Libido or sexual desire is a good indicator of overall health. The presence of libido or lack thereof can indicate someone’s mental and physical functioning. Hypoactive sexual desire disorder (HSDD) has been shown to affect up to 10% US women and thought to be the most common form of female sexual dysfunction (Simon, 2010). HSDD presents as persistent absence of sexual thoughts including desire for sexual activity that causes personal distress and internal difficulties. Oxytocin is a hormone that is release during sexual activity that has many health benefits from mood enhancement, lowered stress hormone called cortisol and lowered blood pressure. Sex releases endorphins and neurotransmitters like dopamine and oxytocin. These hormones affect mood by creating positive feelings of affection, attachment and relationships. When in a state of constant stress or dropping hormone levels, libido can be the first thing to disappear. A great example of this major drop in hormone levels is menopause. The studies show the importance of balancing your hormones helps complement one another, which strengthens libido and one’s overall health.
The primary hormone discussed when relating to libido in women is testosterone. However, this is not the only one associated with helping modulate sexual desire. In fact all ovarian steroids can help libido in women which includes estradiol, testosterone and progesterone. The term female androgen insufficiency has been popularized to focus in on a way to treat low libido in women. At this time there are no approved treatment options for this, but bio-identical hormone therapy has been shown to alleviate affected persons in many situations.
Progesterone is well known as a balancing hormone of estradiol; therefore having some opposing actions as estradiol. It’s believed that high progesterone levels are responsible for premenstrual syndrome (PMS) symptoms and suppression of libido, while low levels can lead to estrogen dominance and sexual dysfunction. Thus research shows that how the intricate balance between estrogen and progesterone plays a major role in health and libido. Roney et al found that salivary estradiol was a significant positive predictor of sexual desire whereas progesterone actually a negative predictor (Roney, 2013). Interestingly, this study did not reliably associate testosterone with sexual desire. Another study by Dennerstein et al, followed 226 perimenopausal women with similar results with self-reported sexual responsiveness. Estradiol levels were found to significantly correlate with sexual desire and responsiveness whereas testosterone did not (Dennerstein, 2002). The distinction does make sense clinically since testosterone is metabolized by an aromatase enzyme that converts testosterone into estradiol as a way to eliminate testosterone from the body. Alexander et al has found that testosterone therapies were only effective at improving sexual functioning when combined with estrogen therapy (Alexander, 2004). All of this show a balance in ovarian steroids to be important for libido and focusing on one will not likely solve the underlying issue.
Ultimately, the important takeaway of this message is that all these hormones play an important part in your health and well-being. Estradiol, progesterone and testosterone work together harmoniously to help how you feel and promote a healthy libido. Evaluating and often treatment for all bio-identical hormones addresses all components to begin a healthier, happier portrayal of you.
Alexander J.L., Kotz K., Dennerstein L., Kutner S.J., Wallen K. & Notelovitz M. (2004) The effects of postmenopausal hormone therapies on female sexual functioning: a review of double-blind, randomized controlled trials. Menopause. 11(6):749–765
Cappelletti, M., & Wallen, K. (2016). Increasing women’s sexual desire: The comparative effectiveness of estrogens and androgens. Hormones and behavior, 78, 178–193. doi:10.1016/j.yhbeh.2015.11.003.
Dennerstein L., Randolph J., Taffe J., Dudley E., & Burger H. (2002). Hormones, mood, sexuality, and the menopausal transition. Fertility and Sterility. 77:42–48.
Roney J.R. & Simmons Z.L. (2013). Hormonal predictors of sexual motivation in natural menstrual cycles.
Hormonal Behavior. 63(4):636-45. doi: https://doi.org/10.1016/j.yhbeh.2013.02.013
Simon, J.A. (2010) “Low Sexual Desire: Is it All in Her Head? Pathophysiology, Diagnosis, and Treatment of Hypoactive Sexual Desire Disorder. Postgraduate Medicine, 122:6, 128-136, doi: 10.3810/pgm.2010.11.2230.