I would say about ⅓ of the questions that come through for our podcast or email have something to do with understanding why our eating patterns are restricted. Or, questions regarding restricting and really, deep down knowing restricting is harmful to our health, but being unable to reflect or accept that fact without the feedback or acknowledgement of others. Which is OKAY. I have been there so many times before, too.
For example, when there is a question along the lines of, “I exercise “x” times a week and eat 1200 calories a day, but have “x” health problems, could this be originating with my calorie deficit?”. A lot of these inquiries are answered by the person asking in the question, but sometimes we need to hear confirmation from others that these things are affecting us negatively.
That is also why referring to ourselves as third person is a common way to gain perspective and insight on things that may be troubling us or if we are looking for insight on what we really need.
I too, have reached out to doctors, research, and my friends or family to understand why my body responds the way it does, or more importantly, why my body isn’t responding the way I want it to. We need to understand why our bodies don’t want to shed weight, recognizing that things like stress and inflammation can cause our bodies to enter a state where shedding weight isn’t the priority in keeping our body functioning. In a way, our bodies have a mind of their own and will make decisions to take care of themselves, even if we think we already are.
Processing and challenging our disordered thinking is not an easy task; in fact it is one that requires consistent work. I have to be mindful daily to make sure I am not falling into my past negative restrictive habits. This journey is a long one, and may often feel like you are taking 8 steps back and only a half step forward some days.
As with most people, I find that there is an ebb and flow of my moods and habits, and surrounding myself with positive people, eliminating negative social media outlets, and incorporating techniques like Cognitive Behavioral Therapy into my daily life can be grounding.
So – how can we use CBT to manage disordered eating?
What is CBT?
CBT is an evidence based treatment model focused on how our thoughts, feelings, environments, and behaviors are intertwined, and that they can be restructured to support better habits and actions. This type of treatment has been used for anxiety and depression in the past, but more so has been used for eating disorders and disordered eating patterns recently.
There are three phases to CBT – Behavioral, cognitive, and relapse/ maintenance. Each phase is targeted on different approaches to break down our existing thoughts surrounding restrictive or disordered eating. If you are interested in reading more on the specific phases, check out this book.
So How Can CBT Help?
The first portion of CBT is understanding why we have developed the patterns that we have. This stage is to gain a grasp on why we have developed the patterns that we have, and educating ourselves on the science behind disordered eating. In order to proceed with healing, we must understand how and why our brain’s have become wired to restrict the way we do.
- Setting Meal Times
This may seem counter intuitive, but it is an effective step in CBT. When we have regularly scheduled meal times at realistic intervals, we know when we will be eating again and as a result are breaking up the controlling binge restrict cycle that so often is in place.
- Challenging Our Dietary Rules
This one is commonly discussed on our podcast, and I find so many women have some sort of dietary rules in place. A few of mine included : eating heavier meals in the morning in order to have the rest of the day to burn it off, not eating after 9 PM, eating carbs throughout the work day, etc. So with these rules we need to challenge them by reversing our thoughts on them. This can include eating a light breakfast and heavier dinner, in my situation. What dietary rules do you have that you are willing to challenge? Did you ever tell yourself a food was off limits, and if so, why? Try eating that food and really reflect on how you feel in that moment. This brings me to our next item.
- Confront and Expose Fear Foods
After the above steps have been incorporated, the next gradual step is to give yourself the permission to expose our fear to food. Part of this is removing the fear from food itself, and understanding food is just food. There is no evil cookie out there, the reason we see the cookie as evil is because of the negative connotation WE place on the cookie. If we remove the fear of eating the cookie, it becomes just that again.
This helps often with those that experience binging or purging. If we got caught off guard in the middle of an area that we are wanting to binge or purge, say by a call from a loved one, or an unexpected immediate deadline, we usually are able to push back our binging which can often lead to no longer feeling the need to binge after the stressor has passed. I would recommend creating a list of things to pull out of your back pocket that can intercept restrictive behaviors. This article has a great list to start with that includes doing your nails, playing with a pet, calling a friend, or listening to music. By allowing yourself to complete this task before indulging the negative behavior, we can catch and stop that negative behavior from happening.
- Continue to Self Monitor
By journaling (this is a great workbook) and keeping track of consumed foods along with emotional feelings we can reflect on what ultimately is causing us to feel restrictive patterns in that moment. For instance, journaling at lunch time at work describing your current mindset and what your eating can allow you to see if you are stressed out about a project at work. Over time, journaling can show us what patterns we have surrounding our mindset. Maybe we only feel binging behaviors when we are stressed at work, or maybe the binging is at home before bed. This step is about maintaining self awareness and really “knowing thyself”.
By no means am I a registered, educated or licensed professional when it comes to CBT. I write purely from my own personal experience and research, and from my research working with women through PfW. All of these tips can be extremely helpful while navigating the world of CBT. However. CBT doesn’t work for everyone, especially when trying to complete on your own.
I was able to utilize CBT to manage disordered eating in the most effective way by utilizing a local mental health professional. CBT takes consistency to be fully optimized; by working with a professional you are more likely to have a successful experience with CBT. To locate a therapist that specializes in CBT, click here.
This website is the holy grail of resources. It contains informative handouts on eating disorders and disordered eating habits, as well as handouts, worksheets and exercises. There is also an extensive further reading page.
This website has a series of in depth modules that walk you through the CBT process.
As always, let me know if you have any questions or concerns or if I can help in any way. Everyday we are one step closer to eliminating restrictive eating if we consistently work towards improving. Keep an eye out for a few future posts on additional ways you can work to eliminate disordered eating tendencies.
One of the more esoteric but much beloved tools in the paleo dieter’s tool-kit is intermittent fasting.
What is intermittent fasting? I.F. is the practice of maintaining overall caloric intake while consuming those calories in fewer meals or in reduced time windows throughout the day. The goal is to create conditions of fasting in the body, but not for extreme lengths of time.
Some examples of intermittent fast strategies include 10, 8, or 5 hour eating windows throughout the day, or perhaps eating just two meals each day: one in the morning, and one at night. The evolutionary premise — the argument that proponents of intermittent fasting make — is that humans evolved to optimize their health under less-than-optimal conditions. Intermittent fasting, they say, is a natural and perhaps even necessary part of being human.
The modern-day scientific correlate appears promising, too:
Most people are nowadays aware that a calorie-restricted diet has the ability not just to decrease body weight but also to lengthen a human life. Emerging research is beginning to show, however, that intermittent fasting is just as effective as calorie restriction in ensuring these health benefits! Amazingly enough, this happens without any of the psychological crippling side effects of cravings and food obsession that practictioners of calorie-restriction often experience.
Intermittent fasting, proponents say, also may benefit the fight against cancer, diabetes, and autoimmunity. Here is an excellent, up-to-date review of the “benefits” of fasting. It is wholly understandable that fasting is all the rage these days.
Intermittent fasting women is a specific interest of mine because of what I have witnessed both in myself and in working with literally thousands of women in the PfW community.
Many women report to me (read more about that in this awesome book) that intermittent fasting causes sleeplessness, anxiety, and irregular periods, among many other symptoms hormone imbalance, such as cystic acne.
I have also personally experienced metabolic distress as a result of fasting, which is evidenced by my interest in hypocretin neurons. Hypocretin neurons have the ability to incite energetic wakefulness, and to prevent a person from falling asleep, in reaction to the body detecting a “starved” state. Hypocretin neurons are one way in which intermittent fasting may dysregulate a woman’s normal hormonal function.
