In a culture so fascinated by sex, hookups and dating apps, it can be easy to turn into an adult version of Goldilocks and question your own libido. Is it too low? Too high? Just right? And is thinking about sex all the time normal?
Fear not: You’re probably fine. Sex drive is a spectrum, which means there is no universal normal when it comes to how often someone wants to have sex, says Dr. Bradley Anawalt, an endocrinologist at UW Medical Center – Roosevelt who specializes in low testosterone and male fertility.
“Doctors struggle enough to define normal sexual activity, so it would be impossible to say someone has a normal or abnormal sex drive, except perhaps on extremes,” Anawalt says.
The absence of any sexual desire is on one end of the extreme. (Note that this is different than someone who identifies as asexual, a spectrum of experiences that involves experiencing little or no sexual attraction or interest in sex.) On the other end is sex addiction or hypersexuality, though some experts argue there is not enough evidence to classify it as an addiction.
Some people might want sex multiple times a week. Others, once a month or less. Variation is normal, Anawalt says, because sex drive is influenced by many things — not just hormones (more on that in a bit).
Is it bad to have a high sex drive (or a low sex drive)?
Your libido is only a problem if you’re unhappy with it, Anawalt says. If you think you have a low libido (or a high libido) and are bothered by it, that’s when you should talk with a doctor. (Or if your partner is complaining about your lack of enthusiasm in the bedroom — something that has brought more than one patient to Anawalt’s office before.)
Even if you don’t want to have sex all the time, you might still think about it all the time. Millennials supposedly invented hookup culture but have less sex than older generations. But that doesn’t mean they aren’t thinking about it — a lot. For most people, thinking about sex daily is still the norm, says Anawalt.
“As you get older, sex drive may decline, but it’s not something that disappears completely,” he says.
Do women have a lower sex drive than men?
Let’s get one stereotype out of the way: Men don’t want sex at dramatically higher rates than women. In general, people of different genders tend to think about sex equally as often, though the thought processes of individual people obviously differ.
The actual difference is in the way people define sex, Anawalt says. If you have a penis, it’s likely you define the act by a familiar formula: erection, orgasm and ejaculation. If you don’t, your definition may be broader, in part because of a lack of the same kinds of visual cues for sexual arousal.
Even then, there isn’t as strong a link between sexual desire and sexual arousal for women, research shows. You can be sexually aroused without actually wanting to have sex — and vice versa.
Men are also more visual when it comes to sex, says Anawalt. Though research has found that visual sexual stimuli activate the same neural network in both men and women, men’s brains respond more strongly. Women may get more aroused if they can imagine themselves in the scenario they are watching, reading, listening to or imagining, but there still isn’t much research on this.
How do hormones affect sex drive?
Three hormones are related to interest in sex: Testosterone, estrogen and oxytocin. Contrary to popular belief, testosterone is not the only one important for sex and sex drive.
Everyone has some testosterone and some estrogen, though the amounts vary depending on someone’s sex assigned at birth, if someone has a hormone disorder and if someone takes hormone blockers or hormone-replacement therapy.
While testosterone increases the desire for sex, it needs to be converted into estrogen by the body to have its full effect, Anawalt says. Estrogen helps prevent vaginal dryness, which can make P-in-V or other penetration painful. Oxytocin is often referred to as the “cuddle hormone” because it makes you want to physically connect with someone after sex, instead of looking for the door.
Hormone therapy for things like menopause, low sexual desire or gender-affirming care can impact libido. Research shows it can initially lower libido in transgender women and increase it in transgender men. The longer someone is on hormones, though, the likelier it is their libido will even out or return to their baseline.
Interestingly, however, hormones alone are not as powerful in determining libido as we typically think they are.
“Hormones tend to be a tiny component of sex drive,” Anawalt says.
Other than hormones, what affects libido?
What does play a big role in libido? Pretty much anything, actually.
Past experiences (good or bad), availability of a willing sexual partner, physical and mental health, what stage you’re at in your relationship, whether or not you have gender dysphoria — all of these things and more can affect someone’s libido, Anawalt says.
Medications can have a particularly powerful effect, says Anawalt. For example, some antidepressants prevent the brain from reabsorbing serotonin and dopamine, two neurotransmitters that play a role in libido. This means that they can decrease someone’s libido, sexual satisfaction and ability to orgasm.
Conversely, people who are on medication for Parkinson’s disease may be more interested in sex because the dopamine in their brain is being constantly replenished, Anawalt says.
And, though we don’t like to admit it, sex is kind of like exercise. And like exercise, we can slack off or make it a healthy habit. Part of what makes you want to exercise more is just going and doing it, even when you aren’t completely enthusiastic about it.
“Sex is a physical activity, like taking a shower or going for a walk or stretching, except there are more barriers to it. When you exercise, that’s between you and yourself. With sex, another person is involved — a person who maybe insulted you yesterday, for instance. There are all these variables,” Anawalt says.
And, like any activity, if you aren’t feeling good about it after the fact for whatever reason, that can create a negative feedback loop that prevents you from wanting to participate again, Anawalt says.
Instead of worrying about whether you’re “normal” or not, recognize that sex drive can fluctuate and that there is a broad spectrum of what’s considered normal to doctors.
After all, as Anawalt says: “Sex is complicated.”
This article was originally published on February 20, 2018. It has been reviewed and updated with new info.