A 30-year-old businesswoman, trying to launch her career, comes into my office complaining of low libido and fatigue. She shares details about her marriage, explaining that she loves her husband, and they have a loving and supportive relationship. She is passionate about her career, and finds herself working more often than not. Although she doesn’t have any kids, she and her husband are entertaining the idea for the future. Her chief complaint? I never want to have sex.
We order a thyroid and hormone panel, only to find out that her testosterone is low, and her adrenals are tired. Her first question for me is: “How did this happen?!”
Many, many women (and men) come into my office, complaining of a low sex drive. Some might look at this and think “What’s the problem? That’s normal once you’ve been with your partner for awhile.”
Well, I’m here to tell you that, actually, it’s not. A low libido can indicate a wide variety of things, including decreased sex hormones, stress, fatigue, anxiety and/or depression. Because of its intricacy within the human body, it’s hard to determine the root cause without a comprehensive physical exam and intake with your physician, and follow-up lab work.
Possible causes of a low libido include…
HORMONE AND METABOLIC CHANGES
- Low Testosterone
- Low Estrogen
- Low Progesterone
- Without enough pregnenolone, we won’t produce proper amounts of sex hormones. See hormone cascade.
- Adrenal Fatigue
- Pituitary problems
- Low Oxytocin
- Medications and drugs
- See drug list
- History or current use of Birth Control Pill
- The birth control pill causes an increase in the Sex Hormone Binding Globulin (SHBG).
- SHBG is like a parking garage and testosterone is like a Ferrari on the road. When you have too many parking garages, they suck up all of the Ferraris and there is no testosterone on the road – Hence, no libido.
- At Living Wellness, we aim to “cleanse” the body of the pill’s effects, support the metabolism, and support the body’s elimination processes in the liver and the gut.
- We use herbs, food and natural supplements to do this.
Besides just hormonal and metabolic causes, there are other reasons why one can suffer from a low libido, with one of the most obvious reasons being anatomical trauma, dysregulation and/or abnormalities. These could include:
- Postpartum women
- Post-surgical (scar tissue/adhesions)
- Injury trauma
- Post physical trauma
- Ectopic pregnancy
Many times, patients overlook other stressors in their life, besides just the more obvious physical stressors. Our bodies have a hard time discerning between all types of stressors. To them, stress is stress. We either “running from a lion,” or we’re in “rest and digest” mode. Common stressors that could negatively affect a patient’s libido include…
- Neurotransmitter imbalances
- Low dopamine
- Low serotonin
- Low sex hormones (progesterone, estrogen, testosterone)
- Tired thyroid gland
- Low acetyl choline
- Low self esteem
- Postpartum hormonal or postpartum depression
- How we feel about ourselves (awareness, communication)
- We don’t have the right support network
You might look at this list and think “How do you find the root cause?” As naturopathic physicians, that’s our goal. We seek to find the root cause, rather than masking the problem by only providing a pill or supplement.
Many times, a low libido can indicate low levels of oxytocin. Oxytocin is what I like to call the “love and bonding” hormone. It makes you want to bond and cuddle. It doesn’t turn you on, but if you don’t want to cuddle, it’s hard to get aroused, hence, a lowered sex drive.
In my practice, I find that women who have a history of using the birth control pill often complain of a decreased sex drive after coming off the pill – sometimes months, and often times, years later. The birth control pill tampers with your body’s ability to naturally produce and moderate female hormones, which can lead to prolonged hormonal shifts years after you stop the pill. I’ll dive deeper into this topic in another blog post.
During our initial new patient consultation, I’ll ask patients lifestyle questions to learn more about what their work, home, love and family life looks like. From a natural medicine perspective, a person’s lifestyle is key to good health. I’ll often dig deeper to figure out whether any of my patients are dealing with:
LIFESTYLE (DIET AND ENVIRONMENTAL)
- Lifestyle stressors or imbalances
- Nutritional deficiencies
- Too low body fat
- Current or past use of statins
- A diet too low in fat (high carb, low fat or… just low in calories)
- Check out our recipe for our “Libido-Boosting Cho-Cado Mousse.” I recommend dipping strawberries into the mousse and turning it into a impromptu date night!
- Environmental exposures (including endocrine disruptors)
- Substance abuse
- Sleep deprivation
Many times, I have women who come to me feeling tired, stressed, anxious, have weight resistance, are gaining weight around their midsection, and just feel “unlike themselves.” After lab testing, we often find that their hormones are a wreck. After further discussion, I find out that they have a history of chronic dieting, most often restricted diets low in calories and all macronutrients, including fat.
When we consume a diet low in fat for years on end, our sex hormones are one of the first things to suffer. Our hormones are built upon cholesterol as their precursor. A diet low in cholesterol will decrease production of pregnenolone, which then lowers testosterone and DHEA – these of which are your “libido” hormones (Refer to the hormone cascade photo above). See how everything is tied together?
Increasing healthy fats within your diet is integral to getting your hormones on track. I have an amazing “Cho-Cado Mousse” recipe that I would urge you to try if you’re easing into consuming more fat. Click here for the recipe.
How can we fix our hormones, help our relationships and therefore, boost our libido?
We can start to prioritize (and deal with) the following:
- Commitments and priorities, people and careers
- Letting go of our “busy addictions”
- Letting go with primary relationship with world, and fuel this part of our life
- Relationship woes
- “When we are vulnerable, we protect ourselves conscious and unconsciously. Any hurt feelings, known or unknown resentments, unspoken frustrations, affect our ocean of intimacy and lovemaking.”
- “When sex is just sex. This place of intimacy doesn’t matter. Sex drive is easy. When its more about relationship, this ocean of intimate is essential for sex drive, libido and orgasm and love making.”
- Dealing with the most common relationship stressors
- Feeling safe
- Living situation
- I highly recommend reading the “The Five Love Languages” book by Gary Chapman.
- Scheduling sex dates and use lubrication, if necessary.
- Quick Tip: If man and women have a different sex time, and pick a time in the middle. 🙂
Many couples might not know this, but there is some science supporting the idea that men and women have different optimal “sex” times. Women tend to be more aroused in the evening, while men are ready to go first thing in the morning. I recommend patients work with their significant other to find a time, in the middle, that works for both parties. Perhaps, scheduling a 3pm sex date would be the best of both worlds?
Naturopathic Approach – Where Do We Go From Here?
As naturopathic physicians, our first order of business is to get to the root of the problem. When did this begin? Why did it start in the first place? What factors are still contributing to the problem? A huge part of this investigation comes from lab testing. I always say… “test, don’t guess.”
First, have a discussion with doctor and assess what’s right for you** Once you have met with your physician and they have conducted a physical exam, looking for a structural problem or anatomical problem…
Lab testing might include:
- Sex hormones – estrogens, testosterone, DHEA
- Thyroid hormones
- Micronutrient levels
Treatments might include:
- Hormone replacement therapy
- Thyroid support
- Adrenal support
- Sex hormone regulation
- Oxytocin supplementation
As always, please consult with your physician before moving forward with any form of treatment. At Living Wellness Medical Center, we offer FREE, 10-minute consultations with all of our doctors, to ensure that the doctor-patient relationship is a good fit. Call our office to schedule your free consultation, or jump right into your 90-minute new patient appointment. Low libido may be common, but it isn’t “normal.” Let’s get to the root of the problem, and help you get your love life (and hormones) back in check.
**The doctors at Living Wellness cannot diagnose or treat anyone without seeing this in-person as a patient. What’s best for others might not be best for you. Each patient requires their own, individualized treatment plan. As always, please be sure to consult with your physician before following any of these recommendations.