After my own bad experience with IF, I decided to investigate intermittent fasting. I looked into both a) the fasting literature that paleo fasting advocates refer to, and b) the literature that exists out in the metabolic and reproductive research archives.
Intermittent Fasting Women: Problems in the Paleosphere
What I found is that the research articles cited by Mark’s Daily Apple (and others), focus on health benefits such as cancer-fighting properties, insulin sensitivity, and immune function.
However. I was struck by what seemed like an egregious sex-based oversight in that MDA post I linked to above. MDA cites this article as a “great overview” of the health benefits of intermittent fasting. This startled me because the article MDA cited was for me one of the strongest proponents of sex-specific differences in response to fasting.
Sex differences were relevant in two striking areas:
1) women in studies covered by the review did not experience increased insulin sensitivity with IF regimes and
2) intermittent fasting women actually experienced a decrease in glucose tolerance.
These two phenomena mean that women’s metabolisms suffered from IF. The men’s metabolisms on the other hand improved with IF across the board. Recall that the review was reported by MDA as “a great overview of benefits [of IF].”
Secondly, in another fasting post at MDA, of which there are many, the health benefits of fasting are listed and reviewed, but the sex-specific aspects of the hormonal response go unmentioned, and reproduction/fertility/menstrual health isn’t mentioned at all.
This is not to say that Mark is not attentive to who should and who should not be fasting. He knows very well and cautions people against the dangers of fasting while stressed. Still, the mere fact of being more sensitive to fasting simply by being a woman is, I would assert, pretty important for a woman who is contemplating or already practicing IF.
This goes nearly unmentioned in the blogosphere.
Intermittent Fasting Women: Problems in the Literature
Beyond reporting biases in the blogosphere, there remains an even greater problem of a significant testing bias in the fasting literature. Searching “men” + “intermittent fasting” in a Harvard article database yields 71 peer-reviewed articles. Searching “intermittent fasting women” yields 13, none of which are a) solely about women b) controlled studies or c) about more than body weight or cardiovascular benefits.
The animal studies are more equitable, but also a bit less applicable to human studies.
It is well-known in both the research and the nutritional communities that caloric restriction is horrible for female reproductive health. This is not news. There is an infertility condition – called hypothalamic amenorrhea – that millions of women suffer from due to being overly restrictive. But what of fasting?
Intermittent Fasting Women: Should we Fast?
The few studies that exist point towards no.
It is not definitive, since the literature is so sparse, and it necessarily differs for women who are overweight versus normal weight (and who have different genetic makeups), but when it comes to hormones, women of reproductive age may do well to err on the side of caution with fasting.
What follows first is a brief review of what can be gleaned in sex-specific responses to fasting in animal studies. Afterwards I talk about what has been concluded by the few relevant human studies.
Mice & Rats
First up is a study that demonstrates the hippocampal changes of calorie restriction and intermittent fasting for both male and female rats. In this study, they do alternate day fasting, which entails free eating on one day and a fast day on the next.
The study found that brain states while fasting were different for male and female rats. For male rats the change in hippocampus size, hippocampal gene expression, and ambulatory behavior was the same no matter what kind of restricted diet they were on – but for female rats, the degree of change in brain chemistry and in behavior was directly proportional to degree of calorie intake, demonstrating the unique sensitivity of female rats to the starvation response.
” The organization of the females’ response to the energy restricted diets is suggestive of some underlying mechanism that may allow for an organized, pre-programmed, response to enhance survival in times of food scarcity. Comparatively, the males’ genetic response was less specific, suggesting that the males respond to a general stressor but they seem to lack the ability to discriminate between a high energy and low energy stressor.”
Moreover, “IF down-regulated many gene pathways in males including those involved in protein degradation and apoptosis, but up-regulated many gene pathways in females including those involved in cellular energy metabolism (glycolysis, gluconeogenesis, pentose phosphate pathway, electron transport and PGC1-α), cell cycle regulation and protein deacetylation.” In this study, both male and female rats gained small amounts of weight on IF diets.
For female rats, even in the most innocuous form of restriction–intermittent fasting–significant physiological changes take place. Male rats do not experience as dramatic hippocampal and general brain chemistry change as female rats do, and their behaviors, specifically their cognition and their dirunal and nocturnal activity, do not change.
Female rats, on the other hand, “masculinize.” They stop ovulating and menstruating. They become hyper-alert, have better memories, and are more energetic during the periods in which they are supposed to be sleep. Theoretically, according to these researchers, this is an adaptive response to starvation. The more the female rats need calories– or at least the more their bodies detect a “starvation” state– the more they develop traits that will help them find food. They get smart, they get energetic, they get active, and they stop sleeping.
In a follow-up study conducted by the same researchers who explored the masculinzation of female rats, the researchers analyzed the gonadal transcription of male and female rats subjected to IF regimes.
This study found that male reproductivity up-regulates in response to metabolic stress. Female reproductivity down-regulates.
Completely opposite to the female rats becoming infertile while fasting, male rats become more fertile. In the researchers’ own words: “our data show that at the level of gonadal gene responses, the male rats on the IF regime adapt to their environment in a manner that is expected to increase the probability of eventual fertilization of females that the males predict are likely to be sub-fertile due to their perception of a food deficient environment.”
In the final relevant IF rat study I could find, researchers subjected rats to the same diets– to 20 and 40 percent Calorie-Restricted (CR) diets, as well as to alternate-day fasting diets, and monitored them over the long term for hormonal responses. The results were striking. Below is the abstract in full because it’s so powerful:
Females and males typically play different roles in survival of the species and would be expected to respond differently to food scarcity or excess. To elucidate the physiological basis of sex differences in responses to energy intake, we maintained groups of male and female rats for 6 months on diets with usual, reduced [20% and 40% caloric restriction (CR), and intermittent fasting (IF)], or elevated (high-fat/high-glucose) energy levels and measured multiple physiological variables related to reproduction, energy metabolism, and behavior.
In response to 40% CR, females became emaciated, ceased cycling, underwent endocrine masculinization, exhibited a heightened stress response, increased their spontaneous activity, improved their learning and memory, and maintained elevated levels of circulating brain-derived neurotrophic factor. In contrast, males on 40% CR maintained a higher body weight than the 40% CR females and did not change their activity levels as significantly as the 40% CR females. Additionally, there was no significant change in the cognitive ability of the males on the 40% CR diet.
Males and females exhibited similar responses of circulating lipids (cholesterols/triglycerides) and energy-regulating hormones (insulin, leptin, adiponectin, ghrelin) to energy restriction, with the changes being quantitatively greater in males. The high-fat/high-glucose diet had no significant effects on most variables measured but adversely affected the reproductive cycle in females. Heightened cognition and motor activity, combined with reproductive shutdown, in females may maximize the probability of their survival during periods of energy scarcity and may be an evolutionary basis for the vulnerability of women to anorexia nervosa.
They also found this:
The weight of the adrenal gland was similar in rats on all diets; however, when normalized to body weight CR and IF diets caused a relative increase in adrenal size, the magnitude of which was greater in females, compared with males.
The testicular weight was unaffected by any of the diets. In contrast, both CR diets and the IF diet caused a decrease in the size of the ovaries.
