Hormones and Libido – “Get that Skip back in your Step”

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A healthy libido is important in many ways that extend beyond the bedroom, and therefore the condition should not be dismissed. When libido is low, it can be a sign of other health issues, i.e. diabetes, cardiovascular disease, kidney disease or cancer. Testosterone is central to the issue and many causes are associated with its deficiency. Although treatments are limited, the natural hormone therapy known as bioidentical hormone replacement therapy, or “BHRT”, is an option that is safe and effective. This is not to suggest overlooking the fact that a good attitude, nutrition, lifestyle, and exercise also play a significant role. For now, let’s shine the light on what may be zapping your zazz.

Causes of Low Libido and Reduced Testosterone

Recognizing known hormone disruptors and minimizing exposure to them is a big step in the right direction. The following are known contributors:

  • Stress
  • Lack of sleep
  • Low thyroid
  • Depression
  • Menopause
  • Diabetes
  • Antidepressants
  • Birth control
  • Tobacco
  • Overuse of alcohol
  • Marijuana
  • Chemical exposures
  • Breastfeeding
  • Diet
  • Pain and pain medications
  • Cancer and kidney disease
  • Heart disease

What is Low Libido?

The literature often refers to low libido as hyposexual desire disorder (HSDD), which is carefully defined to avoid confusion with a circumstantial loss of interest in sex: “Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity…. taking into account factors that affect sexual functioning, such as age and the context of the person’s life.”

The simple definition of low libido is: “A lack of psychic and emotional energy associate with our instinctual biological drive.”

In the late 19th century, “…sex after 50 was often deemed to be exhausting and injurious to body and soul, as the physical function and desire waned”(Marshall, 2010). The advent of Viagra, in 1998, was pivotal for the subject of sexual health on many levels. However, while the drug addressed the mechanics, it failed to compensate for desire and other consequences of low testosterone. It has since been found that combining the erectile dysfunction (ED) drug with testosterone offers greater benefit in many cases. As a result, and due to the association between the two, experts recommend testing for low testosterone in those struggling with ED.

Surprises about low libido:

  • Anti-depressants actually reduce sexual desire (due to too much serotonin).
  • Oral contraceptives reduce “free” testosterone levels and libido, since they increase SHBG (sex-hormone-binding globulin), causing testosterone to stick to your cells, and preventing it from flowing freely through the body.
  • Altered thyroid function can impact sexual function in both men and women, even if the thyroid hormone levels are only slightly off.
  • The labs adjust the “normal” range to accommodate for reduced levels in the population, so don’t think you’re crazy.
  • Athletes often notice testosterone reduction more so than non-athletes since they were higher to begin with, yet lab results could still be “normal”.
  • Americans have larger decrease in testosterone levels due to regulations for fire retardant chemicals on furniture, carpets, etc. These chemicals are banned in other countries.

What about Testosterone?

Testosterone is important for both sexes as it not only helps regulate sex drive, but also has a role in brain function, bone mass, muscle mass and fat distribution. It’s therefore not surprising that studies have found percent body fat, abdominal body fat, and insulin levels are all inversely related to total and “free” testosterone concentrations. This correlation punctuates the importance of diet and lifestyle, factors we can generally control. The benefits of doing what we can to improve in these areas should not be underestimated, even if it doesn’t fully resolve the problem. It also compliments benefits of hormone therapy.

It’s well-established that testosterone levels naturally diminish in the process of aging. However, in the past two decades there has been a notable declined in men’s average testosterone levels at every age, extending beyond normal aging. Contributing to the problem are the many hidden chemicals we are exposed to in our daily lives, i.e. pesticides and chemical fire retardants. These effects are highlighted in Californians who exhibit the greatest testosterone decrease, and also live in a state requiring high levels of chemical fire retardants in furniture. A bill was recently passed to remove the policy, however it will take years before it’s no longer a public health issue.

Treatment Options

Over 70% of women with low libido have correctable hormonal imbalances and similar estimates have been published for men. Just because hormone levels drop, does not mean they can’t be restored with the right treatment. Currently, BHRT is the safest and most effective option available. Hormone replacement therapies are not the same, and unfortunately the harmful health effects of synthetic hormone replacement (HRTs) have stained the reputation of all forms. Unlike the synthetic versions, BHRTs come from plants and are the same molecular structure of hormones naturally made by the body. In addition to improving libido, one can benefit from the numerous health benefits that come with youthful hormone levels, including age related diseases.

Due to its complexity, optimizing hormone levels requires the expertise of a trained BHRT professional that works with a compounding pharmacy to combine and customize dosages. Testosterone cannot be properly restored without also considering estrogen and progesterone, since optimal health requires “hormonal balance”. The hormones all affect each other, which is why the term “balance” is so commonly used. Adding to the picture is the recent discovery that thyroid hormone levels (T3) have a bigger impact on libido than previously thought (for both sexes), thus it’s important to factor it into the equation as well. A good BHRT practitioner will offer a comprehensive approach tailoring a treatment to safely address your needs so you can get back that extra skip in your step.


1. Clayton, A. The pathophysiology of hypoactive sexual desire disorder in women. Int J Gynaecol Obstet. 2010 Jul;110 (1):7-11.

2. Fishman, J. Flatt, M. Bioidentical Hormones, Menopausal Women, and the Lure of the “Natural” in U.S. Anti-Aging Medicine. Soc Sci Med. 2015 May; 132:79-87

3. Krajerska-Kulak, Sengupta P. Thyroid Function in Male Infertility. Front Endocrinol (Lausanne). 2013; 4:174.

4. Lord, D. The Benefits of Testosterone for Men and Women. NAVA Health and Vitality Center website. Published May 13, 2015.

5. Marshall, B. Science, medicine and virility surveillance: ‘sexy seniors’ in the pharmaceutical imagination. Sociology of Health and English. Feb 8, 2010; 32(2): 211-22.

6. Meyer, P. [Testosterone therapy in female hypoactive sexual desire disorder]. Rev Med Suisse. 2016 Mar 16;12(510):540-3.

7. Somerville, H. Fire retardant chemicals found in small group of Californians. The Mercury News Business. Published Nov. 12, 2014.

8. Yassin, A. Saad, F. Testosterone and Erectile Dysfunction. J of Andro. November/December 2008; 29 (6) 593–604.

About Holtorf Medical Group

The Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease.

We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.