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The most common complaints that I get from patients today, men and women alike, are fatigue, weight gain and low libido. The causes of these symptoms can be similar which include: Stress, sleep deprivation, nutrient deficiencies, environmental exposure/toxins, medications and health problems like atherosclerosis, inflammation and depression. More importantly, hormonal decline and imbalances can have a large impact, especially on libido and the ability to orgasm.  All the causes listed above can also adversely affect your hormones for a double whammy.


For men, testosterone is the major player when it comes to libido but estrogen, DHEA, oxytocin and controlling insulin and cortisol levels have a role.


For women, estrogen, progesterone and testosterone naturally decline with age.  These hormones are responsible for regulating the menstrual cycle, mood, libido and sexual response. Women normally have a heightened sex drive around ovulation and just before their period.  Peri and menopausal women often experience decreased libido caused by an imbalance in those hormones as well as other hormones like DHEA and Oxytocin.


Although all the sex hormones play a role, TESTOSTERONE is the hormone of sexual desire in both men and women.Testosterone declines with age. Women also lose 10% of their testosterone production with each pregnancy (nature’s way of controlling reproduction). 30% of 30 year old women and 50% of 50 year old women suffer from FSD (Female Sexual Desire disorder). The average age for testosterone deficiency is 45y/o in women and 55y/o in men.


52% of all men age 40-70 suffer from erectile dysfunction (ED) to some degree. The strength of a man’s erection is a true barometer of his overall health. ED should be viewed as an early warning sign of silent vascular disease until proven otherwise.


Signs and symptoms of low testosterone for both sexes include: fatigue, insomnia, loss of libido, decreased ability to orgasm, loss of motivation, decreased muscle mass and increased belly fat. Men may also experience erectile dysfunction, irritability, anemia, and osteoporosis.


Who might complain of low testosterone?

Women as they age, but can start early.

Women on the BCP have elevated SHBG which binds up testosterone

Women who suffer from estrogen dominance (same mechanism)

Women who had surgical menopause (immediate 50% loss in T and 80% loss of E2)

Women who had POF (premature ovarian failure and subsequent loss of hormones)

Women who had chemo or radiation to the pelvis

High alcohol intake for both men and women

Men and women who suffer from sleep apnea

Certain medications like

  • Statins

  • Beta blockers (blood pressure medication)

  • Antidepressants (SSRI)

  • Prednisone

  • Chronic opiate use and abuse


As a side note: Why do certain antidepressants cause the inability to orgasm? Well the ability to orgasm requires the neurotransmitter dopamine to be high and serotonin to be low. SSRI’s work by increasing serotonin, which is sexually inhibitory! Everything in life is a risk benefit ratio.


Dopamine is an orgasm accelerator. That’s why amphetamines, cocaine, gambling and risky behaviour, all of which increase dopamine, help with sexual pleasure.  That is probably why having a new partner also temporarily increases libido.


Men and women are very different when it comes to sex. For the most part men can have the worst day of their lives, get shot in the leg and still manage to get an erection and they have to concentrate not to have an orgasm. Women on the other hand are much more complicated and have many killjoy switches that block libido and orgasm; examples are hearing their kids cry, thinking of their to do list, not feeling connected to their partner etc. Women often have to concentrate to have an orgasm. For women their brain is a very sexual organ and if it’s not turned on, good luck reaching that big “O”.


Replacing testosterone in women improves sex drive and ability to orgasm without a doubt. I have women in my practice who love their testosterone. But there is a risk benefit ratio. Unfortunately some women are genetically prone to making more DHT and can get acne, oily skin and lose their hair. (Hair or sex drive? Hmmm).


There are a few studies showing DHEA can increase a woman’s desire but again you have to monitor for side effects. Oxytocin has also hit the spotlight as it is the hormone responsible for make women multi-orgasmic, it increases vaginal secretions, decreases time to orgasm and increases the duration of orgasm (sounds good-I’ll take some to go please). I’m always working on different concoctions to increase a woman’s libido. I often use blood tests to help guide me in prescribing different formulas.




  1. SLEEP-sleeping 7-8 hrs. a night improves mood, memory, lowers stress, prevents weight gain and increases passion boosting hormones!! Correct sleep apnea since this can lower testosterone and is associated with Female Sexual Disorder.

  2. EAT RIGHT-Sugar is a sex killer. Eating too many carbs increases insulin resistance, weight gain and atherosclerosis. Men with diabetes are 3X more likely to have ED than men without diabetes.

  3. BE ACTIVE-exercise increases testosterone and balances other hormones. Men who are sedentary are more likely to have ED than men who are physically active. “The harder you work out, the harder your erections will be”. For women-check out these exercise to increase your likelihood to reach the big “O”. https://vimeo.com/118967707

  4. REDUCE STRESS. Stress causes havoc with all your hormones.

  5. USE YOUR SENSES-Block off one sense to make the others stronger-use blindfold, tie up arms, ear plugs.  

  6. BE MINDFUL and present. Forget the laundry list.

  7. RAISE DOPAMINE. People crave adventure, challenges and enjoy novelty. Act out fantasies, and take supplements to raise dopamine naturally.

  8. TURN YOUR BRAIN ON TO SEX. That’s why 50 Shades of Grey was the best aphrodisiac. Did you know thinking about sex, increases testosterone levels?

  9. IMPROVE YOUR RELATIONSHIP or get a new one.

  10. MAKE SURE YOUR VAJAYJAY IS HAPPY. Treat atrophic vaginitis to prevent pain and bleeding. There are many options out there that are hormonal and non-hormonal like lubricants, hyaluronic acid that can help. Also if you don’t use it you lose it.

  11. TREAT UNDERLYING CAUSES of ED, inflammation and nutrient deficiencies

  12. MOST IMPORTANTLY- BALANCING or REPLACING YOUR HORMONES to optimal levels is the most effective way to improve your mojo. See a Physician who is skilled in this area.