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.

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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!