May 26, 2011

Outsource Sex with Your Husband? Better Yet, Check Your Hormones!


“I would pay someone to have sex with my husband.” There were snorts and yips of laughter. I believe one woman even clapped. from The Sex Drive, Idling in Neutral – The New York Times 4/17/11

I read this article last month and wondered: Is this what we’ve come to? Wives outsourcing sex? Or it physiologic, i.e., is her thyroid wonky? Are her adrenals burned out? Is this woman in her 40s and idle libido is her harbinger of perimenopause?

By no means do I confine this problem to heterosexual couples: there is a phenomenon that cuts across sexual preference, and that is the following — high-libido partners are attracted to low-libido partners. And 70% of the low libido is hormonal in origin. Before you outsource sex with your husband, consider checking your hormonal balance sheet.

Stress, objectively measured as cortisol, has a lot to do with it. Women today are empowered in many ways – we are wildly successful entrepreneurs, in the C-suite, feminizing traditionally male domains. Yet there’s been significant cost hormonally and energetically. Are you feelin’ it?

In longitudinal measures of happiness, women are the scoring the lowest in decades. We’ve never been so preoccupied, stressed out and overwhelmed.  Is our lack of joy linked to low libido? Overdrive trumps our erotic natures?

New data confirms a possible link between career achievement and low sex drive. If you assess stress by measuring cortisol levels at work, women have double the cortisol of men. Not good.

It gets worse. Women head home after work and cortisol climbs still higher, according to John Gray, PhD, in his latest Men Are from Mars, Women Are from Venus book on hormones. Men? Their cortisol settles back down to a normal place once home.

As John puts it, your adrenal glands, which make cortisol, are a hormone factory which “abandons its other product lines” under stress. That means your cortisol bumps up, often above what your cells can handle, and over time you may become starved for other hormones such as thyroid, DHEA, testosterone, growth hormone, estradiol, and melatonin (for more info on the job description of these hormones, click here to my blog).

Hopefully some of you, Dear Readers, are skeptics and are wanting me to show you the data. For instance, does high cortisol really impact your thyroid? Yes, indeed! Want the mechanism? You make me proud. Here it is: high cortisol both slows down conversion of inactive thyroid hormone (T4) into active thyroid hormone (T3), and you make more reverse T3, which blocks the thyroid receptor.

If working women are the most stressed, I hypothesize that stay-at-home moms would have the best libido. Research confirms this. That’s not to say that staying home is stress-free; we just know stay-at-home moms appear to have greater sexual bandwidth.

While we women have fought for and witnessed significant gains across most professional domains, many of my patients feel disempowered when it comes to waning sex drive. They are firestarters in most realms of their lives, they feel shut down and despairing about their lack of interest in sex.

Time to turn that around by talking to your doctor about whether you’re satisfied with your sex life (and not taking the generic, reduce-your-stress dismissal). Track your sex drive along with other metrics of thyroid health – including faint stirrings of desire, fantasies, erotic dreams, receptivity to sex, affection, facility with orgasm.

Perhaps some of you have no problem with libido. Research shows that your true sex drive in partnership is not fully revealed until you’ve been in relationship for at least four years. So if you’re a serial monogamist, usually of two-to-three-year duration, you may not have collected the data on yourself. Time in relationship will reveal your libidinous truth.

Mating in captivity, as Esther Perel aptly put it, is neither easily understood nor amenable to quick fixes. But tweaking your hormones, cortisol, estrogen, progesterone and testosterone can help you make the most of your particular lot.

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Sara Gottfried, MD  |  Contribution: 1,600