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On the other hand, a person can engage in sexual activity without an actual desire for it.

Other causes include experience of sexual abuse, assault, trauma, or neglect, body image issues and anxiety about engaging in sexual activity.

Physical factors that can affect libido include endocrine issues such as hypothyroidism, the effect of certain prescription medications (for example flutamide), and the attractiveness and biological fitness of one's partner, among various other lifestyle factors.

Freud developed the idea of a series of developmental phases in which the libido fixates on different erogenous zones—first in the oral stage (exemplified by an infant's pleasure in nursing), then in the anal stage (exemplified by a toddler's pleasure in controlling his or her bowels), then in the phallic stage, through a latency stage in which the libido is dormant, to its reemergence at puberty in the genital stage.

Freud pointed out that these libidinal drives can conflict with the conventions of civilised behavior, represented in the psyche by the superego.

Problems can arise from disparity of sexual desires between partners, or poor communication between partners of sexual needs and preferences.

It is the instinct energy or force, contained in what Freud called the id, the strictly unconscious structure of the psyche.

Failure to adequately adapt to the demands of these different stages could result in libidinal energy becoming 'dammed up' or fixated in these stages, producing certain pathological character traits in adulthood.

Thus the psychopathologized individual for Freud was an immature individual, and the goal of psychoanalysis was to bring these fixations to conscious awareness so that the libido energy would be freed up and available for conscious use in some sort of constructive sublimation.

Sex drive can also be affected by medical conditions, medications, lifestyle and relationship issues, and age (e.g., puberty).

A person who has extremely frequent or a suddenly increased sex drive may be experiencing hypersexuality, while the opposite condition is hyposexuality.

However, the levels of testosterone increase at menopause and this may be why some women may experience a contrary effect of an increased libido.