Libido lulls

by Elaine Gottlieb

We tend to take our sexual urges for granted. But what happens when the desire just isn't there?

A steamy movie...the touch of silk...the sound of a soft voice. Many different stimuli can trigger the pleasant sensation of sexual desire, or libido. Just the mention of the word can evoke images of the erotic.

People often confuse libido with other aspects of sexuality, reports psychologist and sex therapist Ron Friedman. "A man who has difficulty achieving erections will come in and say that he has no libido. But when I interview him in more detail, he says he feels very horny and would love to 'perform.' However, because he can't get the equipment to work, he defines his lack of libido as more of an arousal problem than a desire problem," says Friedman, director of the Human Sexuality Program at Beth Israel Deaconess Medical Center in Boston.

Desire is both a physical and psychological phenomenon. First, you must have the proper hormonal balance, particularly testosterone. This critical hormone works in the brain to stimulate desire through a mechanism that is not entirely understood. Without testosterone, it's virtually impossible to experience sexual desire. Since men produce more testosterone than women, you might conclude that men have more sexual desire. But according to longtime sex researchers Masters and Johnson, men and women have about the same innate level of sexual desire.

On the psychological side of the equation, you've got to be interested in sex to feel desire. Your emotional state can determine whether you respond to or barely notice the attractive person who enters the room.

Desire is not a feeling most people can just turn on and off at will. Many factors can affect sexual feeling, including:

Quality of a relationship -

• When a couple isn't getting along, their sex life often suffers. If one partner is upset with the other, he or she may lose interest in sex.

Emotions

• If you suffer from a psychological disorder, such asdepression, it's hard to be interested in sex.

Fetishes

• People with fetishes require a particular object, such as leather or rubber, to experience sexual desire.

Hormones

• People with hormonal imbalances can lose all interest in sex.

Time

• The realities of modern life often make it difficult for couples to find the time for sex; when they try to "hurry up and have sex" they may not be able to respond on demand.

Physical health

• Good physical health promotes sexual desire for psychological as much as physical reasons; people who feel fit and healthy may feel more confident and attractive to others. On the other hand, a variety of physical illnesses—including severe anemia and hepatitis—and prescription drugs, like antihypertensives and antidepressants, can diminish desire, as can the hormonal changes associated with menopause.

Sexual desire is a completely individual experience. While one person may enjoy sex three times a week, another may be content with monthly lovemaking or none at all. There is no right and wrong—it depends on what feels good to you.

Individual differences in sexual desire are probably partly due to biology, Dr. Friedman believes. Some people may have higher levels of testosterone or another genetic factor that increases their desire. Upbringing and life experience also exert a powerful influence on one's sexuality. This doesn't mean however, if you're unhappy with your level of desire, you can't do something about it.

If you experience a sudden change in sexual desire, it's a good idea to see your health care provider to rule out any physical causes and make sure your hormone levels are normal. A testosterone deficiency, for example, can easily be treated by taking additional doses of the hormone.

Hormonal tumors, though rare, can produce a sudden increase in sexual desire. So can the manic phase of manic-depressive illness (bipolar disorder). Depression, on the other hand, diminishes interest in sex just as it makes experiencing any type of pleasure difficult. Anxiety can also be a problem if you're overly worried about a relationship or your sexual performance.

Sex therapists have been successfully treating desire problems for decades, using a combination of psychotherapy and specific physical exercises designed to help people become more comfortable with their sexuality.

The most common complaint reported by therapists is low sexual desire, mostly in women, who are more likely to seek help. Men who come for therapy are usually pushed by their partners. "Men have a harder time admitting it," says Friedman.

Lack of interest in sex by one or both partners is often a symptom of other problems in a relationship. Friedman treated one couple in their '30s because the wife had lost interest in sex, ostensibly because her husband never helped around the house or set a romantic mood. Once the couple learned to communicate better and resolve their differences, the "sexuality took care of itself," he says.

More longstanding problems with low sexual desire can be caused by psychological problems and negative life experiences, like sexual abuse.

An excess of sexual desire, not surprisingly, is not as much of a concern to people, unless there is a mismatch between partners or it leads to sexual compulsivity. When people are so desirous of sex that they become involved in dangerous activities, make inappropriate advances or seek relationships outside marriage, the problem is due to more than excess libido.

From the hormonal explosion of adolescence to the mellowing that comes with age, libido changes over the course of our lives. In general, men reach their sexual peak in their teens and early 20s while women experience a more gradual increase that levels off through adulthood. But these are just statistics that don't account for individual differences.

While some people may not desire sex as frequently in middle age, you shouldn't expect sexual desire to disappear. Sex can be a major source of pleasure and intimacy throughout one's entire life.

Any change in your libido warrants further investigation. Are you overtired? Stressed? Feeling guilty about your relationship? Don't just assume that you're getting old...or that nothing will help. Start by talking to your health care provider openly and honestly. If you have a partner, include him or her in the discussion as well. Maybe it's a medication you're taking. Maybe you need a weekend away from the phone, fax, and email. Maybe you need to work some issues through with your partner. If you're in menopause, hormone replacement therapy might help. Whatever the cause, you don't have to suffer alone.