Hormones and other factors that impact libido
Female Sexual Dysfunction affects an overwhelming number of women globally. Some studies estimate about 41% of premenopausal women experience some form of sexual dysfunction (1).
Female Sexual Dysfunction or FSD is defined as persistent or chronic problems with sexual activity including arousal, orgasm, or pain experienced by women. The causes are multifactorial and include chronic stress, side effects of medications including antidepressants or birth control, hormonal imbalances and (natural decreases in estrogen) menopause, and other health conditions such as depression, diabetes, hypothyroidism. How unsexy – but it doesn’t have to be!
This article will focus on some of the common causes of low libido in women, the testing of hormones, and naturopathic approaches to improving sexual desire.
What is arousal?
A physiological state where there are changes in muscular tension, organ size, heart rate, breathing, that create conditions for copulation. Aspects of arousal are defined by physiological responses such as increases in blood pressure and rate of breathing and a decrease in the activity of the digestive system. While primary arousal is mainly governed by the sympathetic nervous system (aka fight-or-flight nervous system), responses of the parasympathetic nervous system (aka rest-and-digest nervous system) also contribute to the patterns of arousal. Physiologically, arousal patterns are not limited to sexual activity and sympathetic (fight-or-flight) reactions are also present in periods of stress and danger.
How sexual arousal works:
There are 4 stages of arousal: Desire, Arousal, Orgasm, and Resolution.
- Desire: General physiological characteristics of the first phase include increased muscular tension, a quickening heart rate and accelerated pattern of breathing. The skin may become flushed and the nipples are erect. Genital blood flow increases and vaginal lubrication begins. Women may also experience swelling of the breasts and vaginal walls, as well as hardening of the nipples.
- Arousal: Characteristics of this phase are similar and more intense than the previous stage. Muscle spasms may begin as well as an increase in sensitivity to the erogenous zones.
- Orgasm: This phase lasts anywhere between 1-50 seconds in women and consists of involuntary vaginal muscular contractions, and sudden release of tension. A flush may appear over the body.
- Resolution: The final phase of arousal where the body slowly returns to its normal level of functioning and swelling of the breasts and vaginal walls reduce to pre-arousal size and colour.
Stress and libido:
In the literature, chronic psychosocial stress is defined as either a “major life event that induces an extended period of stress such as a death in the family” (2) or “the accumulation of small stressors that are frequently present, such as on-going deadlines, traffic, financial troubles” (2).
Researchers noted that it was these smaller stressors, “daily hassles,” that had a profound negative effect on health as compared to a severely traumatic or stressful life incident. Daily hassles like being in traffic or deadlines that never seem to reach completion are related to sexual difficulties amongst individuals. A survey found that women with higher levels of chronic daily stress experienced increased amounts of sexual dysfunction and lower levels of sexual satisfaction; this was represented in a study measuring levels of genital arousal in women who experienced chronic stress (2). In the same population, women who experienced daily stressors had higher levels of salivary cortisol (the stress hormone). Sex drive in females is affected negatively by the presence of daily chronic stressors.
Medication and libido:
Nearly 60% of individuals globally reported sexual dysfunction as a side effect of antidepressant use (3). SSRI’s (a commonly prescribed class of antidepressant) have been linked to significantly decreased libido, arousal, duration and intensity of orgasm (3)
On the other hand, the use of oral contraceptives has mixed side effects, where many experience a decrease in libido. There are some women who do experience an increase in sexual desire (4)
Other conditions and libido:
Sexual dysfunction also presents in a variety of conditions such as diabetes, heart disease, alcoholism, hormonal imbalances, thyroid disease, and as a symptom of depression; approximately 50% of women reported decreased sexual interest prior to treatment of depression (5).
The Naturopathic Approach
A naturopath will first conduct a thorough history and case taking in order to identify some lead causes that may be impacting a woman’s sex drive. Further investigation into hormone levels via blood, saliva, and urinary testing may be ordered when evaluating the root cause of sexual dysfunction. For instance, monitoring changes and imbalance in sex hormones (estradiol, testosterone, DHEA) and stress hormone (cortisol) illustrates that in the presence of chronically elevated cortisol, the sex hormones that are generally elevated during sexual stimulation/desire are lessened.
A naturopathic doctor will investigate all potential causes for low libido (hormonal, stress-related, side effect of a medication), and work with you to create an individualized treatment plan to gently stimulate your body’s natural arousal mechanisms.
Decreased or absent sex drives are frustrating and generally a symptom of a deeper problem.
Though every case is unique, it is important to note that there are no quick fixes and as with any health goal, lasting changes develop over time.
What can you do today to improve factors that negatively impact your libido?
- Start with stress! Kick your libido out of neutral and into drive! Practice a beginner’s breathing exercise. Our absolute favourite technique is 7-4-8 breathing. Start by sitting or lying comfortably without distraction and with your eyes closed. Inhale for 7 seconds through your nose. Pause for 4 seconds. Exhale through pursed lips for 8 seconds. Repeat.
- Create boundaries between yourself and daily stressors by not bringing them into the bedroom. This means, no work, no screens, no fighting – the bedroom is for sleep and sex only!
- Opt for whole foods that support the libido like maca, and limit heavily processed foods and sugars. Fun fact: Maca root consumption in postmenopausal women with sexual dysfunction caused by SSRI antidepressants, ALLEVIATED symptoms!
- Have a conversation with your naturopath, doctor, or pharmacist if you feel that your medications might be impacting your sex drive.
Interested in learning more?
Book in with our naturopath, Dr. Anousha Usman ND, at The Wellness Suite to rediscover your sexual wellness!
- Mccool, M. E., Zuelke, A., Theurich, M. A., Knuettel, H., Ricci, C., & Apfelbacher, C. (2016). Prevalence of Female Sexual Dysfunction Among Premenopausal Women: A Systematic Review and Meta-Analysis of Observational Studies. Sexual Medicine Reviews,4(3), 197-212.doi:10.1016/j.sxmr.2016.03.002
- Hamilton, L. D., & Meston, C. M. (2013). Chronic Stress and Sexual Function in Women. The Journal of Sexual Medicine,10(10), 2443-2454.doi:10.1111/jsm.12249
- Higgins, A. (2010). Antidepressant-associated sexual dysfunction: Impact, effects, and treatment. Drug, Healthcare and Patient Safety,doi:10.2147/dhps.s7634
- Higgins, J. A., & Smith, N. K. (2016). The Sexual Acceptability of Contraception: Reviewing the Literature and Building a New Concept. The Journal of Sex Research,53(4-5), 417-456.doi:10.1080/00224499.2015.1134425
- Kennedy, S. H., Eisfeld, B. S., Dickens, S. E., Bacchiochi, J. R., & Bagby, R. M. (2000). Antidepressant-Induced Sexual Dysfunction During Treatment With Moclobemide, Paroxetine, Sertraline, and Venlafaxine. The Journal of Clinical Psychiatry,61(4), 276-281.doi:10.4088/jcp.v61n0406