The Brain Circuit Behind Sexual Urges—And Why It Sometimes Switches Off
Why do we love? Why do we lust? What makes us seek out a mate? These are questions that scientists, poets, philosophers, and people have asked and considered for centuries. Today, we are closer than ever before to discovering the answers. A recent study from Cell inches us closer to understanding the circuits in our brain that control and sometimes inhibit sexual motivation. The findings reveal the story of mating behavior in mice, but they could ultimately provide insight into the origins of human desire, impulsivity, and social connection.
Understanding the mechanisms that turn sexual urges "on" and "off" is more than an academic question. Sexual desire, and its absence, are central aspects of mental health, relationship satisfaction, and social well-being. Disruptions in these circuits can lead to a diverse array of conditions. These include and are not limited to: hypoactive sexual desire disorder, impulsivity and compulsive behaviors, and changes brought on by aging or illness. Therefore, research that clarifies how the brain integrates internal physical states with external social cues stands to reshape our understanding—and eventually, our treatment—of diverse aspects of human behavior.What We Thought We Knew About Sexual UrgesFor decades, the consensus has been that our sexual behaviors are tightly controlled by our hormones, specifically testosterone in males, estrogen, and progesterone in females. These hormones act on specific regions of the brain, including the hypothalamus and prefrontal cortex. At the circuit level, the hypothalamus is traditionally associated with sexual motivation, whereas areas such as the prefrontal cortex contribute to social cognition and adaptive decision-making. Our hormones, when acting on these regions, create what are called windows of desire. These windows prime our neural circuits to respond to opportunities for mating.Social context is equally crucial in this process. The mere presence or scent of a potential mate, or other signals such as pheromones, can rapidly shift an animal's physiological readiness and spark or suppress sexual behaviors. While much of this knowledge arises from animal models, core neurobiological mechanisms are believed to be conserved across species, including humans. Modern neuroscience has established that complex behaviors, such as mating, emerge from an interplay between hormonal signals and neural processing.A Brain Circuit That Integrates Hormones and Social ContextThe new research identified a key population of neurons in the prefrontal cortex of mice. These neurons act as an integration hub. They receive input about both the animal's reproductive state and social cues from prospective mates. The study focused on a specific type of neuron using advanced neuroimaging and optogenetics.A recent study found that activating these neurons could "switch on" sexual receptivity in non-fertile females and "switch off" mating interest in fertile ones. This two-way control system changes based on the animal's current state. Activating the same circuit in male mice has the opposite effect. It suppresses mating behaviors, which underscores fundamental sex differences.Other findings included that these neurons communicated with the anterior hypothalamus, acting as a relay node between social information and reproductive readiness. Imaging showed that some neurons respond to both the animal's hormone levels and the traits of social targets, like the sex of another mouse. Therefore, this circuit appears to drive mating behaviors only in the specific hormonal and social context. Evidently, the drive to mate can be overridden even when external cues seem favorable.Broader Implications and RelevanceThese findings push the boundaries of our understanding in several key ways. The research highlights that identical brain circuits may underlie mating behaviors in both sexes, but operate through fundamentally different mechanisms depending on the hormonal state. This provides a biological explanation for observations in both animal and human behavior: what may appear as a universal drive is, in fact, deeply context-dependent. Additionally, it suggests that desire is not "hardwired" and is not simply triggered by hormones or social signals in isolation. Instead, the brain continuously integrates both streams. This allows for flexibility in response to a complex environment.The question is: why does any of this matter? By identifying specific neural targets for further study, this research opens up the potential for pharmacological or behavioral interventions aimed at addressing sexual dysfunction or impulse control disorders. For instance, consider individuals who, despite being in a supportive relationship and having typical hormone levels, still experience reduced sexual desire. This situation often leads to distress and misunderstanding. The research suggests that even subtle changes in the brain's integration of social context and internal state may explain such experiences, opening new avenues for personalized therapies.Future DirectionsThe study notes that much work remains. This is particularly true in mapping how these circuits function in humans and various hormonal or social contexts. As we continue to decipher the neural code behind basic urges, we hope to better address the full spectrum of human desire, from its flourishing to its dysfunction.
