This guest blog post was written by Naturopathic Doctor and Founder of Tribe Medicine, Dr. Leah Gordon, ND.
Disclaimer: the information in this article is for educational purposes only and is not designed to replace individualized recommendations from a practitioner. Always check with your doctor before adding supplements or making changes to your treatment plan.
Let's Talk Low Libido
Let’s talk about sex and the drive to want it, which is called libido. Why? Because it’s rarely talked about in an open and informative way, doctors rarely ask about low sex drive, and I think it’s a bigger problem facing women these days than most people realize.
Low sex drive can be a really important symptom that tells us more is going on below the surface that we need to investigate. Just as pain is a symptom alerting us that something is off in our body, the lack of a libido is alarming and can point toward issues with hormonal imbalances, relationship imbalances, or negative neurological programming.
When it comes to libido, we are all unique beings with different desires, physiology, cultures, experiences, and quirks. To say it simply, sexual desire is incredibly complex. However, given my extensive experience with this personally and in practice, I have found three main overarching root-cause categories to explain low libido in women:
- Hormonal Imbalances
- Sexual Polarity Imbalances
- Negative Neurological Programming
Sexual desire, or the lack thereof, is incredibly complex and often multifactorial. If you are experiencing low libido, know that you are not alone.
The Three Main Hormonal Imbalances
To dive in further, let’s start with the hormones. There are many players involved in this complex system, which means many opportunities for things to go wrong.
Our body loves when things are just right and when they aren’t, we do not run optimally. Although there are many hormones involved in sexuality, these are three of the most common low libido hormonal imbalances I see in practice.
1. Low Testosterone
Testosterone is a hormone that is made in men and women, despite its reputation of being a “male” hormone. In women it helps us build muscle, it is important for bone and brain health, and it’s one of the top libido-boosting hormones we have.
When testosterone is too high in a female, it can cause aggression, acne, or unwanted hair growth. If it is too low, she can have little to no desire for sex!
The Main Causes of Low Testosterone
Elevated sex hormone binding globulin, SHBG for short
- This is a protein that binds to hormones to help them travel through the bloodstream. When the hormones are bound to SHBG they become inactive. So a high SHBG causes a lot of bound testosterone making our free or available testosterone non-existent.
- Lack of exercise, especially resistance training
- Hormonal Birth Control
- Elevated sex hormone binding globulin, SHBG for short
2. Low DHEA
DHEA, stands for dehydroepiandrosterone.
This is a hormone that is made primarily by our adrenal glands, two little bean-sized organs that sit on top of our kidneys. Our adrenal glands are where the stress hormones cortisol and epinephrine are made, as well as some of our sex hormones such as testosterone and estrogen.
In addition to being one of the main libido-boosting agents, DHEA is important in making many of our other hormones, in preventing early aging and vaginal dryness/atrophy, and it is a key to mood, weight, and bone health.
When we are chronically stressed, our adrenal glands suffer, the output of DHEA goes down, and this results in our libido plummeting.
The Main Causes of Low DHEA:
Outside of more severe hormonal medical conditions such as Addison’s disease and hypopituitarism, the main causes of low DHEA are:
- Chronic stress
- Lack of sleep
- Although many of us think of having a difficult boss or juggling work and home life as stress, depleting our nutrients and time for rest are also severe stressors on the body.
- So remember to breathe deeply, get your sleep, and eat your breakfast... your sex life depends on it!
3. High Prolactin
Prolactin is a hormone that our brain makes in an area called the pituitary gland. It is most well known for being the lactation or breastfeeding hormone. This hormone is elevated after birth and this is what prevents women from becoming pregnant right after having a baby. It does this by inhibiting or reducing our normal sex hormones.
In a non-breastfeeding person, this should not be elevated, however I see it functionally high often in women who have never even been pregnant. The reduction in hormones from high prolactin can be a big root-cause to low libido.
The Main Causes of High Prolactin:
- Sustained chronic stress
- Low vitamin B6
- Hormonal birth control
- Low thyroid function
- Excessive cannabis use
- Low dopamine, the neurotransmitter in our brains that is associated with pleasure, reward, and addictive behavior
Note: If prolactin is really high this could mean a prolactinoma is present, which is a benign growth in the pituitary gland. Often, people do not have this, but instead have mildly or functionally elevated prolactin, which is what I see almost 99% of the time in my practice.
