In today’s society, where sex is in your face every time you turn on the TV or open a magazine, you may think that having a low libido is abnormal. However, I’ve talked to enough patients over the years to know that intimacy takes many forms, and for many women—and couples—sex just isn’t that important, especially as they get older.
That said, if low libido is a problem, the first thing you need to do is look for and correct underlying causes. Many of my female patients tell me that fatigue, stress, and the sheer busyness of life push sex into the background. Others say that if a relationship isn’t working, sex is the last thing on their minds. And, men, don’t forget that romance, emotional closeness, and foreplay are important to women. To paraphrase comedian Billy Crystal, men just need a place to have sex, but women need a reason.
Prescription drugs can cause low libido and other sexual problems in women and men. At the top of the list are blood pressure meds, antihistamines, birth control pills, progestins (Provera), and especially antidepressants. SSRIs contribute to low libido and the ability to achieve orgasm in more than half the women who take them! Pharmaceutical companies are hard at work trying to come up with a prescription drug to boost libido in women. But why add another medication to counteract the negative effects of dozens of other drugs? This is disease mongering at its worst for patients and at its best for Big Pharma.
Boost Libido With Hormones
I recommend that you consider bioidentical hormone replacement therapy (HRT) to improve low libido. Hormones are inextricably linked with sex. The hormonal surge during puberty that reshapes the female body also sparks the sex drive, and fluctuations during the monthly cycle cause it to wax and wane. Then along comes menopause, which affects not only libido but all aspects of sexual function.
Estrogen and progesterone are the quintessential female hormones and have strong influences on sexuality. Testosterone, however, is the hormone of desire in both men and women. While bioidentical estrogen balanced with natural progesterone is an effective treatment for vaginal dryness, hot flashes, night sweats, mood swings, and other menopausal symptoms, the addition of natural testosterone will usually boost libido.
Here’s what one of my patients had to say about natural testosterone: “My husband and I have always had a very good relationship. When my interest in sex dropped off during early menopause, I wanted to do something about it for him as much as for me. I was surprised when Dr. Whitaker recommended testosterone, but it has really made a difference and things are back to normal.”
Are Hormones a Safe Treatment for Low Libido?
The popularity of HRT took a serious hit several years ago with the abrupt termination of the Women’s Health Initiative (WHI). This large, government-sponsored, placebo-controlled clinical trial was halted when it was discovered that the women taking Prempro (Premarin plus Provera) had a significantly greater risk of heart attack, stroke, blood clots, and breast cancer than those in the placebo group.
Millions of women, understandably alarmed, quit taking their hormones. And since that time, many have been afraid to use any form of HRT—conventional or natural. As it turns out, recent reanalysis of the WHI data show that these fears are unfounded in the majority of women. The dangers associated with using replacement hormones were applicable only to women who began HRT after age 60.
WHI did, however, underscore the obvious, but long-overlooked, fact that the type of hormones matter. The study used conjugated estrogens derived from horse urine, and progestin, adulterated progesterone that has a host of adverse effects and negates some of estrogen’s benefits. No wonder these drugs caused problems!
Correct Low Libido by Copying Mother Nature
Conventional physicians looking to boost libido are finally coming around to accepting what docs like us at Whitaker Wellness have known for decades: The safest, best tolerated, and most effective replacement hormones are bioidentical hormones, which are identical to what is produced in the human body, in doses customized for each woman.
At the clinic, we use estradiol, the body’s dominant form of estrogen, in transdermal creams that are rubbed into the skin. This delivery method not only ensures steadier blood levels of the hormone, but there’s a reduced risk of blood clots, which are associated with oral estrogen. Furthermore, while oral estrogen/progestin tends to increase fat and decrease lean body mass, transdermal estrogen is associated with improvements in body composition. And when applied directly to the vagina a couple of times a week, it effectively relieves vaginal dryness and atrophy.
The main form of progesterone we use is oral micronized natural progesterone although some women prefer topical creams. Unlike synthetic progestins—which are linked with worsening of cholesterol levels and other cardiovascular risk factors, weight gain, low libido, and mood swings—natural progesterone enhances the positive effects of estrogen and improves quality of life.
For testosterone replacement in women, we use a very small amount of bioidentical transdermal testosterone, alone or mixed with estradiol in the same cream.
DHEA Also Helps Boost Libido
Dehydroepiandrosterone (DHEA) may also help. A precursor to other hormones, DHEA is readily converted into testosterone in females, and a number of women who take it for general health enhancement report that it also helps to boost libido. Although results aren’t as predictable as with testosterone, DHEA has one distinct advantage: It doesn’t require a prescription.
I’ll leave you with these words of wisdom from humorist Dave Barry: “What women want: To be loved, to be listened to, to be desired, to be respected, to be needed, to be trusted, and sometimes, just to be held. What men want: Tickets to the World Series.”
How to Boost Libido: Recap
Most hormones for low libido require a prescription. To find a physician in your area familiar with hormone therapy, visit acam.org. To make an appointment with a Whitaker Wellness physician knowledgeable in bioidentical hormone replacement therapy, call 866-944-8253.
DHEA is available in health food stores or by calling 800- 810-6655. The usual dose for women is 25 mg per day. However, I recommend having your blood level of DHEA-S tested and working with your doctor to adjust your dose to maintain the high-normal level of a young adult.