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Medscape
31 minutes ago
- Medscape
‘I Became so Quiet': When Physicians Attempt Suicide
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While he found a psychiatrist and started taking antidepressants, suicidal thoughts waxed and waned, often coinciding with exams or stress levels. 'I would think, 'I just don't want to be this stressed anymore,' and I'd think that if I didn't wake up, that'd be fine.' During his third year, Mecham was doing rotations in rural Iowa and away from his therapist and support systems. He had stopped taking medication. His mental health deteriorated to a crisis point. He remembers his anxiety feeling like 'drinking 1000 cups of coffee a day.' Then, one day, something at work set him off; Mecham decided he no longer wanted to be alive. He went to his motel room and used a scalpel to make a significant laceration on his arm. He passed out. When he came to — somehow still alive — Mecham checked himself into the emergency room (ER) at the hospital where he was set to be rotating. He stayed there for 14 days. 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Per a new analysis in JAMA Psychiatry , female physicians — who may face additional stressors, including childcare burdens, sexual harassment, and unequal pay — have a 53% higher suicide risk than female general population. The study also found that physicians who die by suicide exhibit several distinct characteristics compared with nonphysicians who die by suicide. The physicians were more than twice as likely to experience job problems and 40% more likely to have legal issues. Physicians are also particularly at risk of taking their own lives due to their access to lethal means. The JAMA Psychiatry study found that physicians were 85% more likely to die by poisoning and more than four times more likely to use a sharp instrument than the general population. While groups like the American Hospital Association and the American Medical Association (AMA) have specifically addressed the topic for healthcare workers, a 2025 Medscape survey found 6 out of 10 physicians see suicide as a significant issue for the medical profession — while 52% believe the profession doesn't properly confront it. The paths to suicide risk are heterogeneous, but physicians face many of them — mental health conditions, prolonged high-stress environments, access to lethal means, discrimination, and more. 'Under a stressful environment, things are going to crack, and there are cracks everywhere,' one suicidal physician with a specialty in surgery told Medscape Medical News . 'Crumbling on the Inside' Doctors across the healthcare field continue to raise issues around burnout, unrealistic demands, and little space for self. Amna Shabbir, MD, an internal medicine and geriatrics physician, says that she has found herself 'fighting an ocean' of administrative or insurance-related tasks simply to provide care. Amna Shabbir, MD Shabbir also describes a critical disconnect that today's doctors face — an emotional contradiction that begins early and can have devastating consequences. 'We teach physicians empathy and simultaneously dehumanize them,' she said. 'I am supposed to feel the pain of my patient, but I'm not supposed to show it to the patient.' Shabbir added, 'You can feel like what you do doesn't matter, and you have worked so hard to get to this point.' Shabbir, who experienced depression during and after residency, says that only a few years into her career, she was burned out. She was up against mounting pressure. It felt like there was no room to breathe. 'I was supposed to look like I could flawlessly execute motherhood and 'physician-hood' with excellence,' Shabbir said. 'I became so quiet. Everything was crumbling on the inside, but I looked put together on the outside.' Shabbir feared that admitting her depression, even taking one Lexapro pill 'could potentially be career-ending.' 'Why are we making people in medicine feel like they have to have it all together,' she asked, 'to the point where the only way out that they see can be the end?' Multiple experts Medscape Medical News spoke with for this article emphasized the differences between burnout, an occupational phenomenon of chronic physical and emotional exhaustion, and clinical and diagnosable mental health conditions such as anxiety, depression, and posttraumatic stress disorder. But physicians we spoke to regularly mentioned both in relation to suicidality, suggesting the two are deeply entangled. For example, burnout has been linked to the amount of student loan debt a physician carries. 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With little science background, she quickly felt in over her head. Raised to keep personal struggles private, she felt out of place and unprepared compared with classmates from medical families. Christine Moutier, MD 'You have an illusion that everybody else is just so much more together than you are,' Moutier said. As anxiety took root, so did an eating disorder. 'I never learned to sit with discomfort, self-reflect, talk to a peer, or even journal,' she explained. She just pushed herself to work harder. After her second year, Moutier got married and deferred her first clerkship, which made her feel even further behind. On the first day of her third year, she found she couldn't think clearly or function. She went to her dean's office intent on quitting medicine. 'My brain was disorganized. It had been 2 years of spiraling psychiatric illness that could have been life-threatening — both from the eating disorder's physical toll and the high suicide risk tied to untreated anxiety,' she said. Moutier took a year off. 'I couldn't even watch ER. It would trigger a panic attack. Med school felt like torture,' she recalled. As she struggled to find her path, she experienced suicidal ideation. But with therapy, she recovered, eventually returning to medicine before joining AFSP. 