What Is Libido?

Libido is sexual appetite or drive. A person's libido is motivated by brain function, hormones, and learned behavior, regardless of their sex, and tends to fluctuate according to mental state, hormonal shifts, and stress. Some medications can affect sexual appetite as well.

Understanding Libido

When a person's libido is high, they're more likely to desire sexual intimacy and to seek it out with a partner or through masturbation. This is healthy and normal, but an overly high libido that interferes with quality of life can be a sign of a hormonal imbalance or neurological disorder. When libido dips, interest in sex does as well and may be completely absent, which can put a strain on intimate relationships. Once diagnosed and a cause is determined, both extremes can be treated.

The neural pathways involved in sexual desire are similar in males and females and include cerebral, spinal, and peripheral components. Libido directly correlates to physical responses: when sexual desire is high, blood flow to the penis resulting in an erection signifies sexual desire, as does lubrication and enlargement of the labia.

Overly High Libido

There's a discernible difference between a robust libido and one that's too high. In fact, aside from contributing to a satisfying sex life, the former has health benefits, including:

• Less stress
• Better mental health
• Healthy relationships
• Boosted confidence
• Better sleep
• More exercise

It's when sexual appetite is so strong that it feels out of control and interferes with daily life that there may be cause for concern.

Symptoms

Your libido is potentially overly high if:

• Your sex life begins to impact your life, relationships, health, and work.
• Sexual desire takes over your thoughts and behavior.
• You use sex to cope with mental challenges such as depression or anxiety. 
• Your relationships are at risk due to your high sexual appetite. 
• You feel empty or unfulfilled after having sex.

If you have persistent sexual urges that cause you to feel uncomfortable or are out of your control, you may have hypersexual disorder.

Causes

An overly high libido is nothing to be ashamed of and may have an underlying medical cause, such as:

• High levels of the mood-regulating neurochemicals dopamine, serotonin, or both
• Certain medications 
• A condition that affects parts of the brain that can impact sexual behavior such as epilepsy or dementia

Treatment

Once the cause of overly high libido is determined, treatment can be targeted to manage the problem. For example, if a medication is to blame, the dosage may be changed or a different drug prescribed.

Likewise, once identified and treated, an underlying brain disorder may no longer affect sexual desire. Other strategies, including psychotherapy and increased physical activity, may help as well.

Low Libido

Waning sexual desire is more common than overly high libido and has more potential causes, most of which, once identified, can be treated, restoring sexual interest,

Symptoms

There are no clinical criteria for diagnosing low libido. What's more, there is a high degree of variation in how it is experienced (since what is "normal" sexual desire for one person may seem high or low to another). However, commonly cited symptoms include:

• Loss of desire for a partner
• Disinterest in masturbation
• Few or no sexual fantasies
• Stress or concern about a lack of interest in sex 

Causes

Hormonal shifts are a common cause of low libido. People of all sexes can experience dips in libido in response to decreases in estrogen, progesterone, and testosterone, with low testosterone being a prime suspect.

Low testosterone, also known as low T, is especially an issue for men, since, in addition to affecting libido, testosterone stimulates sperm production and contributes to muscle mass. Medications to raise testosterone can be considered if fertility is of interest. 

Very low testosterone—defined as below 300 nanograms per deciliter of blood—is called “hypogonadism.” This condition affects 3 million to 4 million men in the United States. For most of them, testosterone levels begin to drop after 30.

Women also can experience a decrease in sexual desire as a result of low testosterone levels, but, for most, waning estrogen is more likely the issue. In a 2008 study, 26% of premenopausal women and 52% of menopausal women (estrogen dips during menopause) struggled with low sexual desire.

People of all gender identities may be sensitive to a lengthy list of emotional and medical factors associated with low libido. A common one is high levels of stress, which can impact hormones and influence the fight-or-flight response, in which heart rate, blood pressure, and breathing increase dramatically in response to a stressful situation and hormones known to decrease sex drive—cortisol and epinephrine—are released. This may cause sexual desire to evaporate altogether.

Other potential causes of low libido include:

• Pain during sexual intercourse
• Diabetes
• High blood pressure
• Arthritis
• Prescription drugs—especially certain antidepressants, including Prozac (fluoxetine)
• Excess alcohol consumption
• Smoking
• Drug use
• Surgery
• Fatigue
• Pregnancy
• Low self-esteem
• Body image issues
• Relationship concerns or issues

Treatment

The key to effectively treating low libido is identifying the cause. In many cases, a combination of approaches may be necessary to enhance sexual drive.

Lifestyle Changes

When a certain habit is likely to be involved in low libido, such as being sedentary, changing your behavior may be helpful, such as:

• Getting more exercise 
• Following a healthy, nutritious diet
• Managing stress
• Quitting smoking, drug use, or excessive alcohol consumption
• Communicating more directly about your needs with your sexual partner

Behavioral Therapy

A therapist who specializes in sexual issues can help you (and your partner, should you choose to attend sessions together) identify emotional sources of lack of sexual drive. They can also offer practical tips and techniques for enhancing desire and enjoyment in the bedroom.

Medication

There are only a few medications known to be helpful in enhancing ebbing sexual desire. For women these include Addyi (flibanserin) and Bremelanotide Vyleesi (bremelanotide).

For men, an erectile dysfunctional medication such as Viagra (sildenafil) may be helpful, even though lifting libido is not a primary purpose of these drugs

Hormone Therapy

More likely to be effective than prescription medications is hormone replacement strategies, including:

• Testosterone replacement therapy, which can be delivered via injection, topical gel, nasally, or orally
• Intrarosa (prasterone), a suppository that is inserted into the vagina to relieve pain during sex

A Word From Verywell

Sexual desire can be a touchy topic. Whether you're experiencing a libido that feels as if it's in overdrive or you have virtually no appetite for physical intimacy at all, you may feel uncomfortable thinking about it—much less talking to your partner or even a medical professional about it. But remember: both the person who loves you and the doctors and therapists who specialize in sexual issues want nothing more than to help you. What's more, while the solution to normalizing sexual desire won't always be straightforward, in all likelihood there is one—one that will be well worth the search.