I see a lot of couples and families young and old in my practice and libido is a common concern. This can be difficult to work through but offers an opportunity to strengthen the bond you have with your partner. Here is a quick checklist of things to consider for a healthy libido.
Manage Your Stress
There is no bigger libido killer… Stress will consume your thoughts and wreak havoc on your sex hormones. This is not a good combination for intimacy. A recent study showed that erectile dysfunction and low libido in young men was related to anxiety, depression and partner difficulties (1). We hear this over and over, that we need to manage our stress… well here it is again! Getting a grip on your stress doesn’t have to be difficult. Simply, it is prioritizing things that make you feel good and letting go of things that do not. This is different for everyone. Ideas include getting outside, dancing, exercise, meditation, hobbies, journaling, listening to or playing music, talking to a therapist etc. The bottom line is that the activity should make you feel lighter and more alive. An extra step that I like to suggest to patients is that you make a mental note as you engage in this activity that you are doing this for yourself, and that this is part of your self-care.
Communication is Key
Enough cannot be said for healthy communication in a relationship. This helps prevent tension between you and your partner and will help nip any potential issues in the bud. I know that this is pointing out the obvious; we have all been here. We know issues are much easier to deal with in their infancy, as compared to managing the emotional hurt that follows when issues grow. I do list this here however because it is SO common. The fact is that this is not always easy. Commitment between both you and your partner will help you find the best way to communicate. I recommend planning regular check-ins with yourself and your partner to ensure nothing is slipping through the cracks.
Put the Play in Foreplay
There is so much more to intimacy than intercourse. Foreplay allows a couple to relax into and explore their partner. Sex can be intimidating and emotionally taxing, especially if you or your partner have had troubles in the past. Extended foreplay can take the pressure off and bring the fun back into the bedroom. For some intercourse can be painful. Prolonged foreplay can increase lubrication in women which can alleviate pain during intercourse for some (2). If lubrication continues to be a problem, lubricants are advised. Please be conscious of the lubricant you use. Some of the ingredients you will want to avoid in these products include alcohols, nonoxynol-9, any petroleum-based ingredients, parabens, chlorhexidine gluconate, flavours (natural and artificial) and all sugars. I like to remind partners that penetration is only one small part of what can be enjoyed and does not need to be included. In fact, many women are unable to experience orgasm by penetration alone (3). Try exploring other options for sex play to bring back the play in your sex life. Who knows what you might learn about yourself or your partner? In some cases, starting with a simple massage can help partners reconnect.
Food for Play
For ages, people have been looking to food for help with libido. It was thought that some foods had aphrodisiac properties based on their shape; for example, avocado resembling a pregnant belly or the phallic appearance of asparagus. Instead, I would propose that you focus on a healthy diet to help prevent diseases such as diabetes and cardiovascular disease that can lead to sexual dysfunction (4, 5). I think you all have an idea of what this is: plenty of veggies, some fruit, healthy fats and proteins, whole grains, limited or no processed and refined foods. I would also suggest known food sensitivities should be avoided, as tummy trouble does not make for fun times between the sheets. Alcohol, and wine in particular, is often touted as an aphrodisiac and while it can make us feel more relaxed, there is a limit. A recent study has shown a linear relationship between erectile dysfunction in men and increasing alcohol consumption (6). This is not a new idea; many studies have been done. A study dating back to the 70s showed that increasing alcohol consumption has a negative proportional effect on female sexual arousal (7).
Make the Relationship a Priority
Nothing kills intimacy like not feeling as if you are a priority to your partner. It is very easy in a relationship to ignore the person you are with. The love and the commitment are there, but so are the burdens of modern life; does this feel familiar? It is easy to place your relationship with your partner at the bottom of the “to do” list because you assume that they will always be there. The fact is relationships need care and attention to grow. Without regular attention, they will fade. Here are some simple suggestions:
Schedule regular date nights
Scheduling intimacy
While this may take the spontaneity out of the picture, for busy couples this ensures intimacy remains a priority.
Take advantage of your common interests
Finding things outside the bedroom that you can enjoy together can help bring you closer.
Spend more time together
This can be as simple as finding ways to do some of the menial everyday tasks together, for example cooking a meal or washing dishes.
Do nice things for each other
Small gestures go a long way to let your partner know you are thinking about them.
