of 8 doses per month. Some women experience nausea, which is more common after the first injection but tends to improve with the second injection. Other side effects include vomiting, flushing, headache and a skin reaction at the site of the injection.

These medications aren't FDA-approved for use in postmenopausal women.

Hormone Therapy

Dryness or shrinking of the vagina, one of the hallmark signs of genitourinary syndrome of menopause (GSM), might make sex uncomfortable and, in turn, reduce your desire. Certain hormone medications that aim to relieve GSM symptoms could help make sex more comfortable. And being more comfortable during sex may improve your desire.

Hormone therapies include:

  • Estrogen: Estrogen is available in many forms, including pills, patches, sprays and gels. Smaller doses of estrogen are found in vaginal creams and a slow-releasing suppository or ring. Your doctor can help you understand the risks and benefits of each form. But, estrogen won't improve sexual functioning related to hypoactive sexual desire disorder.

  • Testosterone: The male hormone testosterone plays an important role in female sexual function, even though testosterone occurs in much lower amounts in women. Testosterone isn't approved by the FDA for sexual dysfunction in women, but sometimes it's prescribed off-label to help lift a lagging libido. The use of testosterone in women is controversial. Taking it can cause acne, excess body hair, and mood or personality changes.

  • Prasterone: This vaginal insert delivers the hormone dehydroepiandrosterone (DHEA) directly to the vagina to help ease painful sex. You use this medication nightly to ease the symptoms of moderate to severe vaginal dryness associated with GSM.

  • Ospemifene: Taken daily, this pill can help relieve painful sex symptoms in women with moderate to severe GSM.

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