Quick Summary
- 1Medical experts emphasize that there is no universal standard for libido, as sexual desire varies widely between individuals and throughout a person's life.
- 2A healthy sex life is defined not by frequency but by the absence of suffering and discomfort.
- 3Fluctuations are normal and often linked to stress, relationship changes, or life transitions like postpartum and menopause.
- 4However, persistent low desire accompanied by pain, emotional distress, or other physical symptoms warrants medical evaluation.
Quick Summary
Medical experts emphasize that there is no universal standard for libido, as sexual desire varies widely between individuals and throughout a person's life. A healthy sex life is defined not by frequency but by the absence of suffering and discomfort. Fluctuations are normal and often linked to stress, relationship changes, or life transitions like postpartum and menopause. However, persistent low desire accompanied by pain, emotional distress, or other physical symptoms warrants medical evaluation. Causes are rarely singular, often involving a mix of hormonal, emotional, and lifestyle factors. Treatment is multidisciplinary, focusing on the root cause rather than just symptoms, and warns against self-medication.
Defining Healthy Libido
Sexual desire is highly variable and does not follow a specific frequency or number. Experts agree that comparing one's sexuality to external standards is often counterproductive. The central point is that libido is not a metric to be measured against a universal average.
In clinical practice, the focus is on the impact of sexual desire on a person's life rather than the frequency of sexual relations. According to Raquel Magalhães, a gynecologist at Hospital Nove de Julho, a healthy sexual desire is one that does not generate suffering. She states, "If a person has sexual relations once a week, once a year or almost never, and this does not cause discomfort for them or their partner, there is no problem at all."
This approach helps dismantle the idea that low libido is automatically a sign of disease. In many cases, it is simply a response of the body and mind to the current life situation. Sexual desire is sensitive to emotional, physical, and social environments.
"If a person has sexual relations once a week, once a year or almost never, and this does not cause discomfort for them or their partner, there is no problem at all."— Raquel Magalhães, Gynecologist
Causes of Fluctuations
Periods of intense stress, work overload, family conflicts, grief, or projects requiring significant mental investment commonly shift psychic energy to other priorities. During these phases, it is common for sexual interest to decrease and then return. The same applies to transition moments such as the postpartum period, breastfeeding, climacteric, and menopause.
According to urogynecologist Rebeka Cavalcanti, libido does not function linearly. She notes, "What calls attention in the consultation is not the quantity, but the change in pattern and the impact on quality of life." Long-term relationships also go through phases of greater or lesser desire, which does not necessarily mean a loss of bond or affective failure.
Hormonal changes can influence sexual desire, but they rarely act in isolation. They usually combine with emotional, relational factors, and lifestyle. According to gynecologist Mauricio Abrão, the drop in libido almost never has a single origin. Factors that may enter the equation include:
- Chronic stress
- Sleep deprivation
- Relationship conflicts
- Low self-esteem and sedentary lifestyle
Diseases such as depression, anxiety, diabetes, and thyroid disorders can also interfere with sexual response. Additionally, medications used to treat these conditions, such as antidepressants, may affect desire in some patients, though this effect is not universal.
When to Seek Evaluation
The line separating a natural fluctuation from a health problem lies not in the absence of desire itself, but in the persistence of the complaint and associated suffering. Experts recommend attention when the decrease in libido lasts for months, appears without a clear trigger, or is accompanied by other physical and emotional signs.
Specific symptoms that should never be ignored include:
- Pain during intercourse
- Vaginal dryness or burning
- Bleeding
- Extreme fatigue
- Significant mood changes
- Generalized loss of pleasure
Experts explain that the body tends to avoid experiences associated with discomfort, which can lead to a progressive silencing of desire. Treating only the libido without addressing the cause of pain usually leads to frustration. Men and women often experience these issues differently. In women, desire is more dependent on context, comfort, and emotional safety. In men, the decrease is frequently associated with performance difficulties. Urologist Rafael Grunewald highlights the importance of differentiating between low libido and erectile dysfunction, the latter potentially linked to cardiovascular and metabolic diseases requiring specific investigation.
Treatment and Management
When a person seeks help, evaluation begins with a detailed conversation about life history, emotional health, routine, sleep, medication use, and relationship quality. Laboratory tests are requested only when they make sense for that specific context, not as an automatic protocol.
There is no standard treatment. If indicated, treatment may involve:
- Adjustment of medications
- Control of underlying diseases
- Local therapies for pain or dryness
- Psychological follow-up
- Pelvic floor physiotherapy or sexual therapy
The approach is usually multidisciplinary. Specialists warn of the risks of self-medication and indiscriminate use of hormones or supplements. These strategies can bring side effects and increase frustration without resolving the root cause. Ultimately, healthy sexuality is not about meeting external expectations, but about living in one's own body with comfort, autonomy, and well-being throughout the different phases of life.
"What calls attention in the consultation is not the quantity, but the change in pattern and the impact on quality of life."— Rebeka Cavalcanti, Urogynecologist
Frequently Asked Questions
It is considered a medical issue if the decrease persists for months, occurs without a clear trigger, causes emotional suffering, or is accompanied by physical symptoms like pain, bleeding, or extreme fatigue.
No. While hormonal changes can influence desire, they rarely act alone. Experts note that stress, sleep deprivation, relationship conflicts, and medications are often contributing factors.
