Shattering the Myth of Fasting for Women: A Review of Female-Specific Responses to Fasting in the Literature

Shattering the Myth of Fasting for Women: A Review of Female-Specific Responses to Fasting in the Literature


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.

Sort of.

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.

Intermittent fasting women

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. 

And this:

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.

And this:

 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.

And this:

 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.

intermittent fasting women


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?

Paleo and Sex: How to Have a Ravenous and Kickass Female Libido

Paleo and Sex: How to Have a Ravenous and Kickass Female Libido

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:



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!


The Estrogen Dominance Post: Where Its Coming From, and What to Do About It

The Estrogen Dominance Post: Where Its Coming From, and What to Do About It

“Estrogen dominance” is not a term typically used by the research or professional medical community. If the condition were described to them, however, they would be able to identify it. It is a real and common thing for women to have excessive estrogen levels. It just so happens that the natural health community is deliberate about addressing it.

The basic problem of estrogen dominance is that estrogen levels are too high relative to other hormones, specifically progesterone. Usually it occurs when estrogen levels go too high, though it can also happen when progesterone levels fall too low. It can occur at any time during life — during reproductive years, perimenopause, or even menopause.

It can also be coming from a wide variety of sources within a woman’s diet and lifestyle. This makes estrogen dominance a bit of a complex nut to crack. But a holistic approach to health (you can read my recommendations for women’s health in my best-seller, here) should at least get everyone on the right track, and provide a proper learning environment in which you can figure out precisely where your dysregulation is coming from.

Estrogen dominance: symptoms

Estrogen dominance can cause a wide variety of symptoms, as well as increase the risk for a wide variety of diseases and conditions.  Symtpoms associated with estrogen dominance include:

Weight gain


Mood swings

High emotional sensitivity

Heavy periods

Breast tenderness


Decreased libido

Sluggish metabolism

Menstrual cramps

Conditions that appear to be more common in women with estrogen dominance and that may in fact explicitly develop as a result of estrogen dominance include:

Cystic Fibroids

Ovarian Cysts






Hypothyroidism (estrogen is antagonistic to thyroid hormone)

Breast Cancer

Ovarian Cancer

Cervival Cancer

These aren’t problems we can just shrug off of our shoulders.  In many ways, we can reasonably view estrogen dominance as contributing to the deaths of thousands of women every year.

Estrogen Dominance: Causes

The causes of estrogen dominance are wide and varied, but largely have to do with metabolic dysregulation and organ malfunction.  Some dietary factors may also offset the balance.

1) Being overweight:

Fat cells perform a function called “aromatization” which converts testosterone to estrogen. The more body fat, the more the body tips the balance towards estrogen and away from testosterone.

Now, this does not mean testosterone levels are necessarily low in overweight women. To the contrary: testosterone levels tend to be high in overweight women. This is not always the case but is quite common: it’s because testosterone production is stimulated by insulin, and many overweight women have some degree of insulin resistance.

Woman predisposed to insulin insensitivity often experience increases in both testosterone and estrogen levels. Progesterone receives no bump from weight gain, however:  progesterone thus remains incapable of offsetting the estrogen increases associated with higher body fat percentages in overweight women.  (To learn how to lose weight in a way that is healthy, sustainable, and hormone supporting, check out this resource)

2) Overburdening the liver

The liver is responsible for clearing the body of “old” hormones, especially estrogen.  If the liver is overburdened with a hyper-caloric diet, with high volumes of sugar, with high volumes of alcohol, or with high volumes of processing chemicals, then, it becomes sluggish in it’s ability to process everything.  When the liver slows down, estrogen ends up becoming back-logged in a way, and wreaks havoc on the reproductive system as it waits for the liver to heal and to catch up in its bloodstream clearing capacity.

This effect is interestingly even more pronounced in men than it is in women, and it accounts largely for the development of breast-like fat deposits in heavy drinkers. Being overweight and being stressed may also contribute to this process in men.

