Valentine’s Day. Love, romance and possibly a little more rambunctious activity should be in store for most couples but, unfortunately, too often women as young as their early 30’s and men in their early 40’s tell me that they rarely have the energy for spontaneous, joyful sex.  Even worse, they report little sexual desire and even tell me “I would rather have an extra hour sleep.” If you can identify, you are not alone.  According to the Masters and Johnson Institute, at least a third of American couples of all ages experience a lack of sexual desire.

I think the world would be a better place if more people, who are blessed to be in relationships with people they care about and trust, would have sex more often.  This is not just my personal opinion. Scientific evidence is accumulating to support what many have suspected all along: good sex not only adds great enjoyment to our lives, but it also actually improves our health and may even contribute to our longevity. In his book Sexual Healing, Dr. Paul Pearsall, Director of Behavioral Medicine at Detroit's Beaumont Hospital, states:  “When we experience intimate, mutually caring sexual intimacy, we may experience a measurable change in neuron-chemicals and hormones that pour through the body and help promote health and healing.”

My guess is that you probably agree with the idea that “more sex is a good thing” but how to translate that idea into your everyday reality may seem daunting.   In working with me to write From Belly Fat to Belly Flat, Genie had the opportunity to talk to many women and men about their sex drive, or lack of.  The statements that seemed to encapsulate the basic issue came from Sharon, age 37, and Dave, age 42.  Sharon said, “Ms. James, it is just plain hard to feel sexy and ‘in the mood’ when you are bone tired and, when you look in the mirror, you think you look like a potato.”  Dave remorsefully reported, “Once I turned 40 it seemed like my giddy-up just got gone.”

Can you identify with Sharon or Dave?  If so, you may be also suffering from hypo-active sexual desire disorder, more commonly referred to in lay language as "low libido".   It is important for you to understand that if you are a woman over 30 or a man over 40 and you have a low libido, your problems with arousal and desire could stem from an underlying hormonal imbalance that occurs with age.  The medical term for this specific type of hormone imbalance is estrogen dominance. The good news is that estrogen dominance can be treated safely and naturally.  Let me explain.   

The human body produces three sex hormones: estrogen, progesterone and testosterone. Typically, women in their twenties evidence a physiologic balance of these three hormones which later becomes their baseline for normal, healthy hormone production. As women age, however, their hormone levels begin to shift and this can occur as early as then end of the second or the beginning of the third decade of life. Progesterone is the first hormone to drop off in levels of production, actually dropping 120 times faster than estrogen levels. When progesterone levels begin to fall an imbalance occurs and the female body is said to be estrogen dominant. Without the progesterone required to balance estrogen production, the female body's sexual anatomy is handicapped. This is evidenced by vaginal atrophy (loss of muscle tension), decreased vaginal mucus production (vaginal dryness) and decreased clitoral blood flow leading to reduced responsiveness. No wonder why, for many women over 30, sex isn’t as fun as it used to be.

For Dave, it was a big surprise that progesterone deficiency and estrogen dominance were also the underlying physiologic cause of his lost “giddy-up”. Like most men, Dave associated the hormone testosterone with his sex drive. Testosterone does influence the male libido but, once again, progesterone levels are the driving force because, in men, progesterone is the biochemical precursor of testosterone. When a man’s progesterone levels begin to drop, his testosterone levels also fall. This occurs when a man enters male menopause- or andropause- usually sometimes in his early to mid-40’s. (Note:  You can read more about the condition of andropause and what to do about it in our first book, From Hormone Hell to Hormone Well).

Abdominal fat in men increases the conversion of testosterone into estrogen. As estrogen levels rise, so does the tendency to accumulate more abdominal fat, fueling the situation. The risk of prostate cancer also increases with higher estrogen levels. This hormonal distress, specifically estrogen dominance, associated with abdominal obesity is also the major culprit contributing to diminished sexual prowess.

For many women and men, bio-identical progesterone cream is a fundamental first step in treating low, or hypo-active, sexual desire and response. Women using my Natural Balance Cream typically report enhanced sexual function including increased vaginal lubrication and improved clitoral response.  Men report improved feelings of desire and “readiness.”

As Genie and I were writing From Belly Fat to Belly Flat, we were delighted at how quickly women and men on our 3-Step Belly Flat Program (including bio-identical progesterone replacement along with recommended meal plans and supplements that work in concert to help reduce the body’s extra estrogen load) who were starting to drop those extra pounds around their middle also reported a coincident surge of libido.  “I feel better, I look better and I have energy left over at the end of the day so it is easier to get in the mood” and “I just feel sexier now that I can see my toes again” were typical of the many comments we heard, usually within the first few weeks.

I would like to conclude be stating that some people, approximately twenty percent of the men and women I see over 50 years of age, find that they need the addition of another hormone (such as bio-identical estrogen or testosterone) to restore their optimum hormonal balance and improve their sex drive.  For these persons, I recommend that they have a complete hormone profile and consultation to determine exactly which hormones are deficient.  Please note that, while neither my self nor my trained nurse practitioners can prescribe prescription strength bio-identical hormone replacement by telephone, we can interpret your individual hormone profile and, also, instruct you how to locate a physician in your area who is knowledgeable about bio-identical hormone replacement.

With life expectancy extending well into the eighties, shouldn’t sexual desire and pleasure to be just as potent and enjoyable for the young-at-heart as it is for the young-in-years?  With a little hormone help, now it can be.

Happy Valentines!  We wish you WELL!

C.W. Randolph, Jr., M.D. and Genie James, M.M.Sc.
Medical Director                    Executive Director
The Natural Hormone Institute of America

Dr. Randolph is a practicing gynecologist and an internationally recognized expert in the field of in bio-identical hormone replacement. He is the Medical Director for the The Natural Hormone Institute of America and is also the author of From Hormone Hell to Hormone Well as well as From Belly Fat to Belly Flat (to be released in January ’08).

* Please Note: Because legally we are unable to provide prescriptions for telephone consultation patients unless they have been previously seen in my office, should you require a prescription for a more comprehensive panel of bio-identical hormone replacement, my nurse practitioner will advise you how to locate a physician and compounding pharmacy in your area.