And this, bearing in mind that “daytime” for nocturnal rats is “nighttime” for humans:
The daytime activity of females was doubled in response to IF, whereas the IF diet did not affect the activity level of males. Nighttime activity levels of males and females were unaffected by dietary energy restriction.
Uterine activity was monitored daily with vaginal smear tests; cyclicity was scored as regular, irregular, or absent. The mild energy-restriction diets (20% CR and IF) significantly increased the proportion of animals displaying irregular cycling patterns, whereas the 40% CR animals displayed an almost complete loss of estrous cyclicity.
In males, corticosterone levels were elevated only in response to the 40% CR diet, whereas in females corticosterone levels were significantly elevated in response to all three energy-restriction diets, suggesting a relative hyperactivation in females of the adrenal stress response to reduced energy availability.
For lipids, all the rats did well: “Collectively, these data suggest that atherogenic profiles of both males and females are improved by dietary energy restriction.” Interestingly, too, as they pointed out in the abstract, human females also perform cognitively much “better” (memory and alertness) on CR and IF diets than on normal feeding schedules.
There are of course some caveats to this study: A) They are rats. B) They are somewhat “metabolically morbid” rats, which may make them more susceptible to disease. C) The rats were allowed to eat ad libitum on the IF days, but they simply did not meet their caloric requirements this way. So while it is a somewhat natural form of IF, it is still calorically reduced, such that that must be taken into account when gasping in horror at the hormonal responses of IF-ing female rats.
The Few Human Studies
I mentioned above that through the same review that MDA used as a “great overview” of IF benefits for all sexes, I found harmful metabolic effects for women subjected to alternate-day fasting regimes.
This is the study:
Heilbronn et al found that with IF, insulin sensitivity improved in men (21 participants) but not in women (20 participants): after three weeks of alternate day fasting, insulin response to a test meal was reduced in men. Women experienced no significant change. “It is interesting that this effect on insulin sensitivity occurred only in male subjects,” they report.
With respect to other health markers female health actually declined, specifically with respect to glucose tolerance:
“Another diabetes risk factor that has shown a sex-specific effect is glucose tolerance. After 3 weeks of ADF, women but not men had an increase in the area under the glucose curve. This unfavorable effect on glucose tolerance in women, accompanied by an apparent lack of an effect on insulin sensitivity, suggests that short-term ADF may be more beneficial in men than in women in reducing type 2 diabetes risk. ” The opening line of their discussion reads: “Alternate day fasting may adversely affect glucose tolerance in nonobese women but not in nonobese men.”
In a follow up study, Heibron et. al studied the effects of alternate-day fasting on cardiovascular risk. When human subjects fasted on alternate days for another three week period, circulating concentrations of HDL cholesterol increased, whereas triacylglycerol concentrations decreased. This is a good thing. However, the shifts in lipid concentrations were shown to be sex specific: ie, only the women had an increase in HDL-cholesterol concentrations, and only the men had a decrease in triacylglycerol concentrations.
The most recent review of IF agrees with my conclusion: sex-specific differences in metabolism exist and need to be studied further.
This study of alternate day fasting included 12 women and 4 men. In eight weeks, body weight decreased by about 10 pounds, and body fat percentage decreased from 45 to 42. Blood pressure decreased, total cholesterol, LDL cholesterol, and traicylglycerol decreased. These people were significantly obese, which limits the results of this study to an obese population. However, “perimenopausal women were excluded from the study, and postmenopausal women (absence of menses for >2 y) were required to maintain their current hormone replacement therapy regimen for the duration of the study.” (Their words, my emphasis)
The one, big study of intermittent fasting conducted on men and women looked at differences between isocaloric feeding schedules: 3 meals/day feeding versus 1 meal/day.
The study focused on body weight composition, blood pressure, and body temperature in subjects. Subjects were fed isocalorically either one meal each day or three meals each day. All subjects were between 40 and 50 years old (excluding women of reproductive age), and between BMIs of 18 and 25. They ate, so far as I can tell, a healthy diet with 35 percent fat, PUFA < MUFA < SFA. Only 15 of the original 69 completed the study (which goes to show just how fun everyone thought fasting was). As for the results,
“Systolic and diastolic blood pressures were significantly lowered by ≈6% during the period when subjects were consuming 3 meals/d than when they were consuming 1 meal/d. No significant differences in heart rate and body temperature were observed between the 2 diet regimens. Hunger was enormously larger in the one meal/day than in the three meals/day group. “The 1 meal/d diet was significantly higher for hunger (P = 0.003), desire to eat (P = 0.004), and prospective consumption (P = 0.006) than was the 3 meals/d diet. Feelings of fullness were significantly (P = 0.001) lower in the 1 meal/d than in the 3 meals/diet.” Body weight dropped only four pounds after several months. Cortisol dropped, but Total, LDL, and HDL cholesterol were 11.7%, 16.8%, and 8.4% higher, respectively, in subjects consuming 1 meal/d than in those consuming 3 meals/d.
In sum: patients on the one meal/day regiment were unhappy, hungry, lost a little bit of weight, increased cholesterol. This was a small sample, included somewhat menopausal women, and all people of normal body weight.
Intermittent Fasting Women: In Conclusion
All that being said, that’s it. That’s all that exists! Women don’t have much to go on.
There are a few rodent studies. They found that when alternate-day fasting,female rats and found significant negative hormonal changes occurring in the females.
There are even fewer human studies. Human studies on alternate day fasting have not been conducted on women of reproductive age at all, nor have any studies analyzed reproductive responses to fasting.
Moreover, the few studies that have been conducted on non-obese women have demonstrated that their metabolic responses are not nearly as robust as those of men, and may in fact be antagonistic to their health.
This post has focused on sex-specific responses to fasting, specifically intermittent fasting women. Another important distinction to make is between different body weights. Overweight and obese patients appear to experience significant improvements with IF regimes, but normal weight patients do not show the same across-the-board benefits. For women this may be a particularly sensitive issue. Overweight women may experience metabolic benefits, whereas normal weight women do not. I suspect that that may roughly be the case, but who knows. Honestly, no one at this point.
The practical solution, then, I believe, is to look at options, to be honest about priorities, and to listen to one’s body with awareness and love.
Is fasting worth trying if a woman is overweight and trying to improve her metabolic markers, and so far hasn’t had much success? Perhaps. Should it be undertaken if a woman is of normal weight? What if she is a light sleeper? What if her periods begin to dysregulate? Or stop? What if she starts getting acne, getting a stronger appetite, or losing her appetite altogether? These things happen, and I see them in women who fast and contact me time and time again.
We women (people!) should be honest with ourselves about our priorities, and act constantly with our mental and physical health foremost in our minds. All women are different. But the literature is so sparse in this area that we cannot make any real statements or predictions about the effects of fasting, other than that we just don’t know, and that we should continue to emphasize the centrality of awareness, caution, and loving nourishment in moving forward.
IF is one realm in which the female body has unique characteristics and needs that demand attention. There are boatloads of others. If you’re interested in reading about the collective set of them and learning how to optimize female skin, weight loss, and hormone balance, for a few examples, you could do worse than my best-selling book, Sexy by Nature, here.
And that’s a wrap! What do you think?
Sex is one of the most important things we do.
Desiring sex, therefore, is one of the most important things we can feel.
According to a Journal of the American Medical Association (JAMA) study reported on in February 1999, about 43 percent of women (compared to 31 percent of men) suffer sexual inadequacy for one reason or another. Interestingly, this is thought to actually underestimate the real level of sexual dysfunction in the U.S. Yikes.