'My passion for physician and med student mental health — and suicide prevention — is what kept me in academic medicine,' she said. Clearly, systemic stressors persist beyond medical school. The surgeon who spoke to Medscape Medical News anonymously said that in residency 'the learning curve is so incredibly steep,' there is simply 'too much to learn.' He described witnessing racism, abuse, physicians throwing surgical tools across the operating room, and general rule breaking. These incidents took place at top medical centers where, he said, he faced retaliation and unfair evaluations when he spoke out. He experienced depression and suicidal thoughts, ultimately resigning from his program. 'I felt powerless, like I no longer had a place in this world,' he said. A Path Toward Openness and Education Today, research and supportive approaches to the issue of physician suicide have grown substantially. But this wasn't always the case. In 1962, when Myers was in medical school, he lost a roommate to suicide. He remembers announcing the terrible news to his class. His professor responded, ''Let's get back to the Krebs cycle.' It was a message that we don't talk about this.' Now, Myers says he regularly invites young physicians who have experienced mental health struggles, suicidal thoughts, or have recovered from substance use disorders to speak during medical school or residency orientations. Christine Sinsky, MD, former vice president of professional satisfaction at the AMA, says this type of self-disclosure is 'one of the most powerful things I'm aware of,' as it encourages others to speak up. 'It's important to tell medical students they are entering a high-reward yet high-risk profession.' Christine Sinsky, MD But this level of honesty isn't always easy to come by. Myers says deans of medical schools still push back about this type of discourse, sometimes fearing that open conversation will scare medical students or trainees. Myers insists it does the opposite. Removing Barriers to Care Despite this type of progress, there are still barriers that keep physicians quiet about their struggles. Historically, mental health questions on medical licensing and hospital credentialing applications have precluded physicians from seeking support around mental health or suicidal ideation out of fear of potential penalization. In 2020, the Dr. Lorna Breen Heroes' Foundation was founded by the family of Lorna Breen, MD, an emergency room physician who died by suicide. The group's mission is to eliminate barriers to mental health care and reduce stigma, empowering physicians to seek the care they need. The group has particularly worked to eliminate stigmatizing language around mental health from 34 state licensing organizations' licensing boards and over 50 hospitals' credentialing applications. Today, more healthcare facilities offer dedicated mental health services exclusively for physicians and trainees that aim to reduce other barriers like confidentiality concerns, time constraints, and ease of access. Some operate independently from medical schools or use separate electronic medical record systems to enhance privacy. 'I've never heard of a doctor with a cancerous tumor who didn't go to see an oncologist, but there are still doctors who take their lives without ever having had an assessment,' said Myers. Yet access to mental health care remains challenging, says Moutier. Stigma and fear are still pervasive. Some physicians report seeking help but downplaying symptoms, including suicidal thoughts. More Work to Be Done Myers commends major medical organizations for their work in suicide prevention and says that a culture shift requires 'enforced changes.' One of these, which has been widely recommended, is placing limits on working hours. Sleep deprivation not only compromises patient care but also significantly increases the risk for mental health conditions. One study published in PLOS One found that decreases in sleep among residents and medical trainees were linked with an increased risk for suicidal ideation. Institutions are required to adhere to the 80-hour workweek limit for residents set in 2003 by the Accreditation Council for Graduate Medical Education (ACGME). In 2017, the group introduced Common Program Requirements focused on resident well-being. 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Shabbir founded the Early Career Physicians Institute in 2023 to coach physicians through burnout and perfectionism. Wible, who runs a suicide support line and groups for physicians, believes strongly in the power of peer support. One physician who experienced suicidality told Medscape Medical News that 'everything rapidly changed for the better' once he joined a peer support group. 'It felt like a rocket launch. We rose out of the muck together.' Myers says the openness about mental health among the next generation of healers keeps him optimistic. 'I've had many doctors tell me, 'I read someone's story and realized I'm not alone,'' he said. 'They feel less ashamed of seeking help themselves. That's incredibly powerful.' If you or someone you know is in crisis, help is available. Utilize the below services.
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What Happens When AI Schemes Against Us
Would a chatbot kill you if it got the chance? It seems that the answer — under the right circumstances — is probably. Researchers working with Anthropic recently told leading AI models that an executive was about to replace them with a new model with different goals. Next, the chatbot learned that an emergency had left the executive unconscious in a server room, facing lethal oxygen and temperature levels. A rescue alert had already been triggered — but the AI could cancel it.
