Libido is an important aspect of health that often goes undiscussed in medical visits, but it is a topic worthy of attention as our bodies are designed to benefit from this aspect of ourselves beyond that of species survival. There are myriad benefits sexual interest and practices have on our wellbeing from the hormones, physical connection, and play involved, whether with self or others, and a decrease in these factors can signal an underlying health issue or lead to one. A lack of sexual desire is one of the most common complaints in the category of sexual dysfunction and can provide valuable insight into health, and for this reason should be addressed more often in medical settings. In understanding this importance, below is an overview of some of the top causes for low libido.
Worry over low testosterone is a common concern voiced by men but it affects women just as much as the main hormonal driver of libido. While there are diagnosable conditions that directly cause or predispose someone to low testosterone, today’s modern lifestyle is actually one of the greatest contributors to this problem as increased stress and poor sleep are common along with lack of physical activity and inadequate nutrition. This occurs because biochemical signaling in our bodies is largely directed by our daily activities and this includes our hormones. In the example of stress, this causes the body to produce more cortisol and studies show it tends to do so at the expense of testosterone – the more cortisol circulating the less affect testosterone seems to have. Cortisol also affects thyroid function which can influence the amount of testosterone available in the body. Poor sleep contributes in the same way as this is the body’s time for restoration and when it is cut short keeps cortisol high and disrupts other hormone-balancing processes, contributing to lower testosterone. Testosterone is also needed in the muscle-building process and therefore exercise is an important factor in testosterone production and levels. Concurrently, proper nutrition ensures the body has the building blocks to actually make testosterone (see below). While addressing these lifestyles are important, there are times when supplementing with testosterone or a testosterone precursor can be beneficial.
Hormones are made from the nutrients we ingest and sustaining a healthy, varied diet is essential to a balanced hormone status. On the macro level, adequate fat and protein are needed to provide the building blocks for all hormones while vitamins and minerals are necessary to drive these processes. Unfortunately, many individuals are deficient in these key nutrients, especially in the latter category of vitamins and minerals, due to poor diet and digestive function. These deficiencies not only contribute to hormonal imbalance but also poor sperm and egg quality and thus infertility risk. Optimizing nutrition also enhances our energy levels, mood, and cardiovascular health, further contributing to sexual health. While this is best achieved through diet, a supplement program tailored to individual needs can offer support while longer-term dietary changes are implemented.
Medication Side Effects
A side effect of many common prescriptions is loss of libido and/or decrease in sexual performance. SSRIs (a class of anti-depressant) and birth control medications are two pharmaceutical categories well-documented in regard to this, the former even having its own name: post-SSRI sexual dysfunction or PSSD. Birth control interferes with testosterone production while also increasing a protein in the body that binds to it, making it less available for the body to use. The mechanism for SSRIs effect on libido is less understood but is postulated to include dopamine-serotonin interactions as well as direct disruption to nerve and hormone signaling to the sexual organs. For those wishing to discontinue these medications, it is important to work with a provider well-versed in supporting the body holistically while these changes are made as to provide the best outcome for sustaining individual health goals once off them.
Poor Circulatory Health
There is a strong link between cardiovascular health and sexual function as vascular health affects the ability of blood to flow to the sex organs as well as stamina.6 In men, this most directly impacts erectile function as vessels within the penis responsible for erection are smaller than those of the heart and can be compromised before problems present in a standard cardiovascular exam. Damage to the blood vessels by way of plaque buildup and inflammation contribute to this, and cardiovascular health should always be considered when erectile dysfunction first presents. These same issues affect women although are less obvious where impaired blood flow to the sexual organs can affect sexual arousal, vaginal lubrication, and ability to orgasm. A heart-healthy diet such as the Mediterranean diet has been shown to benefit men with erectile dysfunction.
More often than not, a mental/emotional component is at play in low sexual desire and the underlying issues are almost always poor stress management, unresolved past trauma, and/or a loss of self. Many individuals today are overwhelmed and living a life incongruent with their needs and when this occurs it creates a loss of connection with self and with others. The ultimate outcome of this is an overall lack of intimacy in our lives and our culture is rampant with this issue. For this reason, it is becoming increasingly important to take time for ourselves and self-reflection to identify and appropriately address our personal needs. Good self-care habits, mindfulness practices, and strong community and social support are crucial to this process, as is working with therapists and other mental health facilitators when needed, and the scientific evident to support this is mounting; the implications of our emotional health to physical health such as libido is too strong to not make it a priority.
Not surprisingly, several of these factors are often at play. If you are experiencing low libido, working with a holistically-minded provider who can address these multiple factors with an in-depth assessment of your individual health needs is a great first step. In addition to addressing the foundations of health in diet and lifestyle considerations, support in the way of herbs, nutraceuticals, and other treatments can help in the immediate while the longer-term pieces are worked on, and practitioners trained in these therapeutics can help guide you in the appropriate and effective use of them.