What follows is a description of the physiological components of female libido, how to maximize those components, and then a discussion of the psychosocial components. The psychosocial components are the trickiest to get a handle on, but they are also treatable with proper therapy (if necessary), love, empowered embodiment, and raging, well-deserved confidence.
Need more information to find you raging, well-deserved confidence? Check out my bestselling book on women’s health.
What factors play a role in female libido?
Specific foods are not in reality relevant for female libido, except for how they may temporarily increase testosterone levels (a la oysters). Instead, all of the physiological factors that influence female libido boil down to long-term sex hormone levels and balance.
First, absolute levels of hormones are important: for example, the greater amount of sex hormones in the blood, the sexier a woman will feel.
Secondly, balance is also crucial. For example, estrogen is not typically considered important in arousing a woman’s sex drive. But having clinically low estrogen levels–that is, estrogen levels below the baseline for proper sexual function–prohibits absolutely any kind of sensation a woman might have in her clitoris. That’s scary.
This is the effect that all hormones have on sex drive, generally:
1.Testosterone: Increases female libido. Testosterone is the hormone primarily responsible for sex drive in both men and women. When women with hypoactive sexual dysfunction disorder are treated with testosterone, for example, they often experienced increased sex drive.
Higher testosterone levels also enlarge the clitoris (good to know if yours is shy!), but unfortunately if other hormone levels do not rise along with testosterone, symptoms of hyperandrogenism such as facial hair and acne may manifest themselves. For this reason, testosterone supplementation is not an advisable method of increasing female libido.
2. Estrogen: Crucial at baseline for sexual function. It is also the primary hormone responsible for vaginal lubrication. However, estrogen is a testosterone antagonist, so the more estrogen a woman has in her system, the less testosterone she has available to pump up her libido. Estrogen dominance therefore is one of the greatest culprits in contemporary Western sexual dysfunction.
3. Progesterone: Another testosterone antagonist. Having elevated progesterone levels relative to the rest of the sex hormones prevents a woman from achieving orgasm.
4. Prolactin: Not talked about very often, since it’s primary role is in lactation, but it is also involved in pituitary-ovary signalling. Increasing prolactin levels increase vaginal lubrication and sex drive.
5. Luteinizing Hormone: Highly correlated with sex drive. LH is a pituitary hormone that triggers ovulation in a woman. Many researchers believe LH is one of the primary game-makers in sexual arousal.
Because of the role each of these hormones play in female libido, the menstrual cycle demonstrates a clear pattern in fluctuating libido for most women.
So how does the menstrual cycle affect female libido?
Testosterone levels rise gradually from about the 24th day of a woman’s menstrual cycle until ovulation on about the 14th day of the next cycle, and during this period women’s desire for sex has been shown, in general, to increase consistently. The 13th day (the cusp of ovulation) day is generally the day with the highest testosterone levels. It is also the day on which LH spikes. Ovulation, therefore, and no surprise here, is typically the randiest time of the month for a woman. In the week following ovulation, the testosterone level is the lowest and as a result women experience less interest in sex.
During the week following ovulation, progesterone levels increase, and this often results in a woman experiencing difficulty achieving orgasm. Although the last days of the menstrual cycle are marked by a constant testosterone level, women’s libido may boost as a result of the thickening of the uterine lining which stimulates nerve endings and makes a woman feel aroused.
Also, estrogen levels are at their lowest throughout menstruation and into the follicular phase (the first two weeks of the cycle) so women experience the least vaginal lubrication at this time. Because testosterone and estrogen are both increasing, however, sexual desire is ramping up again in time for ovulation.
What factors influence these hormone levels, and how do we make the best of them?
Estrogen Dominance: As I mentioned above, estrogen is a testosterone antagonist. When estrogen levels are too high relative to testosterone levels, female libido plummets. Women can become estrogen dominant by consuming too much soy (since soy acts as an estrogen in the body), by being overweight (since estrogen is produced in fat cells; see my book on healthy weight loss here), and by being stressed out (since estrogen can act as part of the inflammatory response). Women with estrogen dominance often experience symptoms of PMS, too, which does nothing to help libido.
Birth Control Pills: Birth control pills are another way that women can become estrogen dominant. But that is not the only way they negatively effect female libido. Progesterone levels are often elevated out of the normal range on birth control pills, and testosterone sometimes plummets.
Yet the effects of birth control pills on women is wholly unpredictable. Increasing levels of one hormone might decrease another, or might increase them exponentially, depending on how the woman’s HPA axis and ovarian feedback mechanisms work. Women also experience a whole range of side effects on birth control pills ranging from acne to suicidal depression. Birth control pills are no laughing matter, and their effect on female libido is wide ranging.
All that said, since birth control really is so unpredictable, birth control can play a stimulatory role on female libido, especially if she has chronically low levels of sex hormones in her blood. Some women feel like a million bucks on estrogen pills. If that is the case, however, birth control pills are only putting a band-aid on the problem, rather than solving it at its core. That often requires looking at physiological problems that deplete sex hormone levels such as low body fat, stress, and energy deficits.
See Birth Control Unlocked for more information on birth control options outside of the pill.
Testosterone blockers: Some women get on testosterone blockers to help them with symptoms of hyperandrogenism or problems in their menstrual cycles that come from high testosterone production. However, blocking testosterone is as good as eliminating it entirely. Spironolactone and flutamide are the two most commonly used testosterone blockers.
Hypothyroidism: Up to ten percent of women have clinical or sublicinical low thyroid issues. Hypothyroidism is significantly linked to low libido. T3, the active form of thyroid hormone, is crucial for the proper functioning of cells and organs. Without T3, the reproductive system barely manages to inch forward. Sex hormones suffer greatly, both at the ovarian level as well as in production at the hypothalamic and pituitary levels.
Hypothyroidism is caused by a wide variety of problems. Hashimoto’s thyroiditis is a an autoimmune condition that accounts for the vast majority of Western hypothyroidism. This can be mitigated by eliminating modern toxins, specifically wheat, dairy, and omega 6 vegetable oils, from the diet, and also by paying attention to gut health with gut-healing diets such as the GAPS diet or the one I recommend in Sexy By Nature.
Iodine-deficient diets can cause hypothyroidism. This used to be uncommon in western countries, since western countries iodize their salt, but sea salt often does not contain much iodine in it. Moreover, many Americans are now eschewing salt for “health benefits” (this is misguided), so their iodine levels are suffering. The solution to this is to consume iodized salt, or to perhaps supplement with kelp for a while. Iodine supplementation is tricky, however, and should build up slowly a la the recommendations of Paul Jaminet.
High intake of raw cruciferous vegetables can hurt an already suffering thyroid gland. Yet more importantly, low-carbohydrate diets contribute to hypothyroidism. Glucose is required for the conversion of T4 to T3 in the liver, so without adequate glucose supplies the body’s thyroid functioning suffers. This is a problem that many paleo women wrestle with. Adding just 50 or 100 grams of starchy carbohydrate to a daily diet, however, can increase energy, improve sleep quality, improve quality of skin and hair, and also boost reproductive function.
Repairing sub-clinical hypothyroidism has also been shown to remove ovarian cysts and help anovulatory women both ovulate and menstruate. For more on hypothyroidism, see Chris Kresser‘s work.
