sex health blog
July 22, 2020

Sex is a fundamental piece of any relationship. It stimulates closeness, bonding, and well, it’s fun! We at Potter’s House know how important this aspect of life can be, and we advocate for healthy and safe sexual activity for all of our patients.

Sometimes you just can’t get “in the mood”, and you are not alone. Just within our Potter’s House community, we have hundreds of men and women who struggle with this. We are going to focus primarily on women and share advice to improve low libido (sex drive).

Although not the focus of this blog post, anxiety, depression, body image issues, and stress are major factors that play a role in your sexual health. Be sure to talk to your doctor about your sexual health concerns so they can eliminate any physiological or psychological conditions that could be contributing.

40% of women report some sort of “sexual dysfunction,” which includes lack of sexual desire (libido), impaired arousal, difficulty to orgasm, and pain with sex.1 This is a lot of women! Just because women struggle with some of these issues, it does not mean we are “dysfunctional.” This issue is common, and there are methods that can help!

Let’s talk about some of the options:

Option #1: Talk it out with a counselor2

  • A sex therapist will focus primarily on your sexual relationship with your partner.
  • A couples counselor will focus more on the communication and trust within your relationship, which is also an essential part of your sexual experiences.

Option #2: Lifestyle modifications

  • Better sleep – According to The National Sleep Foundation, one third of women make sex less of a priority when then are sleep-deprived.3
  • Reducing stress – When you are stressed, sex is the last thing on your mind. Your body focuses all its energy on your vital organs. In addition, stress causes an increase in cortisol production which disrupts the production of your other hormones, including those that regulate your sex drive.2,4 As women, we try to do it all, but it takes a toll on our bodies. Here are some suggestions to help reduce stress:
    • Establish support for work/home responsibilities.2
    • Practice yoga.5
    • Meditation
  • Novel experiences – Dopamine triggers your motivation and desire to have sex. Dopamine is produced in your brain when you experience excitement or pleasure. Examples include riding a roller coaster, traveling, eating delicious food, date night, and getting frisky!2,6
  • Physical touch – Cuddling, hand holding, and hugging are a few physical acts that can increase levels of oxytocin. It is also the hormone produced after orgasm that gives you the feeling of “bonding”.2,7 The more oxytocin your body produces (the more physical intimacy you experience), the more your body wants – increasing your desire.
    • Low levels of oxytocin can lead to decreased sexual desire.7
  • Exercise – Exercise has been proven to increase stamina, body image, and sex drive.2 This could be in part because building large muscles, like those in your arms and legs, actually boosts your natural testosterone levels.1,8 We’ll discuss this in more detail in the next section.
  • Setting the mood – Lavender (capsules or aromatherapy) has been shown to improve sexual desire as well as sleep, depression, and anxiety.9 A lavender candle, topical oil, or a diffuser is a great addition to the bedroom.

Option #3: Compounded prescription medications1

  • Libido Cream – This cream is composed of several different ingredients. These ingredients help to bring more blood flow to the clitoral and vaginal tissues, making the area more sensitive and easier to orgasm.
  • Testosterone – Women need testosterone too, although in much smaller doses than men. It can be applied topically as a cream or taken as a lozenge that dissolves under the tongue. Bringing testosterone levels up to an optimal level can help increase your sexual drive and desire.
  • Oxytocin – Remember, this is your lovey-dovey, bonding hormone. It is available to be dissolved under the tongue as well, or in a nasal spray. Oxytocin is a natural hormone produced by your body during intimacy, like hugging, cuddling, holding your baby, and having sex. The best part is, the more oxytocin you have, the more you want to partake in these kinds of activities. It is your snuggle hormone! (We also recommend this for men too).
  • There are other prescription medications available. Please talk to your doctor or pharmacist about these options if you would like to learn more.

Option #4: Natural Supplements

  • DHEA – 5-15mg daily
    • This hormone is naturally made in your body and is essential for making testosterone (which we know is related to sex drive). Supplementation can help to replenish your testosterone levels if they are low, which happens naturally as we age.10
  • Manganese – 15-30mg daily
    • The mechanism of how this supplement works is unknown, but small studies have shown that it can improve sex drive.10
  • Vitamin C – 3000mg daily
    • Vitamin C reduces stress and inflammatory markers. These markers are a leading cause of dysfunction of bodily processes, including libido.10
  • Gingko Biloba extract – Approximately 200mg daily
    • Anti-depressant medications can cause sexual dysfunction. This supplement has been used in combination with anti-depressants to counteract that effect.10

So, we’ve discussed methods that can improve your sex drive, but what about things that can worsen it? Let’s identify possible factors in our lives that could be lowering sex drive.

Medications and certain health conditions can decrease sexual drive and impair ability to orgasm.4 The following is a list of medications and health conditions most commonly seen in our patient population that are associated with this.4 If you worry that this could be impacting you, please talk with your pharmacist or health care provider.

