If your sex life has taken a turn for the worse lately, you may be wondering what’s behind your bedroom woes.
Experts say many biological factors can wreak havoc on our sex lives—and one common culprit is having a hormonal imbalance resulting from a particular underlying condition, or simply due to age.
“While there are certain medical conditions or treatments that can affect hormone health, there are some typical times when hormones start declining,” Shoma Datta-Thomas, MD, FACOG, a board-certified aesthetic gynecologist and the head of wellness medicine at Modern Age, tells Best Life.
Read on to learn five ways a hormonal imbalance could be ruining your sex life—and what can help.
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According to Datta-Thomas, low testosterone levels are a common culprit behind a less-than-thriving sex life. She notes that natural levels of testosterone can start falling as early as in the 30s in some individuals. “In biological males, low testosterone can cause issues like low libido, erectile dysfunction, low mood, loss of muscle mass, hair loss, weight gain, and fatigue,” says Datta-Thomas. “These issues can start earlier, or be more severe, in cases of overlapping medical issues such as high blood pressure, cholesterol, diabetes, significant alcohol and drug use, or even certain prescriptions,” she adds.
Women, too, experience sexual side effects, though the problem is less widely recognized and less often treated. “In biological females, testosterone supports estrogen production which contributes to libido and helps brain, heart, bone and muscle mass. While treatment of low testosterone is not standardized, testosterone therapy can really help sexual function in women,” she says.
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As women begin perimenopause—typically starting in their 40s—their estrogen levels fall. This can impact not only libido, but also comfort and satisfaction levels during sexual encounters.
“These lower estrogen levels can result in thinning of the vulvar and vaginal skin, and a lack of natural lubrication which can make sex painful,” says Datta-Thomas. “This pain and lack of lubrication can further complicate feelings of sexual desire or arousal.”
Some women opt for hormone replacement therapy to combat symptoms of menopause, including its sexual side effects. However, it’s important to ask your doctor about the risks and benefits of beginning hormone replacement therapy.
According to Anna Cabeca, DO, MD, FACOG, a triple-board certified OB-GYN and author of The Hormone Fix, many people begin to experience a decline in the hormone dehydroepiandrosterone (DHEA) in their late 20s and 30s.
“By the age of 70 to 80 years, levels may be as low as 10 percent to 20 percent of those encountered in young individuals,” says a 2018 study published in The World Journal of Men’s Health. That study notes that low levels of DHEA are associated with higher levels of erectile dysfunction in men.
However, Cabeca adds that declining DHEA levels can also affect women. “DHEA is produced by ovaries in women, testes in men, and adrenals in both,” she tells Best Life. “When DHEA is low, it is associated with low libido and drive. Estrogen and testosterone are made from DHEA, so when DHEA is low, that can cause a decrease in testosterone and estrogen as well.”
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Oxytocin is a naturally occurring hormone that is instrumental to various aspects of reproduction, labor, and lactation. Known as the “love” hormone, oxytocin plays a vital role in sexual arousal, recognition, trust, romantic attraction, and more, says the Cleveland Clinic.
Cabeca says that your oxytocin levels can become imbalanced with cortisol levels, and that this can decrease feelings of connection and love, ultimately disrupting your sex life. “Oxytocin and cortisol oppose each other. They are the two boxers in a ring, or the two kids on a seesaw. When one goes up, the other is forced to go down. The key is balancing the two,” she explains.
Polycystic ovary syndrome (PCOS) is a hormonal problem that causes some women of childbearing age to generate abnormal amounts of androgens—a male sex hormone that most women usually produce in small amounts. Additionally, many women with PCOS also develop small cysts or extra follicles in the ovaries. Alex Okell, MSc, a registered associate nutritionist and founder of PCOSCollective.com, tells Best Life that PCOS is the most common endocrine condition among people with ovaries of reproductive age, affecting up to 10 percent of people with ovaries.
Okell says PCOS can impact sex and intimacy by triggering low libido and sexual satisfaction. She adds that many people with PCOS report feeling “self-conscious and dissatisfied with appearance” and have a “perceived loss of femininity,” which can further lower one’s interest in sex.
Speak with your doctor if you have questions about how your hormones may be affecting your sex life—and what you can do about it.