However, Mr. T is far from the only hormonal or metabolic issue that can make us feel less than frisky. It’s also not typically low testosterone causing low libido in younger women or women with PCOS.
Testosterone is the hormone that comes to mind when we think about a lack of luster sex drive, and it is certainly a player – especially for women in perimenopause and post menopause. However, Mr. T is far from the only hormonal or metabolic issue that can make us feel less than frisky. It’s also not typically low testosterone causing low libido in younger women or women with PCOS.
Here’s what else to lookout for if you’re thinking “Honey, Not Tonight” All Too Often:
1. Low Estrogen
Estrogen is our Marilyn Monroe hormone. She’s responsible for our smooth, soft skin and hourglass figure. It makes us look feminine and feel sexy. Without her our boobs droop, our vaginas dry up and our ability to get aroused and have an orgasm disappears. She’s a heavy hitter when it comes to our libido.
Estrogen can dip low as we age, so good adrenal support is a must if you’re experiencing the hormonal fluctuations of perimenopause (fluctuating high and low estrogen, overall waning progesterone) or are past menopause as the adrenals play back up when our ovary production starts of hormones dip. Rhodiola 200mg 2-3 times a day is a good start, as is managing all those pesky life stresses (more on that here).
Estrogen can also be low when you have PCOS and aren’t ovulating properly. While most women with PCOS get estrogen dominant, they can still be low estrogen. More on making sense of that seemingly controversial statement about estrogen dominance here. Basically when we aren’t ovulating well, we aren’t kicking out enough estrogen from our ovaries thanks to faulty follicles that are a hallmark of PCOS.
You may not know if you are low estrogen or not without testing, but the longer your cycle is or the fewer periods you get in a year the more likely you are to be dealing with low estrogen as part of your PCOS picture.
In this case, or if you’re going through the perimenopause transition, then maca is the herb to try. Often a dose around 2000mg (1500-3000mg) per day does the trick. Try taking it only days 1-14 of your period and try it throughout, this is pretty individual for what works.
If you have PCOS and you feel worse on maca, we need to work more on low progesterone and estrogen dominance vs. just raising estrogen – as well as a host of other metabolic issues that are part and parcel with PCOS.
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Low thyroid can impact your sex hormones and your metabolism in oh so many ways so it can definitely be a potential cause of low libido. And remember that there is a high correlation between hypothyroidism, Hashimoto’s in particular, and women with PCOS as well as women going through menopause. If this sounds like you, there may be more than one cause of your low libido: low estrogen and low thyroid.
Not to mention inflammation from Hashimoto’s which impacts the effect of all hormone receptors, which can decrease the effectiveness of even normal looking hormone levels. More on getting your thyroid adequately worked up here.
3. Low Dopamine (And/Or High Prolactin)
Dopamine is our take charge, go for it, get it done, feel really, really good brain chemical. When it’s low we have disorganized attention, a short fuse for stress, depression that can come and go but when it’s there feels like life will never ever get better, cravings for sugary +fatty foods and to round out this terrible list: low libido.
Dopamine can be low for a variety of reasons, but it’s very common for women with PCOS to have low dopamine. This may be partly due to elevated prolactin, also common in women with PCOS.
This hormone is also elevated in breastfeeding moms, more on the hormonal downsides of breastfeeding here. What’s more is that prolactin itself can be a hindrance to our libido itself and it tends to make insulin resistance slightly worse…..PCOS ladies, we can have it rough in this department no doubt!
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Low dopamine can also be a cause of low thyroid as it’s a key neurotransmitter to get an adequate TSH signal to the thyroid to instruct it to make more thyroid hormone. In this case TSH is often below 1.8 on labs with borderline low T4 and T3. More on making sense of TSH here, especially if you have Hashimoto’s.
4. Low Fat Soluble Vitamins and Unhealthy Cell Membranes
Could that sound any less sexy? Probably not, but here’s why it matters to your sex life: All hormones work via receptors and receptors need a healthy cell membrane to live and work in. Enter vitamins A, E, D and a little something called phosphatidyl choline. Vitamin D gets all the attention, but vitamins A and E are also crucial for hormonal and immune health as well.
Both D and A can be tested via simple blood tests so that you can get your levels in adequate range. For vitamin E a good dose is around 400mg of mixed tocopherals (avoid supplements that contain only alpha form) per day and 400mg 1-2 times daily of phosphatidyl choline (which can be obtained on its own or as part of krill oil). And keep in mind that fat soluble vitamins compete for absorption so if you’ve been taking big doses of D and very little A or E, you’re likely quite deficient in these.
Note: vitamin K is the other fat soluble vitamin but use caution when supplementing as it can cause bleeding/clotting issues if you aren’t using professional guidance.
One more consideration for those of us with PCOS:
We often have elevated testosterone, or normal – but rarely low. One of the few bonuses of PCOS for many women is that the elevated testosterone can give them a boost in libido. It can also give them thyroid resistance, low progesterone, faulty ovulation, insulin resistance, weight gain, breakouts and unwanted hair – none of which feel particularly sexy.
So we don’t want to tank your testosterone, but we do want to manage it so that your overall hormonal balance is improved. 30mg of zinc works amazing here, as do herbs like nettle and saw palmetto found in my clear+normalize (2 caps twice daily).
Finally, How Sexy Is Your Mindset?
When we go through periods of low libido in a long term relationship or a marriage it can really take its toll. Even when you get your chemistry back on line it can be tough to get your sex life back on line as well. Increasing your desire is the first step, but be aware that it can take some reconnecting to put all the pieces of a great sex life back in place.
Therapy can be incredibly useful of course, but getting your mindset to come around is key as well.
If you’ve been lagging in the libido department for a while you simply may not see yourself as a sexual person any more or feel like you can’t connect to that sexy lady you once thought yourself to be. But you can change that as easy as you change your mind about a haircut.
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OK, it may take a little more getting used to than bangs or a new foil, but you get the idea. You have to start to see yourself as sexy, as desirable and you have to start seeing your relationship as one with a hot sex life – even if it isn’t quite there yet. It’s a case for pretending a bit until it feels real. And of course, good communication with your partner is paramount. And don’t give up, couples recover from this all the time, it just takes patience.