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Hormone Help: Libido Help for Women

Q:  A 62-year-old woman started working with me recently, and one of her main goals is to boost her libido.  She says she loves that her husband is still “in the mood” at times, but even when they are on vacation, she’s just not interested.  She’s also got a lot of stress, so our sessions are focusing on reducing that.  But at her age, I have to assume that hormones are part of the problem.  Do you agree?   If you do, then what can you suggest I have her ask her doctor for in terms of testing to find out what the problem is?

A:  Yes, stress can be a major libido buster!  Especially if a big part of that stress is  in her intimate relationship.  But in an otherwise healthy relationship, post-menopausal, waning libido is commonly caused by hormones.   Far before menopause, women begin to produce less progesterone.  Among many other critical functions, progesterone is a woman’s precursor to testosterone.  DHEA is an adrenal hormone whose production also reduces as we age.  If your client is low on either DHEA and/or progesterone, then she may not be producing enough testosterone to boost her sex drive.  Yes, women make and need some testosterone!

Ideally, I recommend both blood tests and saliva testing too.  In this case, for progesterone, DHEA, and (very important) “free” testosterone (not just “total”) at a minimum.  Blood levels show what total amount of hormone has been produced and is in circulation.  Unfortunately, a blood level only reflects a single point in time, and hormone levels can vary substantially throughout a day.  Also, blood levels reflect total circulating hormone, and typically 90+% of our hormone is bound to proteins and thus kept “in storage”.  Salivary tests usually are collected 4+ times during the day and averaged to reflect a more accurate, typical level.  Also, the salivary glands filter out bound hormone.  This means a salivary test shows you how much of your hormone is actually unbound and therefore available to have cellular effects.

DHEA can be found in oral or transdermal supplements if needed (start very low for women ~10mg/day).  Progesterone can easily be found in health food store creams for transdermal application (many of my clients use ProgestaCare).  Testosterone creams are available from many physicians if test results warrant it.   I would also recommend she check her cholesterol, specifically her LDL and HDL levels.  Contrary to health myths otherwise, LDL cholesterol is important and plays many key roles in the body; it is the starting point for synthesis of all steroid hormones in the body (including all of these I’ve mentioned).

2 Questions for “Hormone Help: Libido Help for Women”

  1. 1

    Do you have insight into optimal levels of testosterone? In general, it seems that most practitioners go by conventional ranges for testosterone. I have also found that several functional medicine physicians follow conventional serum levels of testosterone, even in cases where women complain of low libido, muscle loss, and diminished energy, etc. I understand that optimal for one woman may be very different than optimal for another, especially if they started off with generally higher levels of testosterone. Curious if you may be able to clarify optimal ranges. Thanks.

    • 1.1
      SAFM Team says:

      Indeed, optimal hormone ranges will depend on the person and what their challenges are. Someone struggling with insulin resistance vs a post-menopausal woman will need completely different considerations. What is key about hormones is that the BALANCE of overall hormones is typically what creates health and wellness, not just ‘optimal’ level of one hormone. You may appreciate this chart from Dr. Gottfried that does a good job at summarizing the optimal levels of all hormones: https://thehormonecurebook.com/downloads/bonus-lab-ranges.pdf

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