Hormones to Ask Your Doctor About
If you are curious about any hormonal imbalances you may be experiencing, these are the hormones I always check in my patients with low libido:
- Testosterone: total, free, and bio-available
- Estrogen and Progesterone
Sexual Polarity Imbalances: Masculine & Feminine Dynamics
It takes two to tango, and in order to create desire between two people, there needs to be polarity. This is what we commonly call passion or chemistry.
When people say “Opposites Attract” they don’t mean that someone who likes hiking should be with someone who likes to play video games. They mean that the polar opposite masculine and feminine energies naturally attract each other and that is what creates the passion and desire between two individuals.
Feminine and Masculine Energies
As an example of this polarity, a woman in a state of intense feminine energy will be attracted to a partner who is in a state of intense masculine energy. If you are in a state of feminine energy and your partner is also in a state of feminine energy, there will be no sexual desire or chemistry and you may feel like you are best friends rather than lovers.
It’s important to recognize where your dominant energy is, and, if you and your partner are the same, to determine how one of you can shift temporarily for the sake of a sexual experience.
For example, if you both work and come home with to-do lists and tasks, and your mind is busy analyzing the day, you are both in your masculine energies. This means no polarity.
Sexually, if you like to be picked up or pushed against the wall with passionate kisses while your partner takes control, you like to be in the feminine because that is the receiving energy. If your partner also likes to be in their feminine and is expecting you to take control, you are not on opposite sides of this spectrum. One of you needs to be feminine and one needs to be masculine.
Know that we often have our base energy but we can shift between masculine and feminine throughout our day and even throughout a sexual experience. The key is being conscious of it and knowing how to be opposite.
Masculine vs. Feminine Traits
Example: Making dinner reservations, opening the door, pulling partner in for a kiss, making decisions, enjoys controlling the flow in the bedroom.
Brain-Body Imbalances: Negative Neural Programming
Our brain is a learning machine. It has evolved to keep us alive by doing so quickly and remembering intensely, especially if a situation had emotion tied to it.
Emotional learning is ingrained deeply because our brain knows that if there was emotion, it was important. This allows us to react appropriately if and when that experience happens again.
Neural Programming and Libido
Just as Pavlov’s dogs learned to salivate in anticipation of their bones at the sound of a bell, our bodies also have physical responses to learned associations in the past.
The way an early sexual experience should go is that we create a positive association with sex. We are kissed for the first time and we get butterflies and our sexual tissues become excited. We like that feeling, so our brain tells us that we want more of it; we desire it, if you will.
In this same way, our brain remembers negative experiences linked to sex and this can cause our body to shut down around sexual interactions, even if our conscious mind doesn’t want it to.
Common Negative Neural Programming Experiences:
A few of the most common negative neural programming experiences:
- Being raised in a household, culture, or religion that made sex wrong or shameful
- Experiencing sexual assault or sexual trauma
- Having a bad sexual experience, where performance, pain, embarrassment, shame, or fear were predominant
If any of these happen, especially early in our sexual development, our brain associates sexual behavior with those unpleasant feelings and it literally shuts down the part of our nervous system responsible for sexual desire and response.
The brain needs to be retrained in positive neural programming to teach the nervous and endocrine systems that sex is ok, safe, and pleasurable.
As you can see, sexual desire, or the lack thereof, is incredibly complex and often multifactorial. If you are experiencing low libido, know that you are not alone.
It is nothing to be ashamed of and it may in fact be a blessing in disguise, bringing awareness to some imbalance that might have been overlooked otherwise. I know that was the case for me in my own personal journey.
I urge you to seek help from a health professional who understands and works with low libido to help find your root cause so you can get your sex drive and your life back!
Dr. Leah Gordon(ND) is a naturopathic and functional medicine doctor, and founder of Tribe Medicine— an integrative and holistically-minded medical practice in San Diego, CA. She offers a unique and personalized approach to helping her patients achieve their health goals. In addition to comprehensive intakes, she incorporates in-depth specialized laboratory testing to uncover the root causes of imbalance and utilizes holistic treatment plans to guide her patients toward optimal health. Her own healing journey, paired with her rigorous medical training, has made her an expert in understanding the obstacles to healing in the areas of hormone imbalance, low libido, thyroid, adrenal and digestive health, and preconception and fertility care. Dr. Gordon is especially passionate about teaching and empowering our TRIBE of women to live healthier lives for the health of themselves, their children and future children, their communities, and our planet.
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