A common concern that many women seem to bring up as they approach or hit menopause is a decline in sexual desire. While many women accept a decline as inevitable, this is not necessarily true. Arguably, some illnesses and prescription drugs can have a negative impact on our sex life but by and large, women can aspire to a long and healthy sex life by addressing the root cause of dysfunctions. Research showing that staying active sexually can bring benefits physically and emotionally, is even more reason to prioritize sexual health and well-being.
Now that we have established that it is normal and natural to desire sex at any age, let’s explore the reasons why we may experience fluctuations in our sex drive, and various ways to get our sexy back!
The Hormonal Link
When experiencing a lack of sexual desire during perimenopause or menopause, hormonal changes are often pointed out as the usual suspects and women are presented with hormone replacement therapy (HRT) as a cure-all panacea for all symptoms.
Perimenopause is a stage in a woman's reproductive life when she may begin experiencing the first signs of her menopausal transition. For most women, perimenopause begins in their 40s and lasts until she has not had a menstrual period for 12 months, at which time she enters menopause. In addition to the common symptoms of insomnia, hot flashes, vaginal dryness, mood swings, and weight gain associated with perimenopause and menopause, a woman's libido is also affected by changing estrogen, progesterone and testosterone levels.
- Estrogens are the primary female hormones. They help regulate the menstrual cycle, control the development of female sex organs, and thicken the lining of the uterus to support pregnancy. As we approach menopause, levels of estrogen begin to decrease and symptoms such as hot sweats, vaginal dryness - that can lead to painful intercourse - unstable mood and sleep patterns can occur and have an impact on your sex drive.
- Progesterone acts as a precursor to estrogen and testosterone. It is important in maintaining sufficiently high levels of the other hormones for optimal sexual pleasure. Progesterone is particularly vulnerable to the devastating action of chronic stress because it is used as raw material for the production of the stress hormone cortisol.
- Testosterone is the hormone most commonly associated with libido. Lower testosterone levels can impact sexual interest, arousal, lubrication as well as orgasms. Testosterone is produced mostly by the ovaries but it can also be made through the conversion of dehydroepiandrosterone (DHEA), a hormone secreted by the adrenal glands. However, when stress is present, DHEA is diverted into cortisol instead.
The Stress Connection
Although hormones have an undeniable impact on our general health and sense of well-being, we can’t overlook the fact that by the time women reach their mid-forties and perimenopause, they have usually been running on empty for nearly a decade! So what if our waning sex life actually had more to do with our crazy lifestyle than with our hormones?
The HPA Axis
The intricate connection between our brain and our endocrine system, known as the hypothalamic-pituitary-adrenal (HPA) axis, plays a crucial role in both mind and body health. The HPA axis starts with the hypothalamus, often considered the “master gland” of the neuroendocrine system. Amongst its many functions, the hypothalamus controls the pituitary gland, a bean-sized structure which sits right underneath. During stressful periods, the hypothalamus secretes corticotropin-releasing factor (CRF), a peptide hormone and neurotransmitter whose role is to stimulate the pituitary synthesis of adrenocorticotropic hormone (ACTH). ACTH then travels through the bloodstream to reach the adrenal glands - located on top of our kidneys - and causes them to release the stress hormones cortisol, adrenaline and norepinephrine.
Modern-day superwomen work hard to manage multiple roles simultaneously, striving to succeed both in their career and family life at the same time. The concept of Superwomen popularized in the ‘80s by Marjorie Hansen Shaevitz in her book The Superwoman Syndrome is considered by post second-wave feminists like Betty Friedan as the double enslavement of women, both at home and at work. According to Women in Canada: A Gender-based Statistical Report released by Statistics Canada in 2016, 25% to 30% of women aged 20 to 64 perceived that most days in their life were “quite a bit” or “extremely” stressful.
The stress response is meant to improve our chances of surviving a physical threat to our safety temporarily, but prolonged, frequent or extreme stress can have devastating effects on the body and brain.
Here are some of the consequences of chronic stress:
|Biochemical actions of stress|
|↑ Cortisol ↑Adrenaline ↑Noradrenaline (norepinephrine)||↓Sexual Response & Function · ↓Estrogens · ↓Testosterone · ↓Progesterone||Altered neurotransmitters · Noradrenalin · Dopamine · Serotonin · Acetylcholine · GABA|
|↑Insulin (due to ↑ glucose)||↑ Visceral fat deposition (belly)||Impaired immunity · ↑ Secretory IgA · ↓Antigen penetration · ↑ IgG · ↓ NK cell activity · ↓ IL-2|
|↑Oxidative stress||↑ Inflammation||↓TSH, T4, T3|
|↑ Bone loss||↑ GI complaints & ulcers||↓Cognition & Memory|
|↑Need for detoxification / ↓ capacity to detoxify|
Steroid Hormones Imbalance
Stress-induced, over-activation of the HPA axis and its resulting adrenal dysfunction profoundly affects hormonal balance in several ways. The adrenals are responsible for approximately 35% of steroid hormones production prior to menopause and for at least half of their production after menopause onset. The bottom line is: ALL steroid hormones are disrupted by chronic stress.
Besides its ill-effects on our hormonal balance and libido, stress is also considered to be the number one reason why people eat poorly and quit healthy lifestyles programs.[iii] This is further aggravating the problem since a bad diet and lack of physical activity also have a negative impact on our sex drive. However, with greater understanding of the root cause, comes a greater ability to rectify imbalances. Stay tuned next week for insights into what diets and supplements help improve these causes of low libido.
[i] Tong, Rosemarie. Feminist Thought: a more comprehensive introduction, 1998, pp. 27, 28
[iii] Nutritional Strategies for Wild Moods & Crazy Days. Managing the Stress Response. Functional Medicine Clinical Series. 2006. P.