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Sex Talk

The Fall—and Rise—of Libido

    Libido problems can play havoc with women’s lives and relationships. “Low libido, not in itself a problem, becomes a problem when it causes distress for the woman, the marriage or the partnership,” says Sara Gottfried, M.D. At least half the perimenopausal women Gottfried sees in her practice—women typically aged between 35 and 50—report dissatisfaction with their libido and/or sex life.
    Gottfried, an Oakland-based board-certified gynecologist who practices integrative medicine with a focus on libido, menopause and hormone imbalance, says women with libido woes typically fall into one of three categories:
• The perimenopausal woman. Here, Gottfried says, wild fluctuations of hormones, typically estrogen, generally correlate with loss of interest in sex. Many women in their 40s no longer ovulate regularly. This means less progesterone is produced. Low progesterone can lead to a relative estrogen dominance, resulting in lowered libido. In a case like this, she adds, an off-the-shelf progesterone cream from, for example, Whole Foods, is sometimes all that’s needed.
• The menopausal women (51, Gottfried says, is the typical age for menopause). Here, loss of interest in sex is sometimes coupled with complaints of vaginal dryness, which can be caused by low estrogen.
• The postpartum woman (new moms). “They have a couple of kids and they find they give, give, give, and they’re depleted. Children can highjack the libido for 18 years.” Stress, in general, can also deplete a woman’s sex drive. “Some people have a lot of stress, and the libido stays strong, but others are not so resilient,” she says.
    While distress can result when someone with a high libido is in a relationship with someone with a low libido, it’s rare, says Gottfried, that a woman will complain about libido in isolation. While hormones are often to blame, libido issues tend to reflect other problems in the relationship. Gottfried suggests a DIY nonprescription saliva kit as an alternative to a blood test to measure the levels of any of the five hormones most likely to impact sex; namely testosterone, estrogen, progesterone, cortisol (directly linked to adrenal fatigue and stress) and DHEA (dehydroepiandrosterone). And there are many off-the-shelf natural remedies to regulate imbalances.
    For example, “every ancient culture in world has developed supplements. There’s Asian, Siberian (eleuthero), Peruvian (maca) and Indian (ashwagandha) ginseng, all of which modulate cortisol levels. Whole Foods stores have shelves and shelves to choose from.”
    While couples counseling or sex coaching may be necessary when the relationship is the issue, lifestyle changes can lift libido.
    She suggests:
• Have a contemplative practice, for example yoga, meditation or tai chi;
• Get enough sleep;
• Eat healthy foods—mostly plants—and not too much;
• Limit alcohol consumption;
• Get checked for an underactive thyroid if you’ve gained weight for no apparent reason and can’t lose it; your hands are often cold; and you need to wear socks to bed;
• Get the TV out of the bedroom (“Bedrooms should only be for sleep and sex.”);
• Do exercises that connect you to your erotic self;
• And “there is a lot of power in women talking about libido issues with other women.”


Center for Integrative Medicine, Dr. Sara Gottfried, 300 Lakeside Drive, Suite 202, Oakland, (510) 893-3907, www.doctorgottfried.com. For more on hormones and libido, check out her blog, drgottfried.blogspot.com.

The Canary Club, www.canaryclub.org (an online resource for hormone saliva kits)

Pharmaca Integrative Pharmacy, 5729 College Ave., Oakland, (510) 740-1468, (saliva kits and natural remedies)

Elephant Pharmacy, 1607 Shattuck Ave., Berkeley, (510) 549-9200 (saliva kits and natural remedies)

Whole Foods Market, 295 27th St., Oakland, (510) 834-9800 (natural remedies)

Sex and Intimacy Coaching, Celeste & Danielle, (510) 868-2768, www.celesteanddanielle.com (workshops and individual sex coaching for men, women and couples)


For books, sex advice, workshops and sex aids, visit Good Vibrations, 2504 San Pablo Ave., Berkeley (510) 841-8987, www.goodvibes.com.

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