Stress: Stress is a psychological libido-killer, but it also has a physiological analog. When stressed, the body produces cortisol. Cortisol has a negative feedback effect on the hypothalamus, and it can inhibit all of the hormonal signalling that comes out of the hypothalamus. The hypothalamus is responsible for inciting pituitary function, so stress plays a very real role in inhibiting reproductive function. As many as five percent of women suffer reproductive symptoms of chronic stress.
Low Dopamine: Dopamine is the most important neurotransmitter for sexual prowess and reproductive function. Fortunately, dopamine deficiencies are very often corrected with the introduction of exercise into someone’s daily life. Almost nothing increases dopamine levels as well as exercise does. (Although sex also has potent dopamine-releasing effects: skin-to-skin contact shoots dopamine levels through the roof. But then dopamine levels plummet post-orgasm, creating withdrawal-type symptoms. This is how the body reinforces sexual behavior.)
Some women have reported to me personally the return of menstruation from amenorrhea after resuming regular sexual activity. They were as surprised as I was. Yet perhaps we should not have been so surprised. Dopamine is a potent neurotransmitter and, coupled with serotonin, can significantly up-regulate sex hormone production.
Low serotonin: Though excess serotonin has been linked to decreased arousal, serotonin also increases prolactin levels. Prolactin is important for vaginal lubrication and for sexual arousal. Ways to increase serotonin levels include adequate protein ingestion (.5 g/lb of lean body weight each day), adequate sun exposure, and perhaps most important of all, adequate sleep.
Low Body Fat/Excess Exercise/Energy Deficits: These three phenomenon almost always manifest in tandem. Yet the end result is the same: with low body fat, with excess exercise, and with caloric deficits, the body detects starvation. Leptin levels plummet, and the hypothalamus stops thinking that the body is sufficiently fed. Without leptin, the entire pituitary sex hormone cascade is not enacted. No LH, no testosterone, no estrogen, no prolactin, no progesterone. Body fat is unquestionably crucial for all reproductive function. Female libido just happens to be the one that’s the most fun to explore once proper body fat levels are restored.
Psychological factors effecting female libido:
There remain the psychological aspects to increasing female libido. And of them there are many. Perhaps a woman’s libido has been killed by a negative sexual experience. Or perhaps the woman is too stressed out by other factors to care about sex…or perhaps sexual relations between two people are strained because they can’t stand each other outside of the bedroom even more than they can’t stand each other inside the bedroom. Perhaps a woman’s lover is an ugly lump.
Many of those factors are outside my realm of expertise.
Some of them are inside of it, however, and fiercely.
Women need first to think they are sexy. I am so tired of women comparing themselves to others, and always thinking that beauty is relative. Beauty is not relative. It is everywhere. And in everyone. If she is beautiful it does not mean that you are less so. Period. I don’t care if you have a chubby stomach. I don’t care if you think your hair is boring. I don’t care if your right boob is larger than your left. Not a single other person cares either. At all. The only person who cares is you. No one wants to make you “perfect” but you.
You don’t have a single thing in the world to apologize for. No one is looking for apologies.
Instead, people are looking for statements. They are looking for fun. They are looking for inspiration, for character, and for life.
In that way, what other people want from each other is not necessarily for them to meet some ridiculous standard but instead to make them feel good. Whether that’s through sharing of your self-love, through your wicked personality, or through your liberated and unapologetically wild fantasies is totally up to you. The point being that confidence and self-love are the most important factors for actually being attractive. Sure, classic “looks” may follow, but only after a woman has convinced others that she is worth looking at.
Not a single person in the world wants to sleep with an apologizer. “Sorry, I don’t like who I am,” does not necessarily read like a 5-star resume. People won’t be throwing themselves at that. What they will instead throw themselves at is: “I am different from what you expect. But that’s an asset. I am worthy like you wouldn’t believe, and I am going to rock your world.”
Confidence is key. Beauty is key. And the thing is– damnit–it’s not faked confidence. It’s not faked beauty. You really are beautiful. You really are unique. You really are a natural, sexual, alive, vibrant woman. You do not have a thing in the world to apologize for. You are who you are, and you love being yourself, and you can share yourself powerfully and joyfully with others through sex.
This kind of self-love is why people get laid. It’s not because they have perfect torsos and racks as big as wombats. It’s because they have hot souls.
So confidence is important. So important, I wrote a book on how to find it through food and lifestyle. There’s one other crucial aspect I can speak to. It’s this:
SEX IS AWESOME.
IT IS NOT DIRTY.
Look. Sex is natural. Sex is so natural, in fact, that it’s the very reason we all exist. And sexual desire is natural. It is, by extension, the very reason we all exist. For that reason, along with many others, there is not a single immoral aspect to having sexual desire or having sex. Period.
And sex is not gross.
And a woman’s desire is not gross.
And a woman’s vagina is not gross.
And a woman having sex is not gross and not a slut.
Or maybe she is a slut, but that’s cool because that’s natural, too.
Men who don’t understand any of that are not real men.
The whole point being that American culture is a culture in which sexuality, and female sexuality in particular, is a dirty thing.
That is not okay.
It’s so not okay.
It is, in fact, plain old wrong. Sex is natural. If a woman (or man!) wants to be delighting in it, and more power to her. She is embracing her natural body. She is embracing her natural desires. She is owning her own confidence. And she is exalting in the vibrancy of her very existence.
If that’s not hot, I don’t know what is.
High fives for sex!
We already know how important the gut is to the health and functioning of the body. (Find my article A Healthy Gut in 4 Steps: This Week In Paleo here)
But did you know that the gut doesn’t just determine the health of our digestion or immune system but even the health of our brains and our offspring?
In fact, evidence is mounting that the microbiome (that collection of bacteria, fungi, and other creatures who colonize the colon, skin, etc) may determine whether you suffer from anxiety, depression, and may play a role in the development of autism in young children, among other things.
If you are pregnant, thinking of becoming pregnant, or have a young child, these are important things you should know.
The Microbiome and Pregnancy
Before birth, the mother’s microbiome actually changes to produce extra lactobacillus (which helps the baby digest milk) as well as several other bacteria that give the infant an important start in the world, helping with their immune systems and digestion, as well as several other things.
These bacteria coat the vaginal wall in preparation for the infant’s trip through the birth canal.
However, some mothers are placed on antibiotics while pregnant. They are sometimes important but these broad spectrum antibiotics destroy both negative and positive bacteria, meaning fewer bacteria overall for the baby.
It is wise to seek a doctor with a well-rounded view and respect for the microbiome, one who is careful with prescriptions of antibiotics, especially during pregnancy.
The Journey of Birth
When it comes time to give birth, the journey through the birth canal is one of the most important moments for the microbiological quantity and quality of an infant.
That trip through the birth canal is vitally important for a new baby. The microbiome of the vaginal wall infiltrates the babies mouth, eyes, ears, and gets into every mucous membrane, rapidly providing the important first colonization.
However, many babies are now born via cesarean section and therefore are not colonized by the bacteria on the vaginal wall, but rather by the skin of whoever they first spend time touching. This is significant because the microbiota of the skin is different than what is present in a healthy gut.
If C-sections are necessary (and they often are, though the medical community is beginning to admit they have historically been overused for many reasons) then many women are requesting or performing vaginal swabs to the mucous membranes of infants just after birth so that the infants can be colonized by the mother’s microbiome.
It might sound weird, but this could prove to be a vitally important procedure for the health, immune system, and psychology of children.
