Libido

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PSSD, otherwise known as Post SSRI Sexual Dysfunction, is the condition diagnosed to those experiencing the long term decreased libido after usage of SSRIs. The exact causes of PSSD have not been determined.[42] Symptoms of PSSD in both sexes include genital anesthesia (most common symptom), weak/pleasure-lacking orgasm, and decreased libido. Symptoms for men include erectile dysfunction and delayed ejaculation, while women may experience decreased or loss of vaginal lubrication, nipple insensitivity, and anorgasmia.[42] PSSD is generally classified in two conditions. The first is early onset, with symptoms first being reported during SSRI usage and continuing after treatment, with the second classification occurring after the user stops usage of SSRIs.[42] It is highly recommended by researchers that doctors inform patients well about the potential impact to sexual health/function before prescribing SSRIs. There are currently no recognized treatments for PSSD. [42] In May 2019 the European Medicines Agency officially recognized the existence of PSSD as a medical condition. [43]

Testosterone is one of the hormones controlling libido in human beings. Emerging research[44] 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.[45]

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.[46] Multiple studies have shown that usage of oral contraceptives is associated with either a small increase or decrease in libido, with most users reporting a stable sex drive.[47]

Impact of age[edit]

Males reach the peak of their sex drive in their teenage years, while females reach it in their thirties.[48][49] 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.[50]
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".[51] 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.[51] Masturbation among youth is considered developmentally normal and healthy, 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.[51] 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.[51]

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.[52] Older adults generally develop a reduced libido due to declining health and environmental or social factors.[52] In contrast to common belief, postmenopausal women often report an increase in sexual desire and an increased willingness to satisfy their partner.[53] 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.[53] 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.[53] Generally, for older adults, being excited about sex, good health, sexual self-esteem and having a sexually talented partner.[54]

Sexual desire disorders[edit]

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 hypoactive sexual desire disorder or may be asexual. A sexual desire disorder is more common in women than in men.[citation needed] Erectile dysfunction may happen to the penis because of lack of sexual desire, but these two should not be confused.[55] For example, large recreational doses of amphetamine or methamphetamine can simultaneously cause erectile dysfunction and significantly increase libido.[56] However, men can also experience a decrease in their libido as they age.

The American Medical Association has estimated that several million US women suffer from 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.[40] 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. Also, women commonly lack sexual desire in the period immediately after giving birth. Moreover, any condition affecting the genital area can make women reject the idea of having intercourse. It has been estimated that half of women experience different health problems in the area of the vagina and vulva, such as thinning, tightening, dryness or atrophy. Frustration may appear as a result of these issues and because many of them lead to painful sexual intercourse, many women prefer not having sex at all. Surgery or major health conditions such as arthritis, cancer, diabetes, high blood pressure, coronary artery disease or infertility may have the same effect in women.[3] Surgery that affects the hormonal levels in women include oophorectomies.

Libido

Impact of age[edit]

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