Women: Not Into Sex? Could be Hormone Imbalance


Forty-three percent of women report low libido, but in my practice, the numbers are much higher.

While libido is the most complex symptom that I work with by far, it often has biological determinants along with the more nuanced emotional pieces of couple connectivity, negotiation of sexual boundaries and divergent need/desire. In fact, 70% of low libido is due in part to a hormonal imbalance. For a questionnaire on the most common types, go here. Then again, low libido is usually multi-factorial.

What sets us up in a potential libido trap is that high-libido types are attracted to low-libido types, which places one on the path for disconnection unless one becomes an effective navigatrix. One important question for discernment is this: Are you satisfied with your sexual life? Are you or your partner experiencing any distress over your sexual connection?

What are the most common hormone imbalances I see?

  1. Low thyroid function. I find there is an epidemic of under-replacement.
  2. Estrogen dominance. Even if you estradiol is low, you can have a super-low progesterone and the net result is estrogen dominance.
  3. Adrenal dysregulation. Both high and low cortisol cause a problem here. High cortisol – enter the world of fight , flight collapse. Who wants sex when it feels like a tiger is chasing you? Your body helps you with this: cortisol blocks the progesterone receptor. Low cortisol – just too tired to care. A root canal sounds easier.
  4. Low androgens. Particularly in low adrenal function or burned out adrenals, there just aren’t the precursor hormones such as pregnenolone to make DHEA and testosterone. Low testosterone also decreases your conversion from T4 to T3. Ah, the interdependence of it all.

You may be reading this and thinking to yourself, “Hallelujah, that is one thing I don’t have to worry about.” Before you get too comfortable, please know that it takes four years to get to know a partner. Four years before your long-term libido is truly apparent, before you get past the more unconscious attraction that first fires up and feeds a relationship.

For those of you with kids, you know already that children hijack libido for 18 years and for most of us, regular luscious satisfying sex takes tremendous attention and planning. Imagine being Obama’s executive assistant or Oprah’s – that’s about the commitment you need to have.

In every workshop, I always get one woman who is having better, hotter sex than she was 10 years ago. Of course, I want to know her secret. It’s usually a combination of radical self care, deep emotional connectivity with her partner, and a commitment to an unfolding, deepening, mature sense of her erotic creature as she ages. Plus her hormones are where they need to be.

Written by Dr. Sara Gottfried


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