Since pregnant women spend nine months building this special colony for their baby, it’s a shame not to be able to pass it on, and may one day be shown to be quite damaging to the infant.
The first three years of life are vitally important for development of a child, especially their microbiome but many children experience ear infections early in life, or other issues which may be prescribed antibiotics.
Studies on rats have shown that those kept sterile or “germ-free” develop social anxiety, even autistic-like features, as well as a penchant towards obesity and other diseases.
Not only that, but with animals from conventional farms being fed antibiotics to both prevent illness and promote fat storage, we are all are inadvertently consuming antibiotics through food when we eat conventional meat.
Though there are times when antibiotics are necessary and can be lifesaving, it is generally agreed upon that they have been historically overused, often with little to no benefit and, it is being discovered, more and more detriment. In many cases, the condition would go away in time and may not even be a bacterial infection.
According to many medical professionals, it is often difficult to discern whether an issue is bacterial or a virus. Because many doctors receive pressure from patients for relief or are determined to “cover their bases”, antibiotics have been overprescribed. Pair that with the overuse of germ-killing products like hand sanitizer and it’s clear why there has been such a rise in antibiotic resistant bacteria, which can be deadly.
Most of us were probably placed on antibiotics at some point which threw our microbiome out of whack.
And it’s important for us to work with the best information and knowledge we have to try to put a healthy gut back together.
As adults, early childhood issues of the microbiome promote a range of conditions including obesity, diabetes, and associated illnesses, as well as diseases of the gut like Chron’s, and autoimmune conditions, allergies, and the like.
Psychologically there is growing evidence that an affected microbiome can stimulate anxiety, depression, and other mental health issues.
In several studies, as well as my work anecdotally, probiotics do seem to help many people improve mood, digestion, and symptoms of illnesses and conditions like irritable bowl syndrome.
For those with depression and anxiety, I think it makes sense to take a probiotic and for anyone- children and adults- who have had to use rounds of antibiotics, I think it is valuable to take a probiotic.
The probiotics used in most supplements are those with heavy research backing their efficacy. It’s hard to know just how much bacteria actually gets through the stomach acid with these probiotics, but several have special coatings to hopefully help them reach the colon intact.
I particularly like this probiotic for adults (find it here). Though it has fewer colonies, it is supposed to be more effective, remaining intact through the stomach and small intestine so that it can reach the colon.
This is a probiotic recommended for children (find it here). As with anything with kids, please make sure you get your doctor’s OK before giving these to your child.
Remember that a healthy diet is vital for the health of the gut as well. As much as I’d love it, we can’t just take a supplement and be done with it.
If you’ve had success with probiotic therapy, I’d love to hear from you! Which ones have worked for you? Which haven’t? And what have you done to improve your microbiome?
I have often warned about the dangers of birth control. I have also on the other hand said that I don’t think it’s all that much of a big deal.
Because here’s the thing: birth control is complicated. Obviously the most ideal situation is for no one to be on it. Hormonal birth control very obviously interrupts natural hormonal processes.
But as women today we have to make choice. Sometimes, especially in the context of a healthy body and a healthy diet, hormonal birth control is the best we can do (just, I hope, consider getting on the lowest dose possible).
That being said, we need to be cognizant of the risks we take, and what we can do to mitigate them.
There are 9 crucial nutrients that can be depleted by using hormonal birth control (see an extensive review of which here; free pdf here; you can also find all the source papers for this post listed in that paper’s bibliography).
For the most part, I believe that a nutrient-dense diet such as paleo in the context of a healthy gut and a healthy body will ameliorate many of these potential risks for many people.
But if you struggle with your health in any other way, are on a high dose pill, or are on the pill for a long time, you may want to seriously consider upping your intake of the 9 nutrients I discuss below.
Birth Control Risk Nutrient 1: Zinc
Zinc is an essential mineral that is not only found in several enzymes–which makes it crucial to lots of bodily functions–but it also, notably, is critical for immune system function. It also plays a key role in the metabolism of RNA and DNA, and promotes plasticity (flexibility) in the brain. It is important for immune health, hormone health, insulin modulation, and brain health.
The zinc status of women using birth control has been of concern since the mid 1960s, when scientists noticed that women on the pill has lower zinc levels than women who were not on it. These results have been extensively replicated. The thought is that birth control pills inhibit zinc absorption into the relevant tissues. This is a very big deal – the importance of zinc cannot be overstated.
The best sources of zinc are oysters (by almost a factor of ten), followed by liver, beef, and lamb. Turkey and shrimp also have good amounts of zinc. From plants, zinc can be obtained from lentils, quinoa, chick peas, and many kinds of seeds including pumpkin and sesame seeds.
High quality Zinc supplement
Birth Control Risk Nutrient 2: Magnesium
Magnesium iis one of the most abundant minerals that plays a role as a catalyst. That is–it is necessary for chemical reactions in the body to take place–more than 300 of them, in fact. For instance, ATP (adenosine triphosphate), the main source of energy in cells, must be bound to a magnesium ion in order to be biologically active.
It has been repeatedly shown that women on the pill have lower levels of magnesium than women on it. Interestingly, some researchers hypothesize that this is one of the reasons certain pills have been associated with risks of thrombosis. The pill can disrupt the magnesium / calcium balance in the blood and ergo lead to blood coagulability.
Magnesium is important for many other body functions such as blood sugar and insulin management, adrenal health, bone health, and mental health.
As important as magnesium is, it unfortunately is no long abundant in the human diet. Research estimates that at least 48% of Americans do not get nearly enough magnesium in their diets. This is in part because magnesium has been depleted from American soils.
Unfortunately for paleo dieters, the majority of foods high in magnesium are not on the typical paleo menu. High magnesium foods include mostly legumes, nuts and seeds: soybeans, pumpkin seeds, sesame seeds, quinoa, black beans, cashews, navy beans, sunflower seeds, almonds. Grains are also reasonably high in magnesium.
Fortunately for paleo dieters, kale, swiss chard, and beet greens are all great sources.
Nevertheless, magnesium is probably one of the greatest “risk” minerals for paleo dieters, which is why I typically recommend supplementing.
High quality magnesium citrate supplement
Blog about different types of magnesium to take
Birth Control Risk Nutrient 3: Selenium
Selenium is a micronutrient that functions as cofactor for reduction of antioxidant enzymes. This makes it incredibly important for detox processes. It also plays a role in the functioning of the thyroid gland and in every cell that uses thyroid hormone. It is incredibly important for managing thyroid disease, and specifically Hashimoto’s.
Hormonal birth control inhibits selenium absorption. For example; Heese et al conducted a study involving 200 female students, half of whom had been taking low-dosage triphasic pills for at least 3 months. They had significantly less selenium than control students. The amount of studies conducted on selenium is not as robust in other areas, but it points to a serious issue worth considering. This is especially important considering that selenium has been suggested to have a beneficial role in the prevention of cancer, especially breast cancer.
Fortunately for paleo dieters, many animal sources of protein are great sources of selenium, particularly seafood. Shrimp, sardines, tuna, and salmon all have whopping doses and can meet a whole days need; other protein sources like chicken, turkey, beef, eggs, and lamb are also good sources.
Mushrooms, barley, mustard, and asparagus are the best plan sources of selenium.
High quality chelated selenium supplement
Birth Control Risk Nutrient 4: Vitamin E
As an antioxidant, vitamin E helps protect the body against oxidizing damage. This can come from inflammation, from radical oxygen species, from trans fats, from the combination of eating too much fructose and PUFAs, and from consuming burned food, to name a few examples. Antioxidants help protect against this truly destructive damage.
