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).