Libido : Learn More

Libido – What Libido?!

Sex drive - it's not a subject that most women feel comfortable discussing amongst themselves or sometimes even with their partners. However, low sexual libido, a previously understudied condition, is starting to gain more attention from women and medical researchers alike.

This diminished sexual desire often occurs in both men and women with advancing age and can result from a number of biologic and psychological circumstances. For women, who are twice as likely as men to experience low libido, it is often an unfortunate consequence of a hysterectomy and, ironically, estrogen therapies used to treat menopause-related symptoms like hot flashes and insomnia. Even in women of child-bearing years, various factors can lead to imbalances that cause the desire for sexual contact to diminish. In addition, low libido can lead to feelings of unhappiness, concern and frustration, plus it can have a major impact on a woman's relationship with her partner.

There are physical and emotional factors that affect your sex drive – and they’re interdependent. Let’s take a look at the physical factors as they’re often times the easiest to straighten out.

Hormonal Imbalance and Loss of Libido

The simplest cause of low libido is hormonal imbalance(s). Hormone imbalance can occur at any point in a woman’s life, but loss of libido is particularly prevalent among women as they approach and go through menopause. As such, we often see low libido accompanied by other common symptoms of peri-menopause and menopause – hot flashes, insomnia, fatigue, mood swings, and weight gain. When those women get back in balance, their desire often returns as well. (See our Peri-Menopause and/or Menopause sections and the What you can do sections in this Health Department for more information on ways to rebalance your hormones naturally.)

In truth, a woman’s sexuality has to change in peri-menopause and menopause. Instead of giving up, or trying to hold on to how things were in the past, I encourage you to welcome this change in your sexuality. You really can find your way to a sexuality that suits you now – hopefully better than ever. With no fear of pregnancy, and the kids out of the house, that’s a real possibility. It’s perfectly natural for a woman to be sexually active throughout her life. And there’s a great deal of evidence that it’s good for your health.

Sex stimulates a natural “high” from the release of opiate-like endorphins in your brain. It burns calories, feels good, and keeps your muscles and tissues in shape. In fact, studies have confirmed that an active sex life is associated with living longer and enjoying better physical health, with a fuller sense of personal worth, potential and well-being. Physical changes in the vagina with Peri-Menopause and Menopause As peri-menopause progresses, the body produces less and less estrogen. This drop in estrogen can create thinning, tightening, and dryness in the vulva and vagina. These changes can lead to a great deal of discomfort. Since our bodies are designed to avoid pain, the discomfort associated with sex can cause many women to experience a decreased desire for sex or avoid sex outright because of the pain.

Women that have used Premarin and Prempro in the past are more likely to suffer these physical changes to the vaginal area and it may take many months to develop these symptoms after stopping the drugs. Learn more about Premarin and Prempro and how they could be adversely affecting your health, even once you discontinue using them.

Testosterone’s role in libido

For most women, a natural and gradual decline in testosterone levels begins about 10 years before menopause and may be further reduced if they begin taking estrogen replacement therapy to treat the symptoms of menopause. However, women of all ages may experience a decrease in their testosterone (due to high stress, improper nutrition, other hormone imbalances, etc.), which in turn can lead to low libido because testosterone affects most aspects of libido including sexual interest, sexual arousal, sexual response, vaginal lubrication and orgasm.

Your testosterone comes primarily from your ovaries, both directly and indirectly via their production of progesterone, which serves as a building block for many hormones, including testosterone. DHEA, a hormone from the adrenal glands, also readily converts into testosterone in women. High stress diverts DHEA into cortisol instead of testosterone. That’s one of the key reasons why libido is often lower under high-stress situations. Moreover, all of your sex hormones originate from cholesterol; thus, fat-free or very low-fat diets and cholesterol lowering medications can negatively affect sex drive.

Just because a woman goes through peri-menopause or menopause does not condemn them to low sex drive. Some women maintain healthy levels of testosterone throughout peri-menopause and menopause; and these women often do not experience decreased libido. Their bodies appear to be more balanced due to (a) better compensation by the adrenals (remember DHEA converts to testosterone), (b) more efficient production of testosterone from other hormones, (c) optimal nutritional support or a combination of the above.

After a total hysterectomy (i.e. both uterus and ovaries removed), women may have very low or nearly undetectable levels of testosterone, as well as dramatically lower levels of estrogen and progesterone. Surgical removal of the uterus and ovaries or just the uterus can create severe, immediate hormone imbalances that can impact mood (often causing anxiety and or depression), sleep/insomnia, gastrointestinal health, energy levels, skin health as well as libido. If you are experiencing these symptoms, you are not alone: nearly one in four women enter menopause as a result of surgery or medical treatments that adversely affects their ovaries. That means there are millions of women that know exactly what you are going through.

In addition, keep in mind that surgery, nutrition and stress aren’t the only things that affect testosterone levels: certain medications including birth control pills, as well as childbirth and breastfeeding, and illness can also adversely affect a woman's testosterone levels, leading to decreased libido.

Is Prescription Testosterone the answer?

We have seen many women in the clinic that initially started on prescription testosterone in the hope of seeing fast improvement in their sex drive and sexual response. In my opinion, this is a mistake – the lack of testosterone isn’t the problem – it’s merely a symptom of the problem. Just take a moment and think about it – if stress (whether it is physical, psychological, emotional, work, relationships, trauma, etc.) is causing biochemical changes that lead to lower testosterone, taking more testosterone isn’t going to solve the root cause, it’s just going to mask it. That’s why we start with a simple, natural approach including therapies and modalities as needed to fine-tune your program.

A natural approach such as that outlined in our What You Can Do section helps balance your hormones through a combination of methods: nutritional supplements, natural progesterone cream, a healthy dietary plan, and lifestyle changes.

Stress and Libido

Nutrition and Libido

What you eat has a very large effect on your libido. When I say this to a room full of women, I get a lot of blank stares and confused looks. It seems that very, very few people consciously realize that what they eat every day has a dramatic impact on their hormone levels. If a person has just one nutritional imbalance, it can create hormone imbalances; most people have 7-10 nutritional imbalances, setting the stage for dramatic shifts in hormone levels. In addition to causing nutritional and hormone imbalances, chronic (also called ‘yo-yo’) dieting has a terrible impact on your energy and self-image, and therefore on your sex drive. Also, as we talked about before, fat-free and low-fat diets are a particular concern because your body needs good fats and cholesterol to make its hormones, including the testosterone.