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Let’s talk about sex … and stress: The effects of stress on sex drive

It’s a Friday evening, and you’re looking forward to a special evening alone with your partner. You collect your things to leave the office … when your boss dumps an extra project on your desk for the weekend. Then some hotshot in a turbocharged sports car cuts you off, and you spill your drink on your lap. By the time you finally arrive at home, you realize you left your passion somewhere between your desk and the exit ramp.

The Relationship Between Stress and Sex

man not interested in sexThe relationship between stress and sex is complex, but clinicians and lovers have long recognized stress’s ability to interfere with human sexuality and reproduction. The stress response is controlled by the hypothalamic-pituitary-adrenal (HPA) axis. The sexual response is controlled by the hypothalamic-pituitary-gonadal (HPG) axis. Notice some similarities? The hypothalamus is a part of the brain that controls the “four Fs” of our most basic instincts: fighting, fleeing, feeding, and … mating. The hypothalamus directs the pituitary, or “master gland,” which is found as a small protrusion off of the hypothalamus. The pituitary controls the secretion of hormones throughout the body. Depending on the messages it receives from the hypothalamus, it may signal the adrenals to secrete cortisol, a stress hormone, or the gonads to secrete sex hormones. Stress hormones can impact and interfere with sexual function at all three levels of the HPG axis: at the brain, pituitary, and gonads.

However, in addition to stress hormones, the adrenals can also produce DHEA, a sex hormone. DHEA is a precursor to both testosterone and estrogen. Although testosterone is often thought of as a male hormone, women also have it in smaller amounts, and it has a strong impact on libido. In menstruating women, the ovaries are the major source of testosterone, but the adrenals contribute via their production of DHEA. After menopause, the adrenals become critical to a woman’s supply. If a woman has adrenal fatigue, not only will her production of stress hormones decrease, but her testosterone—and her libido—will too.

Higher stress is associated with reduced sexual functioning in general. Women who had higher levels of cortisol (the stress hormone) and lower levels of DHEA (the sex hormone) after watching an erotic movie experienced less physiological arousal than women with a lower cortisol/DHEA ratio. Prolonged stress has been shown to decrease sexual response in women, and women with greater levels of chronic daily stress report more sexual complaints.

Stress can interfere with sex on a psychological level, too. Cognitive distraction (thinking or worrying about problems) interferes with sexual functioning. So if you are ruminating about multiple stressors, it will be difficult to put your full attention on either your partner or your own sensations and responses.

Continue to part 2 – Supporting Your Sexual Response

Photo credit: Flickr user focus.recompose

References

Bradford A, Meston CM. The impact of anxiety on sexual arousal in women. Behav Res Ther. 2006 Aug;44(8):1067-77. Epub 2005 Sep 30.
Brooks NA, Wilcox G, Walker KZ et al. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal woman are not related to estrogen or androgen content. Menopause. 2008 Nov-Dec;15(6):1157-1162.
Ditzen B, Hoppmann C, Klumb P. Positive couple interactions and daily cortisol: on the stress-protecting role of intimacy. Psychosom Med. 2008 Oct;70(8):883-9. Epub 2008 Oct 8.
Ditzen B, Neumann ID, Bodenmann G, von Dawans B, Turner RA, Ehlert U, Heinrichs M. Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. Psychoneuroendocrinology. 2007 Jun;32(5):565-74. Epub 2007 May 11.
Hamilton LD, Meston CM. The role of salivary cortisol and DHEA-S in response to sexual, humorous, and anxiety-inducing stimuli. Horm Behav. 2011 May;59(5):765-71. Epub 2010 Dec 30.
Hamilton LD, Rellini AH, Meston CM. Cortisol, sexual arousal, and affect in response to sexual stimuli. J Sex Med. 2008 Sep;5(9):2111-8. Epub 2008 Jul 4.
Lennartsson AK, Kushnir MM, Bergquist J, Billig H, Jonsdottir IH. Sex steroid levels temporarily increase in response to acute psychosocial stress in healthy men and women. Int J Psychophysiol. 2012 Mar 9. [Epub ahead of print]
Rivier C, Rivest S. Effect of stress on the activity of the hypothalamic-pituitary-gonadal axis: peripheral and central mechanisms. Biol Reprod. 1991 Oct;45(4):523-32.
Shin BC, Lee MS, Yang EJ, Lim HS, Ernst E.Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010 Aug 6;10:44. Review.
Ter Kuile MM, Vigeveno D, Laan E. Preliminary evidence that acute and chronic daily psychological stress affect sexual arousal in sexually functional women. Behav Res Ther. 2007 Sep;45(9):2078-89. Epub 2007 Mar 19.
Zenico T, Cicero AF, Valmorri L, Mercuriali M, Bercovich E. Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performance in patients with mild erectile dysfunction: a randomized, double-blind clinical trial. Andrologia. 2001 Apr; 41(2):95-9.

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2 Responses to Let’s talk about sex … and stress: The effects of stress on sex drive

  1. hendra says:

    dear sir,
    i have a ed problem since 3 years now,docter said i have a venous leak,but i already have a venous leak surgery but it doesnt work,i can have erect with stimulation but very fast disappear.
    if i take viagra,it works but with no desire sex.
    what should i do,please help me docter,i,m still 36.
    and i also feel tired all the time

    • Thank you for your question.

      We are not able to give medical advice; you should seek a professional’s help. Hormonal studies may be indicated or your problem may be functional/anatomical. As for the fatigue, we suggest taking the Adrenal Fatigue Questionnaire. It will help guide you in the use of the supplements if they are indicated. The fatigue and erectile dysfunction may or may not be related. Maca may potentially be useful. It has been shown in some studies to help with mood and sexual function in men with erectile dysfunction.

      We hope this information helps!

      -Dr. Wilson’s Adrenal Fatigue Team

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