3) Stress:

Stress wreaks havoc on all body systems. Perhaps most pressingly for women, however, it decreases the production of progesterone in the body. When a woman is stressed, her adrenal glands “steal” the precursor to progesterone and instead use it to produce cortisol, the stress hormone. This process is called “pregnenolone steal.”

High volumes of stress can yank the rug out from under progesterone, which can precipitously tip hormonal balance in favor of estrogen.

4) Consumptions of phyto and xenoestrogens

Much as I have difficulty with soy in my own life, I typically preach caution when talking about soy. I honestly believe that it is a good therapeutic tool for some women, and each of us needs to use it appropriately. Sometimes it can be helpful. More often than not I think it is probably harmful.

In every single case, however, soy, flax, legumes, and other sources of estrogen interfere with natural estrogen production.

Phytoestrogens can increase the aromatization process in fat cells that I described above. They increase the rate of testosterone and other hormones being converted into estrogen.

They can also simply just dump an increased estrogen load into the body, which automatically tips the balance. In a properly functioning metabolism, the liver should probably be able to clear out this increased estrogen load.  But sometimes the load is too heavy or the liver not quite strong enough, and that becomes an impossibility.

Phytoestrogens are from plants. Xenoestrogens are from chemicals in the environment, such as BPA.  Plastics and aluminums typically have BPA and you may ingest it if you aren’t careful.  Here’s my favorite BPA free coconut milk, and an awesome bottle that I use for my water.

It is also entirely possible to become estrogen dominance as a result of birth control pill use – a process which I describe in great length in this PDF.

5) A low fiber diet

Estrogen is processed by the liver, but it is also processed partly by gut flora, and also excreted through the digestive track.

It has been shown many times that low fiber diets are associated with estrogen dominance. There are many cofounding variables that may play a role here, but the general idea is that estrogen can be reaborsed through the intestinal walls. With poor gut flora and with slow intestinal motility, estrogen can sit too long in the gut and gets reabsorbed back into the bloodstream.

If you are constipated, this may be an issue for you.

So the answer is not necessarily fiber – fiber may not be what helps get rid of constipation for you – but it is one potential option.

Fiber is generally correlated with improved digestive pace and motion, though not exclusively. A proper amount of fiber helps push things along in the digestive track.  Too much fiber can obviously be damaging.  It causes something health advocates like to call “roughage.” It is abrasive, and it can lead to gut deteriorating conditions such as diverticulitis.  In any case, however, regularly consuming fruits and vegetables can be quite helpful for gut motility… as well as the rest of the body.

If you are really struggling with constipation still you could always try paleo fiber. Though I believe magnesium (my favorite here) may be a healthier way to supplement for constipation. The best possible thing to do however may be to eat fermented foods like these or consider a probiotic supplement like this.

Estrogen dominance: treatment

The best possible thing for estrogen dominance is a natural, paleo-type diet. Cooling inflammation, supporting organ – and particularly liver – function, minimizing phytoestrogen intake, and maximizing nutrient status are all excellent, estrogen-managing aspects of paleo.

A paleo-template type diet includes healthy, grass-fed or wild-caught animal products (with both the protein and the fat), seafood, fruits, vegetables, olive oil, coconut products, starchy vegetables, and to some extent seeds and nuts.

However, in an estrogen dominant system, seeds and nuts can act as phytoestrogens and tip the hormonal balance in favor of estrogen, so they should be carefully stepped around.

Foods that support thyroid health such as seafood and seaweed should also be quite helpful for boosting metabolic health and hormone clearance (if you do not consume seaweed regularly consider a small dose kelp supplement).

Foods to emphasize for estrogen clearing are those that boost B vitamin levels, omega 3 levels (fermented cod liver oil is an excellent way to meet the body’s need for omega 3 while also getting the rare but crucial vitamins A, D, and K), choline (for the liver!), zinc (here), magnesium (here), calcium, and vitamin D.

