Low Sex Drive – Why It Happens and How To Change It
Our ovaries make testosterone directly as well as produce progesterone, which is a building block for other hormones including testosterone. But to do so they require cholesterol. If you are eating a low fat diet, there may not be enough cholesterol to support production of all the hormones we require because our brains and cells need cholesterol too.
Testosterone can also be made through the conversion of DHEA, a hormone secreted by the adrenal glands. But if stress is present, then DHEA will be diverted into cortisol instead.
Both healthy eating and a low stress environment are required for optimal hormonal balance and I see this in my practice all the time – women who are able to maintain good testosterone levels through perimenopause typically have better nutrition and more balanced adrenal function.
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Hysterectomy and Surgical Menopause
We just learned that the ovaries are key to hormonal function. This poses a challenge to the almost one in four women who will reach menopause as a result of surgery or medical treatments that can result in a loss of normal ovarian function. When this happens, sexual issues very likely result, as testosterone production will be reduced or eliminated completely.
This will definitely be the case with a total hysterectomy in which both the uterus and the ovaries are removed. It may also occur with a partial hysterectomy, as even if you maintain your ovaries after surgery, ovarian circulation is compromised in more than half of these cases.
For more information, read our many informative articles in the Hysterectomy section of our Health Library.
Since testosterone is so important for arousal and response as well as lubrication and orgasm, this impacts the sexual experience of millions of women.
If you have your ovaries removed or find your ovarian function to be reduced after surgery, you’ll want to work with your practitioner to explore your hormonal options such as prescription testosterone. But many women think taking prescription testosterone is an easy and quick fix to increasing their sexual desire.
At Women to Women, we discourage jumping to prescriptions as the easy answer. That’s because low testosterone isn’t the problem – it’s the symptom of another problem. Addressing that concern, whether it is physical or emotional, is always a better first step. Most of the time, low testosterone can be rectified with nutrition, supplements and stress management.
Vaginal Dryness
Another physical cause of lower sexual drive is the discomfort that many women feel as they experience physical changes in the vagina. As estrogen levels decline during perimenopause, thinning, tightening and dryness may occur in the vagina and the vulva. In some cases, this can lead to discomfort or even intense pain during sex.
Vitamin E suppositories twice a week can make a huge difference for many women and water based lubricants can help reduce friction during intercourse. Dietary changes, supplements, and in some cases, natural progesterone cream are usually helpful as well.
If your body has adequate support, it can make estrogen from secondary sources even if your ovaries are compromised, so treating both the cause (hormonal balance through better nutrition and lifestyle changes) and the symptom of vaginal dryness is important.
Of course, drinking lots of water can help as well. Any time you are experiencing dryness, whether it’s in your vagina, your mouth, or your skin, it’s a sign that your mucous membranes are dry and more water is a great way to keep them moist from within.
In some cases, good nutrition, hydration and lubrication should do the trick. But sometimes, they just aren’t enough. When they aren’t enough, there are prescription estrogen products that can be applied topically to the vagina. Low-dose estriol vaginal cream can be made by compounding pharmacies and does not carry the health risks of oral synthetic HRT.