Simple ideas could include leaving or sending love notes or simply asking about your partner’s day.
Sleep… the other thing we do in bed!
This should come as no surprise; being tired makes everything difficult including sex. There is research to confirm what we have all experienced. A 2015 study showed an increase in sexual desire in women who got a healthy duration of sleep as compared to women whose sleep was too long or too short (8). Another study done in men indicated a correlation between disordered sleep and low libido (9).
Exercise – of course!
Well, we have covered pretty much all the central tenants of health now: stress management, nutrition, mindfulness, sleep, and now exercise. It should come as no surprise that exercise is important for libido too. It has long been known that testosterone is important for libido in both men and women (10, 11, 12, 13), and resistance exercise can help boost testosterone (14). We also know that exercise is important for preventing a number of conditions that can affect sexual function and desire such as depression, cardiovascular disease and diabetes (15, 16, 17).
Common Supplements for Libido
Some supplements that are often used for libido and sexual disfunction include tribulus, maca, ginkgo, ginseng, vitex, fenugreek, L-arginine and vitamin B3. Supplements can be tricky and should be chosen specifically for you. Your specific case should be considered including other medications or supplements you may be taking. Consult your Naturopathic Doctor to find the best options for you.
Manage Your Health
There are many conditions that can lead to sexual dysfunction and low sexual desire. This can range from hormonal imbalances like hypothyroidism (18) or (peri)menopause (19), to metabolic disorders like diabetes (5), pain syndromes like fibromyalgia (20), and psychological disturbances like anxiety and depression (21). This is not always an easy thing to talk about, but it is important to mention to your health care provider, as it can be a symptom of an underlying condition. Sexual issues can also be caused by a number of medications as well as recreational drugs such as nicotine, cannabis, opioids, cocaine, MDMA, amphetamines and nitrite inhalants (22). If you are experiencing changes in your libido, sexual function or if intercourse is painful, talk to your Naturopathic Doctor for a full work up and for more guidance.
Photo Credits:
Photo by Lucas Favre on Unsplash
References:
Nguyen, H.M.T., Gabrielson. A.T., & Hellstrom, W.J.G. (2017, Oct). Erectile dysfunction in young men-a review of the prevalence and risk factors. Sexual Medicine Reviews, 5(4):508-520. https://doi:10.1016/j.sxmr.2017.05.004
Sutton, K. S., Boyer, S. C., Goldfinger, C., Ezer P., Pukal C. F., & Psych C. (2012, Jan). To lube or not to lube: experiences and perceptions of lubricant use in women with and without dyspareunia. Journal of Sexual Medicine, 9(1):240-250. https://doi.org/10.1111/j.1743-6109.2011.02543.x
Debby Herbenick, D.,Tsung-Chieh, J., Fu,J.A., Sanders, S.A. & Dodge, B. (2017, Aug). Women’s experiences with genital touching, sexual pleasure, and orgasm: results from a U.S. probability sample of women ages 18 to 94. Journal of Sex & Marital Therapy, 44(2):201-212. https://doi.org/10.1080/0092623X.2017.1346530
Archer, S.L., Gragasin, F.S., Webster, L., Bochinski, D. & Michelakis, E. D. (2005, Oct). Aetiology and management of male erectile dysfunction and female sexual dysfunction in patients with cardiovascular disease. Drugs and Aging, 22(10):823-844. https://doi:10.2165/00002512-200522100-00003
Kouidra, Y., Pizzol, D., Cosco, T., Thompson, T., Carnaghi, M., Bertoldo, A., Solmi, M., Stubbs, B. & Vernoese, N. (2017, July). High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies. Diabetic Medicine, 34(9):1185-1192. https://doi.org/10.1111/dme.13403
