What is libido or sexual desire?
Libido, also known as sexual desire, is a reflection of a person’s sexual behaviour and desire to engage in sexual activity. Libido arises from the effect of the hormone testosterone which is generally known as “the male hormone” but is responsible for sexual desire in both men and women. Testosterone is responsible for the peak in sexual interest in men around the age of 20 and women in their mid-thirties.
The ageing process in men and women reduces the bio-availability of testosterone resulting in a natural decline in libido in the older years. However a man’s libido may not necessarily be related to his level of testosterone as there are other factors that can influence sexual desire such as the status of the relationship and psychological and other medical health problems.
Low or high libido
Libido problems usually present as low desire but sometimes excessive desire can be the issue. These problems may present as a lifelong issue that has always been present or occur only in some situations. Another common desire issue is desire discrepancy where the difference of desire within a relationship creates problems within that relationship.
A common cause of low libido is not related to lack of production of testosterone but rather due to relationship problems, such as when a decision is required for a long term commitment in a new relationship. Any medical condition as well as excessive alcohol intake may contribute to reduced libido. Lack of sexual activity and stimulation may have a negative effect on testosterone production. Any damage to the testes in the male or ovaries in the female will affect testosterone production. This can be seen in the removal of such organs or damage from chemotherapy for treatment of cancer. Stress, anxiety, low mood and chronic fatigue are also very common causes of low libido.
Assessment and treatment
An assessment of libido problems requires investigation of medical, psychological and relationship aspects. It is important to involve the couple in the assessment. Medical treatment if required may involve use of testosterone supplementation, usually in the form of daily applications or long acting depot injection. There are pharmaceutical guidelines that provide the level of testosterone in men that qualifies for a subsidised authority prescription. There are no approved guidelines for testosterone treatment in women.
Counselling for libido problems comes under the domain of relationship counsellors, sex therapists and psychologists.