Do hormones affect your sex life? You bet they do! Your ovarian hormones, estradiol and testosterone, have major effects at all levels of the brain and body pathways involved in sexual arousal and response, including the ease and quality of reaching orgasm. Progesterone, on the other hand, tends to dampen down interest in sex. When these hormones get out of balance, they can wreak havoc with your mind and body.
One of my patients went through menopause at 49, and worked hard with exercise and diet to stay fit and healthy, but has not been on any hormone therapy. Now at age 62, she said:
I am too healthy to feel this bad. I feel lethargic, no energy, I ache all over, and if I sit down I’ll fall asleep.
I wake up a lot and feel tired in the mornings. I love my husband dearly, and we always had a great sex life. But I have lost interest in sex and felt almost numb sexually.
When I told my gynecologist, she said I was depressed and gave me Effexor. That made my libido totally disappear and I couldn’t reach orgasm at all. So I stopped that. Then I tried a progesterone cream the pharmacist said would increase my sex drive. That was horrible, I gained weight, felt bloated and depressed, my breasts hurt, and I had zero interest in sex. I stopped that too.
Now, I still don’t have much interest in sex and if we do have sex, it’s painful. I feel flat and blah emotionally, I am gaining fat around my middle and my muscles feel like mush, even though I exercise. I don’t feel like myself at all.
Her hormone blood levels told the story. She did not have the “adrenal fatigue” or hypothyroidism most women are told is the cause of such low energy. She had a loss of estradiol and testosterone, the primary sexual hormones.
Her FSH was menopausal at 113, her estradiol only 30, and testosterone less than 10. To her shock, she now had osteopenia, even taking calcium and doing weight-bearing exercise five days a week.
Before menopause, when her energy, zest, sex drive, and muscle response to exercise were so much better, her FSH would have been less than 20, estradiol above 100, and testosterone between 40 and 60.
After my evaluation, it was obvious to her that she needed a “hormone boost,” not the “mood booster” (antidepressant) prescribed by her gynecologist. We reviewed options, and together decided to try an FDA-approved bioidentical estradiol gel.
At her second appointment, with her estradiol now optimal, I added a low dose of bioidentical compounded testosterone to improve sexual interest, energy, muscle response to exercise, and bone building.
At her third follow up appointment, she had a bounce in her step and a sparkle in her eye:
I feel just great! I am sleeping better now. My energy is back, and I am not depressed. I have better muscle tone with my exercise.
Sex is like old times! I have a huge increase in my libido. It’s like I used to be before menopause – I can easily reach orgasm, and sex isn’t painful now. My husband is thrilled. The hormones you prescribed have given me my life back.
Ladies, if you see yourself in the words of my patients, it’s not all in your head! It’s not just “depression” or “stress.” After menopause, you lose estradiol and testosterone that are the “metabolic fuel” for your brain and body to run properly. Like a high performance car can’t run on sludge fuel, losing estradiol and testosterone means your brain and body gradually begin to lose optimal energy, zest, vitality, strength, stamina, and sex drive.
Get Back to Having Good Sex
You don’t have to live “half a life.” Follow these five action steps below to improve your sex life.
Step 1: Read my book The Savvy Woman’s Guide to Testosterone: How To Revitalize Your Sexuality, Strength, and Stamina to learn how all your hormones play a role in your sexual response, and how to get tested to correctly identify the specific medical-endocrine problems that may cause low libido.
Step 2: Aerobic exercise boosts sex drive. Also try the Sensate Focus exercises in my books and articles on www.herplace.com.
Step 3: Loss of libido and/or difficulty having orgasm is a common side effect of alcohol, marijuana, and many prescription medications: all antidepressants (except Wellbutrin), anti-anxiety agents, mood stabilizers, atypical anti-psychotics, narcotic painkillers, statins, and many blood pressure medicines. Talk with your doctor about either getting off or lowering the doses if you are having sexual problems.
Step 4: Progesterone creams and troches can drastically decrease sex drive and sexual response, especially if estradiol is too low. Progesterone should only be used if you have a uterus and are taking estrogen, and then only in proper doses to protect the uterine lining.
Step 5: If your estradiol is too low, even if testosterone is optimal, women don’t have optimal sex drive or vaginal lubrication. Talk with your doctor about trying an FDA-approved bioidentical estradiol patch, gel, lotion, spray, or pill to improve sexual response.
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