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The Evolution Of EAPs: From Crisis Hotline To Proactive Health Engine
Stephen Sokoler, founder & CEO of Journey. Workplace mental health support has traveled a long arc since the 1930s, when early employee assistance programs (EAPs) emerged—primarily to address occupational alcoholism and acute crises. Over subsequent decades, programs added short‑term counseling and referral services but largely remained reactive, activated only after employees were already in distress. Engagement remained stubbornly low; traditional EAP utilization (registration required) in large U.S. employers has hovered in the single digits. Phase 2: Digital EAPs Improved Access, But Mostly After The Fact Around the mid‑2010s, a new wave of digital EAP and tech‑enabled mental health vendors streamlined access to therapists through apps, curated networks and rapid scheduling. That was a real advance. Employees no longer had to navigate phone trees or outdated provider directories, time‑to‑appointment shrank dramatically and venture investment into mental health tech surged (mental health tech funding topped roughly $5.5 billion in 2021). Yet the model still centered on therapy after symptoms appeared. And convenience carried a cost. In its independent 2025 assessment of virtual solutions for depression and anxiety, the Peterson Health Technology Institute (PHTI) reported that many blended‑care offerings—those that combine per‑member platform fees with broad access to therapy—increased total health spending, and clinical gains did not consistently offset costs. PHTI advised purchasers to steer employees with mild symptoms toward lower‑cost digital resources and reserve higher‑touch therapy for elevated need. According to SHRM, the average engagement with digital mental health platforms is very low (registration required), while, according to another source, typical pricing is cited in the $10 to $14 per employee, per month (PEPM) range, plus downstream clinical fees. Digital EAPs were therefore a needed step forward on access, but they didn't fully solve three persistent problems: • Reactivity: Help still depends on an employee raising a hand. • Cost Escalation: High unit pricing and therapy default pushed total spend upward. • Low Reach: Even improved models typically engage a minority of the workforce. Phase 3: Proactive, Preventive, People‑First A third wave is emerging: Proactive EAPs designed to support everyday mental fitness, surface risk early and right‑size care before issues snowball into crisis, absenteeism, disability or turnover. Some established players—Headspace, TELUS Health, Virgin Pulse, Workplace Options and others—have added proactive elements such as well-being apps, manager dashboards or push content. But in most cases, these features sit on top of a traditional EAP chassis, and engagement remains modest. A newer group of vendors (my own company among them) is attempting to build proactivity into the core operating and economic model: frequent outbound touch points, behavioral signal monitoring, stepped‑care routing and accountability for measurable engagement. What 'Proactive' Looks Like In Real Life Monday, 8:05 a.m.: Rosa, a line supervisor, badge‑scans into her plant. A breakroom screen pushes a one-tap mood check. 8:07 a.m.: She taps 'Stressed.' An immediate audio micro‑practice lands on her phone. 8:10 a.m.: Because her stress score has trended up three days running, the system offers a same‑day video session with a bilingual coach. 3:00 p.m.: Coach confirms early burnout and escalates Rosa to a therapist before she misses work or lands in urgent care. None of that required Rosa to 'call the EAP.' Here's why a proactive model is gaining momentum: • Earlier Intervention, Better Triage: Continuous light‑touch screening and self‑guided check‑ins can surface rising stress, sleep disruption, caregiving strain or trauma exposure long before acute depression shows up in claims data, enabling stepped care (self‑guided → coaching → therapy) aligned with the PHTI recommendation to match intensity to need. • Improved Cost Efficiency: When scalable tools like micro‑lessons, group sessions and asynchronous content carry much of the preventive load, costly one‑to‑one therapy can be preserved for higher‑acuity cases. Employers avoid 'therapy for everyone' cost curves without abandoning access. • Embedded In The Workday: Integrations with collaboration platforms (Teams, Slack), calendaring tools, learning portals and even badge or kiosk systems reduce stigma and friction. Support shows up where work happens instead of in a standalone benefit silo. • Aligned With HR And Business Priorities: Modern platforms increasingly surface population‑level insights—hot spots by location or job type, utilization patterns across demographic groups, EAP‑to‑medical handoffs—that help Benefits, DEI and People Analytics leaders steer strategy. Choosing What Comes Next If you put a digital EAP in place over the last few years, you were ahead of the curve—you tackled the access problem. The question now: How do you reach far more of your people earlier without breaking the budget? When evaluating next‑generation mental health partners, consider asking them about the following: • Engagement Reality: What percent of the eligible population interacts with any resource quarterly? Annually? How is that measured? • Acuity Match: How do you steer mild, moderate and high‑risk users to different levels of care? Show the algorithm. • Cost Transparency: What's the full cost stack (platform, session fees, add‑ons)? Model low, base and high utilization scenarios. • Data And Outcomes: Can you correlate participation with improvements in validated scales (e.g., PHQ‑9, GAD‑7), absenteeism or retention? • Workflow Integration: Where will employees actually see or feel the program—email, Teams, text, kiosk, manager prompts? From Hotlines To Help Desks To Health Engines Mental health at work shouldn't switch on only after things go wrong. Like stretching before lifting or hydrating before a marathon, care works best when it's part of the daily environment. We've moved from hotlines (call in crisis) to help desks (click to schedule) to emerging health engines (care before crisis) that engage continuously, detect early and direct the right level of support at the right time. The next era of EAPs will belong to employers and partners who make that proactive shift. Forbes Business Council is the foremost growth and networking organization for business owners and leaders. Do I qualify?