For that reason, eggs (choline), fish (omega 3 fats, iodine, selenium, and vitamin D), liver and other organ meats (vitamin A,  vitamin K, B vitamins, and iron, zinc, manganese, etc), and high quality animal protein may be your best companions in this journey.

Foods to be avoided are all processed sugars, grains, omega 6 seed oils, phytoestrogens which include soy, flax, legumes, seeds, and some herbs, which I list in great detail here, and alcohol.

Some herbs have also been rumored to be helpful. Personally, I don’t love to recommend herbs, especially ones that affect hormone balance, such as chasteberry. (Though chasteberry, and I did link to a good grand, has been rumored to be quite effective). They simply have not been studied to any significant depth. Everything we know about herbs and hormones comes from what people say – not science.

If you are still interested, the absolute best herbs I can recommend for estrogen dominance are ones that support liver health and may help support estrogen excretion. For that the absolute best are milk thistle and/or dandelion root, in my opinion. You can see a good milk thistle here and a good dandelion root here.

Additionally, L-taurine promotes bile circulation, which enhances estrogen’s excretion out of the body.

Exercise is incredibly important, as it can speed up the liver’s detox processes, sharpen insulin sensitivity, boost weight loss, help mitigate mood swing problems associated with estrogen dominance, and reduce levels of stress hormones in the body. You can read all about my exercise recommendations in this book.

Getting off of the pill or getting on a very low-dose pill is critical. You can read about the side effects, risks, and management tricks of birth control in this PDF.

Stress reduction is huge. I cannot emphasize enough how important this is. Without progesterone, it is nearly impossible to rectify estrogen dominance. They must be in balance. Even if every other aspect of estrogen mitigation is in place, if progesterone is low then estrogen dominance may persist.

Estrogen dominance: In sum

Estrogen dominance plagues a wide variety of women, and at all stages of life.

Supporting organ health, reducing stress, and generally focusing on healthful foods should get us most of the way there towards greater hormone balance.

There are, of course, many other things you can to do help mitigate problems associated with estrogen dominance– for example, experimenting with neurotransmitter supplementation or boosting neurotransmitter health with diet and supplements in order to mitigate mood swing problems– but those are wide and varied and left for their own places in this blog at an upcoming time.

Foods and supplements I have linked to above and which I have personally seen work really well with some clients:

Desiccated liver (in case you don’t like eating it!)

My favorite fermented foods for gut healing, healing constipation

cod liver oil for reducing inflammation and getting the important but rare A, D, and K vitamins

Milk thistle for liver support

Dandelion root for liver support

Paleo fiber

A great probiotic supplement like this

My favorite magnesium here

A list of my favorite fermented foods here

A good small dose kelp supplement


BPA free coconut milk

BPA free water bottle

And that’s a wrap!

You can check out my quick guide PDF on birth control and how to manage it’s symptoms – here – or check out my extensive work on another alarmingly common hormone condition, PCOS – here.

For the real skinny on the impact of hormones on your life, see my book, Sexy by Natureat its site or read reviews and buy it directly from Amazon!


In the meantime: what is your experience?  Does paleo help with these symptoms?  Are you estrogen dominant? What parts of your diet and lifestyle are best for keeping you hormonally balanced and healthy?  What’s worked, and what hasn’t?


The 10 Most Common Causes of Low Libido for Women

The 10 Most Common Causes of Low Libido for Women

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.

You can,

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

Desiccated Liver

My favorite fermented foods

Hormones and Female Libido: The Only Permanent Solution

Hormones and Female Libido: The Only Permanent Solution

When I google tips for how to enhance female libido, I get a lot of answers like “take a ginseng supplement” or “eat oysters four hours before intimacy.” While these tips might be effective in the short term, they are not effective in the long-term.

The ultimate solution (physically, anyway) to female libido is hormone balance.

The relationship between hormones and female libido could not be more clear:

The better your hormones are balanced and the more rich your supply, the more robust your libido will be.