Wang, X. Y., Bai. Y.J., Yang, Y. B., Li, J. H., Tang, Y. & Han, P. (2018, Sept). Alcohol intake and risk of erectile dysfunction: a dose–response meta-analysis of observational studies. International Journal of Impotence Research. 30:342-351. https://doi:s41443-018-0022-x
Wilson, G. T., & Lawson, D. M. (1976). Effects of alcohol on sexual arousal in women. Journal of Abnormal Psychology, 85(5), 489–497. https://doi:org/10.1037/0021-843X.85.5.489
Kalmbach, D. A., Arnedt, J. T., Pillai, V., & Ciesla, J. A. (2015, May). The impact of sleep on female sexual response and behavior: A pilot study. The Journal of Sexual Medicine,12(5), 1221–1232. https://doi:10.1111/jsm.12858
KyuMun, J., JungChoi, S., Seung, M. R., Eun, B. H. & Joo, Y. (2018, Dec). Sleep and libido in men with obstructive sleep apnea syndrome. Sleep Medicine, 52:158-162. https://doi:10.1016/j.sleep.2018.07.016
Nathorst-Böös, J., Flöter, A., Jarkander-Rolff, M.,Carlström, K. & vonSchoultz, B. (2006, Jan). Treatment with percutaneous testosterone gel in postmenopausal women with decreased libido – effects on sexuality and psychological general well-being. Maturitas, 53(1):11-18. https://doi.org/10.1016/j.maturitas.2005.01.002
Travison, T. G., Morley, J. E., Araujo, A. B., O’Donnell, A. B. & McKinlay, J. B. (2006, Jul). The relationship between libido and testosterone levels in aging men. Journal of Clinical Endocrinology & Metabolism. 91(1):2509-2513. https://doi.org/10.1210/jc.2005-2508
Davis, S. R. & Tran, J. (2001, Jan). Testosterone influences libido and well being in women. Cell Press. 12(1):33-37. https://doi:org/10.1016/S1043-2760(00)00333-7
Jacobson, J. and Guay, A. T. (2002). Decreased free testosterone and dehydroepiandrosterone-sulfate (DHEA-S) levels in women with decreased libido. Journal of Sex & Marital Therapy. 28(sup1):129-142. https://doi.org/10.1080/00926230252851258
Cumming, D. C., Wall, S. R., Galbraith, M.A., & Belcastro, A. N. (1987, May). Reproductive hormone responses to resistance exercise. Medicine and Science in Sports and Exercise. 19(3):234-238. PMID: 3110538
Schuch, F. B., Vancampfort, D., Richards, J., Rosenbaum, S., Ward, P.B. and Stubbs, B. (2016, June). Exercise as a treatment for depression: a meta-analysis adjusting for publication bias. Psychiatric Research,77:42-51. https://doi.org/10.1016/j.jpsychires.2016.02.023
Lavie, C. J., Ozemek, C., Carbone, S., Katzmarzyk, P. & Blair, S. N. (2019, Feb). Sedentary behavior, exercise, and cardiovascular health. Circulation Research, 124:799-815. https://doi.org/10.1161/CIRCRESAHA.118.312669
Böhm, A., Weigert, C., Staiger, H. & Häring, H. U. (2016, Mar). Exercise and diabetes: relevance and causes for response variability. Endocrine, 51(3):390-401. https://doi.org/10.1007/s12020-015-0792-6
Gabrielson, A. T., Sarton, R. A. & Hellstrom, W. J. G. (2019, Jan). The impact of thyroid disease on sexual dysfunction in men and women. Sexual Medicine Reviews. 7(1):57-70. https://doi:10.1016/j.sxmr.2018.05.002
Dabrowska-Galas, M., Dabrowska, J. & Michalski, B. (2019, Dec). Sexual Dysfunction in Menopausal Women. Sexual Medicine. 7(4):472-479. https://doi.org/10.1016/j.esxm.2019.06.010
Besiroglu, M. D. H. & Dursun, M. D. M. (2019, Nov). The association between fibromyalgia and female sexual dysfunction: a systematic review and meta-analysis of observational studies. Int J Impot Res, 31:288–297. https://doi.org/10.1038/s41443-018-0098-3
McCabe, M. P., Sharlip, I. D., Lewis, R., Atalla, E., Balon, R., Fischer, A. D., Laumann, E., Sun, L. & Segraves, T. (2016, Feb). Risk factors for sexual dysfunction among women and men: a consensus statement from the fourth international consultation on sexual medicine 2015. Journal of Sexual Medicine, 13(2):153-167. https://doi.org/10.1016/j.jsxm.2015.12.015
Ghadigaonkar, D. S. & Murthy, P. (2019, June). Sexual dysfunction in persons with substance use disorders. Journal of Psychosexual Health, 1(2):117-121. https://doi.org/10.1177/2631831819849365
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