Medications that can reduce libido:

  • Antidepressants
  • Spironolactone
  • Hydochlorothiazide
  • Oral Contraceptives

Conditions that can reduce libido:

  • Menopause2
  • Pregnancy/breast feeding2
  • Obesity
  • Hypothyroidism – Suboptimal thyroid levels affect hundreds of bodily processes including your libido.4,10
  • Iron deficiency – Women with chronically low iron can have increased stress and anxiety contributing to sexual dysfunction. Significant improvements have been seen after 3 months of optimizing iron levels.10

Your partner must be part of the treatment plan. Not every woman requires the same things to feel desire or have an orgasm. It may be time for you and your partner to work together and experiment with different ideas. Whether it be through counseling, lifestyle changes or medications, find what works for YOU. Don’t forget to incorporate date night – let’s get those dopamine and oxytocin levels up (for both of you)!

Sexual health is an area of life many couples may have challenges with. We know, it can be an awkward subject, but please do not hesitate to reach out to one of our pharmacists with any questions. We are here to help!

Book recommendations for additional help:

  • Becoming Cliterate: Why Orgasm Equality Matters–And How to Get It. By Laurie Mintz
  • The Joy of Sex, by Alex Comfort
  • Becoming Orgasmic: A Sexual and Personal Growth Program for Women, by Julia Heiman and Joseph Lopiccolo
  • For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life, by Jennifer Berman, Laura Berman, and Elisabeth Bumiller
  • Getting the Sex You Want: A Woman’s Guide to Becoming Proud, Passionate and Pleased in Bed, by Sandra Leiblum and Judith Sachs
  • Come As You Are: The Surprising New Science That Will Transform Your Sex Life, by Emily Nagoski
  • I [heart] Female Orgasm: An Extraordinary Orgasm Guide, by Dorian Solot and Marshall Miller
  • Real Sex for Real Women: Intimacy, Pleasure & Sexual Wellbeing, by Laura Berman
  • Hot Monogamy: Essential Steps to More Passionate, Intimate Lovemaking, by Patricia Love and Jo Robinson
  • Ruth’s Sex after 50: Revving Up the Romance, Passion & Excitement, by Ruth Westheimer
  • Passionate Marriage: Keeping Love and Intimacy Alive in Committed Relationships, by David Schnarch
  • Healing Painful Sex: A Woman’s Guide to Confronting, Diagnosing, and Treating Sexual Pain, by Deborah Coady, MD and Nancy Fish, MSW, MPH

Websites recommendations for additional help:

References

  1. Goldstein I, Kim NN, Clayton AH et al. Hypoactive Sexual Desire Disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) Expert Consensus Panel Review. Mayo Clin Proc. 2017 Jan;92(1):114-128. doi: 10.1016/j.mayocp.2016.09.018. Epub 2016 Dec 1.
  2. Low Sex Drive In Women. MayoClinic.org. https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/symptoms-causes/syc-20374554. Updated March 28, 2020. Accessed June 6, 2020.
  3. This Is Your Body On No Sleep. SleepFoundation.org. https://www.sleepfoundation.org/articles/ your-body-no-sleep. Accessed June 6, 2020
  4. Wilson, J. Adrenal Fatigue: The 21st Century Stress Syndrome. Petaluma, CA: Smart Publications; 2001.
  5. Dhikav V, Karmarkar G, Gupta R, Verma M, Gupta R, Gupta S, Anand KS. Yoga in female sexual functions. J Sex Med. 2010;7(2 Pt 2):964. Epub 2009 Nov 12.
  6. Johnathan P Cumberwell. Dopamine, Erectile Dysfunction And Libido. https://truelibido.com/dopamine. Accessed April 22, 2020.
  7. PsycohologyToday.com. https://www.psychologytoday.com/us/basics/oxytocin. Accessed June 28, 2020
  8. Function of the Male Reproductive System. In: Barrett KE, Barman SM, Brooks HL, Yuan JJ. Ganong’s Review of Medical Physiology, 26e New York, NY: McGraw-Hill;. http://accesspharmacy.mhmedical.com.mwu.idm.oclc.org/content.aspx?bookid=2525&sectionid=204296105. Accessed May 15, 2020.
  9. Roozbeh N, Ghazanfarpour M, Khadivzadeh T. Effect of Lavender on Sleep, Sexual Desire, Vasomotor, Psychological and Physical Symptom among Menopausal and Elderly Women: A Systematic Review.J Menopausal Med. 2019 Aug;25(2):88-93. doi: 10.6118/jmm.18158. Epub 2019 Jun 5.
  10. Gaby, A. Nutritional Medicine Second Edition. Sexual dysfunction (female). Fritz Perlberg Publishing. Concord, NH. 2017. p893-894.

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