The female body is highly sensitive to hormone fluctuations. This is in large part because the female body needs to be absolutely certain that it is healthy and in a safe enough environment in order to have sex and be pregnant. Why? If it is not healthy enough or in a safe enough environment and you conceive, then you could actually die from the physical stress of it all.

Fortunately you have all the tools you need to balance and boost hormone production. Here are the most efficient and effective steps you can take to get your libido robust and roaring.

1. Hormones and Female Libido: Address underlying hormone conditions

Do you have an underlying hormone condition?

This is a very important question to ask yourself. If you have an underlying health or hormone condition that is blocking healthy hormone production, then you will never be able to boost your libido no matter how hard you try.

The most common types of hormone conditions are:

1) PCOS. 

PCOS affects around 15 percent of American woman, making it the leading cause of infertility in the Western world. Symptoms of PCOS include irregular menstrual cycles, acne, low libido, difficulty losing weight, male pattern hair growth (facial hair), and male pattern hair loss (balding). If you have PCOS, this is definitely a roadblock to a robust libido. You can figure out if you have PCOS, and learn all about what to do about it, in the guide I wrote on the topic, here, or a blog post I wrote on the topic, here.

2) Hypothalamic amenorrhea. 

Hypothalamic amenorrhea is the fancy way of saying that the body is too stressed out in order to have healthy hormone production.

Emotional stress – such as mortgage payments – and physical stress – such as exercising too much and eating too little – are both big components of HA.

You may have HA if your menstrual cycles are absent, light, or irregular, if you have acne, if you have lost a lot of weight or dieted a lot in your life, and if you are stressed out. Here is a comprehensive post I wrote about Hypothalamic amenorrhea symptoms – and here is one about treatment.

You can also have HA and PCOS at the same time, despite what most doctors will tell you. I wrote a post debunking this myth and telling you what to do about it here.

3) Estrogen dominance. 

Estrogen dominance occurs when estrogen levels get too high and throw off hormone balance relative to progesterone, testosterone, and other hormones. If estrogen levels are too high libido will plummet (though estrogen is generally good for libido! Just not too much).

Estrogen dominance can be caused by being overweight, not exercising enough, low liver functionality, inflammation, birth control pill use, and a diet rich in processed foods. You can read all about estrogen dominance and how to overcome it in this post.

You can read all about how to lose weight healthfully in my fat burning and accelerating guide Weight Loss Unlocked, here. 

4) Early or unoptimized menopause. 

Menopause is one major hormonal cause of low libido. Unfortunately this problem is harder to fix than the others, because hormone levels naturally drop. Fortunately with an anti-inflammatory, nutrient dense diet rich in healthy carbs and fat like a paleo diet (read my take on paleo here), hormone balance is often supported and restored in menopause. You may also wish to consider bioidentical hormone replacement therapy, but you really do not have to, as a supremely healthy diet should normally be enough to help. Sometimes patience is really helpful too, as hormone levels fluctuate for a long time and then often settle into a more balanced place.

2. Hormones and female libido: get off the pill, or get on the right one

The birth control pill is another huge factor in female libido. Admittedly, sometimes it can help with libido, but more often than not it squashes it.

One solution for this is to find a variety of the pill that works well for you. If you are on a progesterone-only pill, you may wish to consider getting a formulation that also has estrogen in it. High doses of progesterone have been found to decrease libido when compared to estrogen. Switching kinds of progesterone can also help enhance your libido.

Another option is to ditch hormonal birth control altogether and instead opt for a hormone-free version like the copper IUD or fertility awareness. You can read all about these natural options, as well as the hormonal options, and what to do about them in my quick guide to birth control. 

3. Hormones and female libido: Minimize inflammation

Systemic inflammation and other underlying health conditions like auotimmune diseases can often get in the way of healthy hormone production. When the immune system is in hyperdrive, testosterone levels can rise, stress hormones can rise, and other reproductive hormone levels can fall.