Most of the studies conducted on hormonal birth control and vitamin E have so far been conducted on rats. It significant lowers their serum vitamin E levels. One of the few studies done on humans noticed a significant decrease in the health of platelet clotting in women on birth control pills; this problem went away once they supplemented with vitamin E.
Vitamin E Foods
Vitamin E is unfortunately another one of those nutrients dominated by seeds and legumes. Sunflower seeds top this list, with wheat germ, hazlenuts, almonds, and peanuts also on it. Avocadoes are a great source of vitamin E and probably one of the best for paleo dieters. Leafy greens are also very high in vitamin E. A salad topped with avocado slices is a haven of vitamin E.
Vitamin E supplement (made with safflower oil)
Birth Control Risk Nutrient 5: Vitamin C
Vitamin C is crucial for immune system health, for the manufacture of neurotransmitters, and for adrenal (stress system) health.
Scientists hypothesize that birth control pills — and especially ones containing estrogen — increase the rate of vitamin C metabolism, which decrease its quantity in the blood.
This is probably the nutrient least at risk by birth control pill usage, but it is still important to make sure you get enough, especially if you have gut issues or other health problems.
Vitamin C foods
Leafy greens, other vegetables, and all fruits (yes, citrus, but others too!) all have high quantities of vitamin C. If you are a paleo dieter but don’t go heavy on the veggies you may want to consider upping your dose.
vitamin C supplement
Birth Control Risk Nutrient 6: B6 (pyridoxine)
Vitamin B6 coenzymes are crucial for many bodily functions, most especially protein metabolism. It also helps synthesize neurotransmitters, and is especially crucial for the production of serotonin.
Hormonal birth control has been under fire with respect to B6 since the 60s, when it was found that women taking pills has evidence of a vitmain B6 deficiency — in fact, 75% of women taking birth tcontrol pills may have insufficient B6.
Since low B6 is associated with thrombosis, this is another reason (along with zinc) that birth control pills may be associated with blood clotting and other coagulation risks.
Many sources of animal protein, such as turkey, chicken, beef, tuna, eggs, and salmon, are all high in B6. Plant based sources are sweet potatoes, potatoes, spinach, other leafy greens, bananas, peppers, and garlic.
High quality B complex supplement
Birth Control Risk Nutrient 7: B12 (cobalamin)
Vitamin B12 (also known as cobalamin) is an essential nutrient for many things, but perhaps most of all liver support and detox.
Several studies have found low mean serum vitamin B12 levels in women using birth control pills, even though the mechanism is not yet understood.
Vitamin B12 is fortunately very rich in pretty much all animal protein sources, especially liver. But beef, lamb, poultry, seafood, and eggs all have fairly abundant B12. Dairy also has a reasonable amount of B12 in it. If you are a vegetarian, and especially if you are a vegan, you will need to supplement with B12.
High quality B complex supplement
Birth Control Risk Nutrient 8: B9 (folate)
As early as the 1960s, folate status has been a concern for birth control researchers. Women who are on hormonal contraception tend to have lower levels of B9; it seems as though when they start taking it folate levels decline linearly – but then levels do bounce back up. The mechanism for this is not quite known, but it seems as though excretion of B9 may be an issue, or malabsorption.
Folate probably is not an issue by itself on the pill–it will not cause anemia all on its own; but if you have other health issues (especially anemia) then this is cause for concern.
It is important to get foods with real folate in them – folic acid is a synthetic compound added to foods and is not as supportive of real health as true folate is. To that end, good sources of folate include seafood, beef, and poultry. Legumes come second on this list, as do asparagus, spinach, broccoli, and other leafy greens.
High quality B complex supplement
Birth Control Risk Nutrient 9: B2 (riboflavin)
Vitamin B2, also known as riboflavin, is necessary for energy production and normal cell function and growth.
Riboflavin deficiency is common in women of child-bearing age and of a low socioeconomic level. Using hormonal birth control exacerbates that problem. Studies have shown that vitamin supplements remediate riboflavin issues in women taking the pill.
Altogether, these findings suggest that vitamin B2 supplementation in women taking OCs may be important where vitamin nutrition is poor.
Greens, eggs, turkey, other sources of animal protein, and plant protein sources such as beans and legumes tend to be good sources of vitamin B2. With a diet rich in animal products, vegetables, and fruits, B2 should probably not be a problem to obtain enough of. Not many sources of B2 are excellent sources, but there is a wide variety of foods which contain a decent amount of it.
High quality B complex supplement
And thus with vitamin B2 I bring this list to a close.
All in all, for many of these nutrients, a healthy diet will be enough for many people.
But if you suffer from other health conditions, are a vegetarian, have a history of health problems, or otherwise suspect you may be deficient in any of these nutrients, it may be wise to eat strategically or to consider a low dose supplement.
Above I linked to several of my favorite supplements. Here they are again:
High quality Zinc supplement
High quality magnesium citrate supplement
Blog about different types of magnesium to take
vitamin C supplement
Vitamin E supplement (made with safflower oil)
High quality chelated selenium supplement
High quality B complex supplement
It isn’t easy as a woman in today’s world, trying to navigate birth control options while also taking the best care of yourself possible. I hope very much so that this list will help.
I would love to hear what you think of !
According to a 1999 Journal of the American Medical Association (JAMA) study, about 43 percent of women (compared to 31 percent of men) suffer sexual inadequacy for one reason or another. Interestingly, this is thought to actually underestimate the real level of sexual dysfunction in the U.S.!
Low libido is a serious problem for women. Unfortunately, it can come about from many different causes. Fortunately, with a low stress life style and nutrient-rich, healing diet, you can overcome most of the causes without even really trying.
Knowing about the causes can help you even further. Here is a list of the most common causes of low libido in women:
Causes of Low Libido for Women 1) Stress
Stress is perhaps the greatest of all problems for women’s libidos.
The thing is – you can have every single physical duck in a row, but if you are worried about anything, anything at all in your life, and you don’t have the mental peace and space to allow for sexual exploration and thinking, you will not be able to feel sexual drives.
Of course, it is possible to be stressed out and have a libido – sure! But for women who suffer from low libido, stress is one of the most common culprits.
Stress is a problem because it affects you physically, for one thing. It decreases production of important sex hormones like estrogen. Without estrogen it is nearly impossible to have a libido.
Yet it is also a problem because it affects you psychologically. The female body needs to feel perfectly safe (generally speaking) in order to have good sex… so if you are worried about work, missing sleep over finances, or struggling with your self-esteem in the bedroom (you can read more about what I think about that here in a post on orgasms and here in another post on libido), there is a very good chance your libido will suffer.
Causes of Low Libido for Women 2) Inflammation (& Overweight)
More than being overweight, inflammation is a problem for libido because it impedes both hormone and neurotransmitter function. Without hormones like estrogen and testosterone doing their work, and without happy chemicals like dopamine and serotonin to connect them to the brain, it is very hard to have a robust libido.
But I mention being overweight as well because 1) many people who are overweight have at least some degree of systemic inflammation, and 2) because being overweight is often a psychological problem for many women.
If you feel self-conscious about your body (which you shouldn’t – you can read my best-selling book on bodies and confidence to hear more about why), you may struggle to be able to focus on otherwise awesome things in the bedroom – like how sexy your partner is, how sexy you are, or how good your body feels.
