When you hear the word “libido,” what comes to mind? Just how it’s connected to a drive to have sex? While, yes, libido is the scale we use for how interested you are in sex, there are also many other reasons to consider what a low libido might mean for you.
In general, we examine several categories when we’re talking with patients about the cause of their low libido. They range from emotional to physical, and can often be tied together, which is why we think it’s important to pay attention to the holistic perspective on feelings of low libido. Here are a few things we look for when we speak with patients struggling with this issue.
Desire For & Connection With Your Partner
This is a big factor when it comes to low libido. If there are underlying relationship issues, it can be hard to connect in the bedroom. Communication is key, as are love languages, and noticing and being attentive to what your partner needs. While we’re not a marital counselors or experts on this subject, we will ask questions pertaining to how your relationship is functioning, because not all libido issues are hormonal. If this is a big roadblock for you, we highly recommend seeking a relationship therapist who can guide you through reconnecting to your partner.
If your connection with your partner is solid but you’re noticing that it’s hard to ignite your flame, that’s something we can dig into. Some of these causes can be hormonal, including:
1. Imbalanced estrogen. Too much estrogen makes you irritable and moody, contributes to heavier periods, can make your breasts tender (and more), all of which can make sex really unappealing. But too little estrogen can also stunt your desire. Estrogen promotes serotonin and dopamine (those brain chemicals that promote positive moods and motivation). Without proper amounts of estrogen, you can start to feel depressed, and notice brain fog, and a lack of drive. Low estrogen can also have an effect on your vaginal tissue, but we’ll cover that later.
2. Imbalanced testosterone. One of the more well-known hormones that drives your libido is testosterone, our anabolic (building) hormone. It makes us feel motivated and driven to complete tasks, increases our energy, helps dispel brain fog, and helps build our lean muscle mass. In men, the majority of testosterone is created in the testes. In women, it’s created in the ovaries, adrenals, and fat tissue (although, having more fat tissue doesn’t mean more testosterone!). If you have low-functioning ovaries, or are stressed to the max and are in HPA Axis Dysfunction, you might find your levels of testosterone are lower.
As you can probably imagine, there are many reasons why your testosterone may be low (brain injuries, testicular injury [men], caloric deficiency, high stress, and nutrient deficiencies are just a few), but one we want to explore is past history of hormonal birth control. Being on birth control can increase a protein called SHBG (sex-hormone binding globulin), which shuttles our testosterone around our body. When we have too much SHBG, it can actually decrease the amount of free and bioavailable testosterone we have available to us. As you may imagine, this can also squash your libido.
3. Medication induced. There are many medications that have side effects of libido reduction, or they alter your hormones in a way that can affect your libido indirectly. This isn’t a recommendation to stop your medication, but rather to have an open and honest conversation with your doctor about your libido concerns and how the medication may be playing a part.
4. Other hormonal factors can include mildly elevated prolactin levels, hypothyroidism, cortisol, and oxytocin.
Issues With Orgasm
Beyond hormones and getting aroused, there can be another issue: achieving an orgasm. If this is the issue for you, we start by asking a few questions:
- Can you reach orgasm?
- Is this new, and if so when did things change?
- What was happening around the time your ability to achieve an orgasm was diminished?
One area we can explore is communication. Are your sexual needs being met? Was there enough foreplay for you to get aroused? Are you being present in the moment? If all of that checks out here, we move on to bigger issues, which can include:
1. Nerve innervation. Nerves are what fuel your sexual feelings. The clitorus, vaginal canal, and the penis are filled with nerve endings that make it pleasurable to have sex. Decreased nerve innervation can come from spine and disc issues, prior surgeries in the groin, low back or spine, high blood pressure, uncontrolled blood sugars, smoking, muscle tightness, and more, all of which can either disrupt the nerve transmission, or cause damage to them.
2. Blood flow. Another huge issue can be if you don’t have proper blood flow to the areas being stimulated or to the organs that are producing the hormones. This stunts our ability to orgasm.
Another big reason for low libido or disinterest in sex is related to physical issues. In women, we generally look at vaginal dryness, pain with intercourse, and bleeding post-sex as physical reasons that would decrease your libido, and in men we talk about erectile dysfunction.
Estrogen is a wonderful hormone that helps to improve your lubrication in the vagina, and keeps the vaginal tissue healthy so it doesn’t get damaged. When you’re in peri-menopause or if you’re post-menopausal, we see drops in estrogen numbers that can lead to these issues. We look to supporting your estrogen levels, as well as bolstering proper support to the vaginal tissue itself to make sex more enjoyable.
In men, erectile dysfunction (the ability to achieve and maintain an erection) can be hormonal, physical or mental limitations. We start to ask questions about blood sugars, blood pressure, and looking at your testosterone numbers before recommending medications that can assist with erections.
Regardless of why you might be experiencing low libido, we can help determine the cause and support you and your body in getting back to balance to increase libido. Give us a call to see how we might be able to help you with your low libido.