Reduce inflammation by eliminating foods that are potentially inflammatory and which can block good nutrient absorption. The three major major culprits here are omega 6 vegetable oils (vegetable oil, soybean oil, corn oil, canola oil, wheatgerm oil, sunflower oil, safflower oil and the like), processed or added sugar, and grain products.

Focusing on fresh fruits and vegetables, wild-caught and grass-fed animal products, and healthy fats like olive oil and coconut oil is an excellent place to start. Organ meats are great for reducing inflammation, (here’s a supplement in case you do not like to eat liver), as are eggs, fermented foods (here are my favorites) and the rockstar super-suppelment that boosts the hell out of libido fermented cod liver oil.

4. Hormones and female libido: Get the building blocks you need

Sometimes women don’t have robust libidos because they don’t give their bodies the building blocks they need for robust hormone production.

In order to optimally produce hormones, you should consume:

-At very minimum 50 grams of animal protein a day (and up to 100). This is the equivalent of two cans of tuna, or two palm-sized portions of protein.

-At very minimum, 30 grams of fat each day. This is equivalent to about three tablespoons of oil. If you struggle with libido, I recommend increasing this to 45 grams a day to see if that helps. Fats are absolutely essential for healthy hormone production…. hormones are made out of fat, after all!

-At very minimum, 100 grams of carbohydrate every day. Many women go on low carbohydrate diets and are then puzzled about why they have lost their libidos. Low carbohydrate diets can reduce thyroid function – which is necessary for a robust libido – and can also cause the pituitary gland to slow down its activity. Be sure to eat at least 100 grams – so about four pieces of fruit or two bowls of rice – of carbohydrate every day. If you are an athlete, be sure to eat even more, and to always refuel after a workout.

You can fill in the rest of your diet with whatever macronutrients you like. Yet these minimums must be met in order to assure you get the building blocks you need.

5. Hormones and female libido: Eliminate or manipulate estrogenic foods

Many foods contain estrogenic compounds. Soy and flax are the worst offenders (don’t forget that soybean oil and soy lecithin are in almost all processed foods!), and are very potent phytoestrogens. Other foods that also perform estrogenic functions but are less powerful are nuts, beans, peas, and all other legumes.

For some women these foods are problematic and cause estrogen dominance symptoms. If you suspect that you have estrogen dominance, or if you consume a lot of these foods, consider eliminating them to see if that helps.

If you have low estrogen levels, such as if you have hypothalamic amenorrhea or are in menopause, you may wish to experiment with adding these foods to your diet to see if they help. I know that I personally notice a big spike in my sex drive when I eat these foods. You need robust estrogen levels in order to have a healthy sex drive, and these foods, while not permanent fixes, can definitely help boost your libido in the short-term.

6. Hormones and female libido: Reduce stress!

This last and final recommendation you cannot do, unfortunately, with diet. And it is perhaps the hardest one. But it is the most important.

Stress is a big physical problem for the body. Stress causes inflammation, it causes the thyroid and pituitary glands to shut down, and it causes hormone production to be shunted away from reproductive hormones and instead toward stress hormones, which do nothing other than elevate your heartbeat and make you feel wired.

So stress has a physiological impact on your body that must be eliminated for libido.

Though of course the psychological component of stress is also hugely important. It may in fact be the most important thing you can do for your libido.

I mentioned earlier that the female body is highly attuned to stress. This is true. The female body does not want you to have sex if you are stressed out, because it wants you to wait to be pregnant and care for an infant for a time when you are relaxed and the environment is safe.

Work, relationship trouble, self-doubt, self-consciousness, depression and anxiety are all big, stressful reasons that your libido can be crushed. And I can tell you, I can absolutely promise you, that you can be the healthiest eater in the world. But if you don’t take care of your heart and your brain and reduce stress, you will never have a robust libido.

