This article provides an overview of neuropsychological research into sexual desire. A state that, in men and women, is aroused by stimuli from outside, and by erotic fantasy. Not an inner need that seeks an outlet. The sensitivity of the sexual response system and interoceptive consciousness together determine the threshold for sexual desire. The first varies constantly, under the influence of dopamine, serotonin, testosterone and kisspeptin, among others. The interoceptive consciousness is vulnerable to personal and cultural beliefs about body and sexuality such as shame and guilt. Medicalisation of sexual desire turns these processes upside down. Intimacy, sensuality and erotic fantasy are not the result, but the cause of sexual desire. To promote sexual appetite, improving interoceptive consciousness is more effective than medication.
Conflict of interest and financial support: none declared.