A woman’s sexual desire (libido) is an indicator of overall vitality which naturally fluctuates over the years. Highs and lows in libido can coincide with life events such as the beginning or end of a relationship, and with physiological changes such as pregnancy, menopause, or illness. 43% of women report sexual dysfunction, a seemingly innocuous symptom which can have a significant impact on daily life.
When we look at the physical causes of low libido, it’s apparent that most fall under the umbrella of “neuroendocrine imbalance.” Low libido is commonly accompanied by other symptoms of imbalance – insomnia, fatigue, night sweats, vaginal dryness, foggy thinking, and mood concerns. These symptoms can make daily life miserable and affect how patients perceive themselves. Some women say their symptoms make them feel “old and used up,” as if they are losing their womanhood. In other words: neuroendocrine imbalance does not feel very sexy.
Estrogen helps to maintain the health of the vaginal tissues as well as a woman’s interest in sex. Estrogen levels may drop during the transition to menopause, which can cause a double whammy: decreased interest in sex in combination with drier vaginal tissue can result in painful or uncomfortable sex. At the same time, women may also experience a decrease in the hormone testosterone, which helps to boost sex drive in men and women alike.
Many women experience low libido before they reach perimenopause and menopause. Women who experience estrogen dominance due to low progesterone levels often complain of water retention, fibrocystic breasts, depression, and irregular or heavy periods, as well as low libido. Progesterone supplementation is a consideration to address these symptoms and help restore a woman’s sex drive.
While it’s well known that chronic stress isn’t good for us, we may not realize the toll it takes on libido. Because the body interprets ongoing stress as life threatening, it naturally prioritizes survival over reproduction or pleasure. In today’s world, many women are simply worn out as a result of balancing job, marriage, and caring for aging parents and young children. In short, an exhausted woman does not have the energy for intimacy! Encouraging her partner to help with basic household chores such as dishes, laundry, grocery shopping, and caring for kids can go a long way toward lightening her load and improving her libido. As a result of the emotional load many women carry, testing for HPA axis dysfunction is essential in cases of low libido.
Neurotransmitter imbalance can be another contributor to low libido. Neurotransmitters are responsible for regulating aspects of mood, cognition, and behavior including sexual motivation and reward seeking. Excitatory neurotransmitters like dopamine, norepinephrine, epinephrine, and glutamate stimulate sexual desire and arousal, while inhibitory neurotransmitters like GABA and serotonin facilitate sexual reward and satiety. Decreased libido can be the result of reduced excitatory activity OR increased inhibitory activity.
Testing for and treating neuroendocrine imbalance is important, but remember some of the other common reasons for low libido: medications (such as anti-depressants or blood pressure medication), drug and alcohol abuse, and being overweight. Also, a sedentary lifestyle is known to contribute to a lackluster sex drive. Exercise will build energy and stamina, both contributors to libido.
Start simple. A NeuroHormone Complete Profile is an easy way to evaluate patients with low libido as it measures sex hormones, adrenal function and neurotransmitter balance. Re-establishing neuroendocrine balance may be the first step to help your patients find their way back to a healthy and enjoyable sex life.