I talk a fair bit about my own personal stress reduction techniques in this post. While not directly related to libido, it might be helpful for you. I also talk about the psychosocial aspects of female libido (and how to feel awesome about your lady parts) in this other post on libido.

My favorite books to help you think about sex healthfully are The Guide to Getting it On (a great intro to sex and great sex advice with emotional maturity and cultural awareness), Sex at Dawn (an exploration of the evolutionary origins of human sexuality and what that means for our modern lives) and She Comes First (a guide to pleasuring women!).


Hormones and Female Libido: In Sum

All in all, female libido is complicated in many ways. This is because hormones can be tricky to balance. But armed with knowledge of the ways in which hormones can go awry, and with the dependable help of a female health expert like myself (! 🙂 ), you can absolutely boost your libido again.

Grab a plate of oysters and ginseng in the meantime. But know that in the long-term, the plan that I have laid out here is the most effective.

It has worked for me! (I solved my own PCOS – read about how you can too here). And it works for my clients…. nothing will support your libido better or more permanently than by giving your body the fuel it needs to burn, baby, burn.




What works for you? Do you think my thoughts on hormones and female libido are accurate? What do you recommend?! 


The real reason women orgasm less often than men

The real reason women orgasm less often than men

There are a lot of myths in Western culture that make me furious. Here is one I’ve been thinking about a lot recently:

Women orgasm less than men because NATURE SAYS SO.

According to one large-scale survey of American adults, women have about one orgasm for every three that men have. That is thirty percent. Women orgasm thirty three percent as often as men do.

How do we account for this difference?

The standard means by which Americans explain this difference by suggesting that women’s bodies are simply bad at orgasms.  “It’s complicated!” we say. “Women are delicate flowers!” “Sometimes women orgasm and sometimes they don’t.”

Because NATURE. (Here’s what I have to say about a woman’s nature!)

Where does the idea that it’s a biological imperative that women orgasm infrequently come from?

1) Sigmund Freud. Freud famously argued that an orgasm without vaginal penetration was an “immature” orgasm. The idea that women could orgasm without (GASP!) a male organ inside of her was terrifying for the man. This theory has of course been seriously disproven. Masters and Johnson later showed that stimulating the clitoris on the outside of the body and the vagina on the inside is two different ways of stimulating… get this… the clitoris, because it’s actually a pretty big body part that exists both inside and outside the body. It’s the whole pleasure experience of the woman, period. So. There’s no such thing as an “immature” orgasm. They’re all on the same organ.

All the poor women who think there’s something wrong with them because they don’t orgasm from penetration alone – well. They (YOU) definitely need to know this. It’s all the same organ. And, in fact, more than 75% of women need some sort of external stimulation to orgasm.

Anyway. Freud said that the clitoris was bad and should be ignored.  People (men) really liked how much easier this made their lives. It rationalized what they were already thinking anyway. So the idea stuck, and stuck hard. 

Pun intended.

(For a radically alternative view to Freud, see the electrifyingly awesome book on sex in human history, here.)

2) Accidental ignorance

30% of women and 25% of men don’t know where the clitoris is.

A lot of people, I believe, are accidentally ignorant. Whether its because of a lack of good sex ed or because of the misogynistic culture in which we live (see points below), they simply can’t make heads or tails of female anatomy. It’s not really their fault – and I’m not mad at anyone for accidental ignorance. We are all victims of negativity in our culture in one way or another, and this is simply one of them.

One of my favorite books on this topic is She Comes First: The Thinking Man’s Guide To Pleasuring a Woman by Ian Kerner!  It does a FANTASTIC job of explaining where the clitoris is, how to find it, and what it wants!

3) “What you need is what I need.”

Even for a lot of people who do know where the clitoris is and who are interested in female pleasure, they simply go about it all wrong. Here is something that almost all people do subconsciously:

We treat other people the way we’d like to be treated.

At least in the bedroom, anyway.

