Patients often shy away from discussing the common concern of sexual dysfunction. But depending on the stage of life you’re in, sex hormones can play a crucial role in maintaining balance during sexual development, reproduction, and aging.
While women and men can experience sexual dysfunction at any age, it becomes more prominent with age as sex hormone production slows down. Before the age of 40, most men and women who experience sexual dysfunction are experiencing it due to indirect changes to their hormone levels caused by a variety of life stressors.
Hormones are controlled and regulated as part of the endocrine system. This system starts at the hypothalamus and pituitary gland located in the brain and travels down to the thyroid, parathyroid, adrenals, pineal body, and reproductive organs.
The main hormones involved in sexual dysfunction are testosterone, progesterone, and estrogen. These hormones work as messengers throughout the body to help with reproduction and sexual development, as well as regulating bone and muscle growth, cholesterol levels, and body fat distribution.1
Sexual dysfunction can be categorized as:
Sexual intercourse and activity begin with sexual desire (libido), which is regulated—both in men and women—by the hormones testosterone and dehydroepiandrosterone. Without sexual desire, arousal or sexual activation becomes difficult to access and can domino-effect its way to preventing orgasm. Sexual health is impacted by a number of factors, both in and out of the bedroom, for both sexes.² Discerning whether or not it is a temporary issue or a more permanent functional endocrine problem becomes important as symptoms begin to interfere with everyday life.
Hormone levels in women fluctuate on a monthly basis from the age of puberty until menopause. During the monthly menstrual cycle, libido levels are at their highest before and during ovulation. For premenopausal women, factors that may affect or impede sexual function include:³
Sexual dysfunction for women who are approaching menopause is primarily due to a drop in estrogen and a slow decline of testosterone. While this process is a natural part of aging, some women may experience more severe symptoms than others. Signs of hormonal imbalance in menopausal women include:
Sexual dysfunction in men, as in women, can happen for a multitude of reasons. For men, there are two types of sexual dysfunction: erectile dysfunction (ED) and ejaculation disorders. While testosterone levels are associated with low libido, they are rarely the only cause of sexual dysfunction in men. For this reason, comparing testosterone levels to sex drive is not often useful for diagnosis.
In reality, sexual dysfunction in men is often due to the following underlying issues that, in combination with hormonal imbalance, cause both ED and problems ejaculating:
For men under the age of 30, while low testosterone can strongly contribute to sexual dysfunction, oftentimes it is environmental factors and lifestyle choices that can zap sex drive and performance. In addition to the stress that a demanding workplace, relationship, or financial burden can create, xenoestrogens are another collective of culprits that can wreak havoc on the endocrine system.
Xenoestrogens, known as endocrine disrupters, mimic the hormone estrogen and cause a chemical imbalance known as estrogen dominance. While this can happen in both men and women who overexpose themselves to xenoestrogens, men, in particular, need to be wary, as experts have linked xenoestrogens to the rise in prostate diseases. Xenoestrogen compounds can be found in plastics, pesticides, body wash, and lotion products, as well as meat and dairy products treated with growth hormones.4,5
Treatment options for sexual dysfunction in men and women depend on the root of the problem. If, after consulting a physician, you discover that the root cause behind your sexual dysfunction is endocrine-based, than it may require hormone replacement therapy, especially if you are reaching the natural stage of hormone decline later in life.
For most people, however, sexual desire and arousal issues can be managed and changed with an alteration to their lifestyle. One way you can address underlying emotional and psychological barriers to sex is by talking to a counselor or therapist. Communicating with a professional about experiences with sexual trauma, shame, or psychological issues such as stress and depression can have a major positive impact on your body image, self-esteem, and overall sense of well-being. Adjusting your lifestyle to include exercise, a healthier diet, and a better sleep routine can also work wonders to bring balance to your life and, indirectly, your endocrine system.
Addressing concerns about sexual dysfunction can be both difficult and frightening, but that shouldn’t stop you from taking action if you’re feeling unsatisfied. Depending on your age and lifestyle, the reason and cause of your sexual dysfunction may vary. Talking with a doctor you trust and feel comfortable with is important to ensure you get the proper care. In the end, it will help you learn about the steps you need to take to keep your sexual health balanced and your sex life happy.
Fred Pescatore, MD, is a traditionally trained physician practicing nutritional medicine. To pursue his vision of a more personalized and healthful program, Dr. Pescatore opened Partners in Integrative Medicine. He is the author of several important books, including his newest book, The Hamptons Diet Cookbook, the follow up to his NY Times best seller The Hamptons Diet. He was the Associate Medical Director at the famed Atkins Center for five years. He is the President of the AHCC Research Association, President of the International and American Association of Clinical Nutritionists and is a member of the National Association of Physician Broadcasters, amongst other organizations. For more information, visit www.hamptonsdiet.com.
Sources:
¹“Hormones that Affect Sexual Desire - Our Bodies Our Selves.” 2015. https://www.ourbodiesourselves.org/book-excerpts/health-article/hormones-affecting-sexual-desire/. Accessed November 20, 2019.
²“What is Sexual Dysfunction? - Healthline.” 2016. https://www.healthline.com/health/what-sexual-dysfunction#bad-night-vs.-disorder. Accessed November 20, 2019.
3“What to Know About Hormonal Imbalances - MedicalNewsToday.” 2018. https://www.medicalnewstoday.com/articles/321486.php. Accessed November 20, 2019.
4“Endocrine Disruptors and Prostate Cancer Risk - NCBI.” 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2822396/. Accessed November 20, 2019.
5“Low Testosterone and Sex Drive - WebMD.” https://www.webmd.com/men/how-low-testosterone-can-affect-your-sex-drive#1. Accessed November 20, 2019.
6“Female Sexual Dysfunction - Hormone Health Network.” 2017. https://www.hormone.org/diseases-and-conditions/female-sexual-dysfunction. Accessed November 20, 2019.