Causes of Low Libido for Women 3) Under-eating / Dieting / Over-exercising
Under-eating, dieting, over-exercising, intermittent fasting, calorie counting, very low fat diets and very low carbohydrate diets are all surefire ways to tank your libido.
Because the female body is super sensitive to starvation signals. If it weren’t, and it became pregnant out in the wild during a famine, it would struggle to survive, and in all likelihood die. In order to prevent stressful pregnancies, therefore, female bodies are inherently wired to shut down reproductive function (and therefore reproductive desire) at the drop of a hat.
I cannot tell you how many women I work with who regain their libidos after gaining some fat (if they are much thinner than they used to be), adding carbohydrates back to their diets, or ceasing intermittent fasting. You can read more about the importance of carbohydrates for women in this post, signs you may be over-exercising in this one, or why intermittent fasting may be dangerous here.
Causes of Low Libido for Women 4) Low fat
Low fat diets deserve individual attention because they are so commonly the cause of low libido in women.
A very low fat diet (less than 30 grams of fat a day, in my estimation) is problematic for libido because it fails to deliver to the body the tools it needs to make hormones. Hormones are made out of fat. Without fat in the diet, the female body’s hormone production falters. So without fat in the diet, your libido will suffer as well.
Aim for at very minimum one tablespoon (about 14 grams) of fat per meal, three times a day.
Causes of Low Libido for Women 5) Low carb
Low carbohydrate diets also deserve indidivual attention because they are so commonly the cause of low libido in women.
A very low carbohydrate diet (less than 50 grams of carbohydrate a day) can hinder thyroid function.
Without healthy thyroid function, reproductive hormones and organs do not get the energy they need to work robustly.
Aim for at very minimum 50 grams of starchy carbs (sweet potatoes, rice) or fruit every day. I prefer to start my clients with 100 grams of carbs, but if you are fearful of them you can start with 50 and work your way up to a comfortable level from there.
Causes of Low Libido for Women 6) Hypothyroidism
As I just mentioned, hypothyroidism is a big problem for libido. It prevents reproductive organs from being able to do their jobs properly.
There are two primary categories of hypothyroidism (though of course there are many more ways to categorize it).
The first kind to which I am referring is a ‘simple’ slow down, likely the result of a low carb diet, excessive exercise or stress. This can be rectified by eating more (especially carbohydrates), and reducing stress.
The second kind to which I am referring is Hashimoto’s Thyroiditis, which is an autoimmune condition that must be treated like an autoimmune disease, and which may require thyroid hormone supplementation. Sarah Ballantyne’s The Paleo Approach is an excellent guide to autoimmune healing.
For my favorite guide to thyroid disorders, check out Izabella Wentz’s best-selling Root Cause.
Causes of Low Libido for Women 7) PCOS
PCOS is a hormone condition that affects 15-20% of American women, making it the leading cause of infertility in the United States.
While causing infertility, acne, difficulty with weight loss, and risk for diseases like type II diabetes and heart disease, PCOS also usually has a negative effect on libido.
PCOS is characterized by an irregular or absent menstrual cycle, by elevated testosterone levels, and by having cysts on the ovaries. If you suffer from irregular cycles you may wish to investigate whether or not you have PCOS. You can read more about PCOS in this post: what is PCOS, or check out my globally-cited manual on the condition PCOS Unlocked.
Causes of Low Libido for Women 8) Birth control pills
Birth control pills can be a serious problem for a lot of women for a lot of reasons. Low libido is one of these many potential issues.
Birth control pills – and other forms of hormonal birth control like the Nuva Ring, insert, or patch – contain high levels of artificial types of estrogen and progesterone in them.
Sometimes taking pills helps balanace women’s hormones…
Yet more of than not it has a negative effect on hormone balance, at least where libido is concerned.
If your libido appears to have plummeted when you began taking the pill, either consider getting on a lower dose pill (here is a list of my favorite low dose pills), a variety of the pill that contains more estrogen relative to progesterone (since progesterone can hinder libido), or a hormone-free alternative like the copper IUD or prophylactics.
I have a PDF quick guide to birth control from a paleo perspective available for download here, if you’d like.
Causes of Low Libido for Women 9) Low estrogen (relative to progesterone)
It is hard to tell from looking at medical journals which hormones do precisely what for women’s bodies, particularly when it comes to libido.
Medical journals seem to prove that hormones are important for libido… but not really get any more specific than that.
One thing that is clear, however, is that when progesterone levels are elevated relative to estrogen, libido suffers.
This makes sense evolutionarily: progesterone is secreted after ovulation, so your body isn’t trying so hard to get you to have sex at this time. Estrogen, on the other hand, is secreted right before ovulation, so this is prime time for your body to try to arouse you.
So if you use a progesterone cream, or if you suffer from low estrogen levels from any variety of causes, then this is definitely a problem for your libido worth addressing. This is also a potential issue if you are pregnant, post-partum, or breast-feeding, as progesterone levels rise at these times. The solution in this case is patience.
You can read a bit more about progesterone and stress here, and about some of the causes of low estrogen levels here.
Causes of Low Libido for Women 10) Menopause
Menopause is the final cause – and perhaps the trickiest one to fix – of low libido for women.
During peri-menopause, menopause, and after menopause, hormone levels are in the process of falling, and then remain relatively low.
The ovaries themselves stop making hormones. Since the ovaries are the primary source of estrogen in the female body, libido suffers.
The ovaries also make testosterone and progesterone. Yet testosterone is produced also by the pituitary and adrenal glands, and progesterone levels need to be present, but not quite as much as estrogen, for a robust libido. Fortunately, estrogen is still produced by fat cells, but that is often not enough to make up for the plummeting hormone levels.
There are a few things you can do about this.
1) eat a nutrient-dense, anti-inflammatory diet full of organic vegetables and fruits, organ meats (here’s a supplement in case you do not like to eat liver), eggs, fermented foods (here are my favorites) and the rockstar superfood cod liver oil, which will help assure that all of your organs are functioning well and your inflammation levels are a low as possible,
2) Be sure to eat at least 75 grams of protein a day to help bolster neurotransmitter status (you may also wish to consider a tyrosine or tryptophan supplement which can help dopamine and serotonin production, respectively)
3) Consider low dose short-term hormone-replacement therapy, though I prefer to think of that as a last resort,
or 4) experiment with phytoestrogens like legumes (chick peas, black beans), nuts (macademia nuts, cashews), or small amounts of soy or flax in your diet. These foods act like estrogen in the body and may be able to help give you the libido boost you need. Each woman’s body is different so you won’t know how these affect you until you give them a shot.
And that’s about it for causes of low libido!
Stress and other psychological factors are huge, soooo huge, but physiological factors can also be a big problem. I know at least they were for me… I personally had such a low libido due to starvation, low body fat and excess exercise that I couldn’t even bear the thought of kissing someone. This lasted for years.
I am happy to report that this is no longer the case.
Definitely no longer the case. 🙂
Here is a list of things I recommended for reference:
Izabella Wentz’s Root Cause (for thyroid)
Sarah Ballantyne PhD’s The Paleo Approach
PCOS Unlocked: The Manual
Weight Loss Unlocked: The Paleo Woman’s Solution
Birth Control Unlocked: Your Body, Your Options, Your Guide
Fermented Cod Liver Oil
My favorite fermented foods