So this is what sex ends up looking like: Women act a bit like a tease with men, touch them gently, don’t go right for the male organ right away. (Very, very generally speaking.) Because women generally tend to be more gentle and patient and appreciative of suspense in the bedroom.

On the other hand, men tend to go right for the goods. (At least, this is what Men are from Mars Women are from Venus tells me.) And when they want to increase pleasure, they go harder and faster. Because men generally enjoy it when things are harder and faster.


So let it be known, lads and ladies. You’re doing each other backwards. Think about the psychology of the human being you are with. Don’t assume that they like the style you like. Generally speaking, pleasure tends to be a bit complementary, with women’s bodies responding more positively to lighter touches and men’s to firmer. And if not – well. The right thing to do is ask.

(Here is my favorite book on pleasure for both partners, including psychological stuff. Here’s my favorite for women alone. Here’s my favorite for pleasing guys.)

4) Fear.

“I know women can receive pleasure, but I’m afraid I’ll look stupid if I let anyone know I need help.”


We live in a world in which men are expected to be perfect and manly and not need help. Plus, people are generally very fearful of vulnerability. Sex is already a profoundly vulnerable act. But what if you go into it and say openly “I don’t know what I”m doing!” That is perhaps the most vulnerable act of all. Of course – in that act there is a LOT of strength. It takes a lot of strength to confess ignorance. But it is a highly vulnerable and potentially volatile situation.

We can work to overcome by this developing our skills for acceptance, patience, and open communication. Men are cultured to be incommunicative. We tell them from day one that they should be strong, silent, unemotional types. But that’s just… that’s not right. If we can help make our culture one in which vulnerability and communication are highly prized values, then we can more easily navigate intimate spaces like the bedroom.

5) Misogyny.

Obviously, this is the worst one, and the one at which I concentrate my fury. It says:

“I know women can receive pleasure, but I really can’t be bothered to do it.”

That’s what The Men think.

This is what The Women think:

“I like orgasms, but I really want my partner to think I’m sexy and like me. I feel terribly self-conscious. I am going to please him first and not ask for my own.”

Six months ago, I met a man who was totally lovely and charming and kind. We went up to his hotel room. He pushed me on the bed and put his penis in me and intercourse-d me for maybe ten minutes, saying conquesting things like “this *ss is mine tonight.” He had an orgasm, and then “we” were done having sex.


Stefani was never a part of that sex. Afterward, I just laid there and sort of looked at him. I knew I should have had some fiery feminist thing to say, but I still couldn’t believe that that was it, he wasn’t going to invest in my pleasure at all, I thought surely there must be more coming. But there wasn’t. That was it.

When I say we live in a misogynistic culture that denies female pleasure, this is what I’m talking about. Of course this was a singular situation, but there are so many similar situations that happen on a day to day basis, I don’t even know where to start.

Misogyny — that is, this culture we live in that prioritizes men’s needs over women’s, and which tends to dehumanize and objectify women — makes us (both women and men) think a lot of bad things.

Misogyny makes us think the male orgasm is more important than the female.

It makes us think guys are lusty fellows, and that women are lusty objects.

It makes us think guys enjoy sex but women enjoy the mushy emotional things like cuddling.

It makes us think women are dirty and immoral if they act on sexual desire.

It makes us think, as was the case with my mystery hotel man, that sex is an acceptable form of conquest.

Come to think of it, it makes men want to conquer women in the first place.

It makes us think men have a valid sexual need, and that women are obligated to fulfill that need (see The Man’s Rights Movement or GamerGate or that punk on the shooting spree or any other incidents from 2014).

It makes us think men are sexual and women are sexy.

It makes us think the male orgasm is what makes sex successful and fulfilling.

It makes us think the male orgasm is the END OF SEX. (Hey guys, you have HANDS AND A FACE, I’m just saying.)

To demonstrate that what I’m saying isn’t crazy, I’d like to pull some quotes from an academic article by Elizabeth Armstrong and her colleagues, in the context of another article posted at Alternet.

Elizabeth Armstrong and her colleagues conclude that women’s orgasm rates are strongly related to her evolving relationship with her partner, the activities they include, and his investment in her pleasure.  The more times a woman is with a man, the more she orgasms. Women in relationships in fact orgasm up to seven times as frequently as single women do.

Qualitative research on men’s motivations confirm the last piece.  “I’m all about making her orgasm,” said a man interviewed for their study. “The general her or like the specific her?” he was asked.  “Girlfriend her,” he responded, “In a hookup her, I don’t give a shit.”

Women know the difference. Said one: “When I… meet somebody and I’m gonna have a random hookup… from what I have seen, they’re not even trying to, you know, make it a mutual thing.”

Expecting an orgasm from a male hookup partner is even seen as demanding and rude. One woman explained how she felt like she didn’t have the “right” to ask for an orgasm: “I didn’t feel comfortable I guess. I don’t know. I think I felt kind of guilty almost, like I felt like I was kind of subjecting [guys] to something they didn’t want to do and I felt bad about it.”

Out of nerves, insecurity, or a lack of entitlement, women often prioritize men’s pleasure too. Speaking of hookups, one woman insists: “I will do everything in my power to, like whoever I’m with, to get [him] off.”  My own research confirms that college women often fully accept that hookups usually don’t include orgasms for women. “Even if I was in charge,” said one, “I did not make sure I was being pleased.” “The guy kind of expects to get off,” said another, “while the girl doesn’t expect anything.”


The bottom line is this: women orgasm less than men do for many complicated, interwoven factors. But they are all social factors.

When you remove social barriers to orgasm, women in fact far outstrip men in orgasmic performance. 

That’s right.

Not only do women match men in potential number of orgasms biologically, but in fact we do it more. 

How do we know this?

Well. Women who sleep with women have  many more orgasms than heterosexual women. Women also have no problem experiencing  orgasm through masturbation. The same women who frequently have orgasms during masturbation report  many fewer orgasms when they’re with a partner.

Even the idea that women simply “take longer” than men is a myth. It takes women the same amount of time to orgasm during masturbation as it takes men, on average, to have an orgasm through intercourse:  four minutes.

So here’s the bottom line of the bottom line: 

Women orgasm less than men do because of the social forces of our culture, that live in both the brains of both men and women.

And then we come up with this idea, that no, it’s not our culture’s fault, it’s actually our biology’s fault.

And then we have a seriously powerful rationalization for ignoring female pleasure on our hands.

Saying that the female body is bad at orgasms gives guys (and gals) a free pass.

It is simply easier to go on thinking that female pleasure is “complicated.” One one side of the coin, it lets guys be lazy and feel properly accomplished in the sack. On the other side, it lets us women avoid having to stand up for ourselves and explore and demand equal attention.



So I challenge men to overcome fear and ignorance and help us. Even more importantly, I challenge us women to become better communicators about this. I challenge us to explore our own bodies and sexuality, and to learn what we like and dislike. I challenge us to tell men. I challenge us to be unapologetically sexual. I challenge us to own the real sexual power of our natural bodies – the biological bodies that have the potential to sustain multiple orgasms in quick succession. I challenge us to do this not only for the sake of a quick high between the sheets… but more importantly for the sake of consideration, empathy, and respect, and equality between the sexes.



For my favorite books on the subject, check out (all amazon links):

Sex at Dawn: How We Mate, Why We Stray, and What It Means for Modern Relationships

The Guide to Getting it On: A Book about the Wonders of Sex

The Red Queen: Sex and the Evolution of Human Nature

She Comes First: The Thinking Man’s Guide to Pleasuring a Woman

Passionista: The Empowered Woman’s Guide to Pleasuring a Man

The Male Brain: A Breakthrough Understanding of How Men and Boys Think

And of course, don’t forget my own book Sexy By Nature that covers all things women’s health!

 The Real Reason Women Orgasm Less Often Than Men - Paleo for Women