Low Sex Drive

Low sex drive? Kisspeptin hormone injection may help, researchers say

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Image credit: Daxiao Productions/Stocksy.

  • Hypoactive sexual desire disorder (HSDD) affects about 30% of women and 15% of men.
  • Researchers from Imperial College London in the United Kingdom say the hormone kisspeptin could be used to treat HSDD.
  • Scientists found that kisspeptin helps improve sexual brain processing, boosting sexual responses in both men and women with low sex drive.

Hypoactive sexual desire disorder (HSDD) — where a person has an extremely low sex drive that causes them distress — affects about 30% of women and 15% of menTrusted Source.

Treatment options for HSDD include psychotherapy, sex therapy, lifestyle changes, medications, and hormonal therapies.

Adding to these choices, researchers from Imperial College London in the United Kingdom say the hormone kisspeptinTrusted Source could be used to treat HSDD by boosting their sexual response.

Two studies examining the effect of kisspeptin on HSDD were recently published in the journal JAMA Network Open — one focused on womenTrusted Source and the other on menTrusted Source.

What is HSDD? 

HSDD research suggests that it tends to affect more womenTrusted Source than men. The condition may come on at any time and can either be a long-term issue or only occur in certain situations.

Those at a higher risk for HSDD include those with:

Symptoms of HSDD include:

  • little to no sexual desire
  • little to no sexual thoughts
  • no interest in masturbation
  • inability to be aroused
  • no response to sexual signals
  • inability to orgasm
  • loss of erectile or ejaculatory function in men.

A person can have a low sex drive but not have HSDD. When a person has HSDD, it causes them distress.

Previous research finds people with HSDD have a lower quality of life, lower general happiness, and experience more negative emotions.

What is kisspeptin? 

Kisspeptin is a naturally occurring hormone found in the hypothalamus region of the brain. It helps stimulate the release of other reproductive hormones in the body.

Past research shows that kisspeptin plays an important role in the female reproductive systemTrusted Source, and it also helps regulate a person’s emotions and mood.

According to Dr. Alexander Comninos, honorary senior lecturer in the Department of Metabolism, Digestion and Reproduction at Imperial College London, consultant endocrinologist at Imperial College Healthcare NHS Trust, and co-senior author of the studies, about 10 years ago scientists realized that there was a lot of kisspeptin in areas of the brain related to sexual behavior.

“We tested this in healthy men and found that there was a boosting of sexual brain pathways,” he explained to Medical News Today. “Hence, we wanted to see if we could translate this to determine if giving kisspeptin could help individuals distressed about their low sexual desire.”

Dr. Comninos added there is currently a need for new treatment options for HSDD.

“Currently available treatments in [the] U.S, for women have limited effectiveness and carry significant side effects such as nausea, drowsiness, and interactions with alcohol,” he detailed.

“In men, there are no licensed treatments, as Viagra is predominantly a mechanical agent acting on the penis. Hence there is a significant unmet need to discover new safe and effective treatments for distressing low sexual desire,” Dr. Comninos explained.

Treating HSDD with kisspeptin

For these studies, researchers conducted two clinical trials — one with 32 premenopausal women and another with 32 men, all with an HSDD diagnosis. Participants underwent MRI brain scans, as well as blood and behavioral tests.

At the conclusion of the studies, researchers found men and women who received the treatment with kisspeptin experienced increased sexual brain processing, resulting in positive effects on their sexual behavior, compared to participants who had not received the hormone.

“Kisspeptin receptors are in the reward areas which control sexual desire in the brain,” Prof. Waljit Dhillo, an NIHR senior investigator in the Department of Metabolism, Digestion and Reproduction at Imperial College London. consultant endocrinologist at Imperial College Healthcare NHS Trust, and co-senior author of the studies told MNT.

“When men and women are looking at erotic images, their reward areas in the brain which control sexual arousal are more stimulated,” he explained.

“Our results suggest that giving kisspeptin can restore and even boost the brain balance related to sexual behavior,” Dr. Comninos added.

“It appears to suppress areas related to overthinking that are often overactive in HSDD and thereby release the brake on sexual arousal so they become more aroused. It was great to see that both women and men responded well to kisspeptin and in men, there was even a pro-erectile effect.”

– Dr. Alexander Comninos

When might the treatment be available? 

For the next step in this research, Dr. Dhillo said that “[f]urther trials will be needed in a large group of patients taking it at home to see how effective it will be.”

Dr. Comninos agreed and said if further studies and development go well, we might see kisspeptin-based treatments for distressing low sexual desire in five to 10 years.

“Crucially, kisspeptin appears to be very well tolerated — we did not see any side effects in these studies,” he continued. “Interestingly, there also appear to be other beneficial effects of giving kisspeptin. We have performed early work suggesting that kisspeptin may also have beneficial effects on bones and the liver.”

Potential especially to help men

MNT also spoke with Dr. Barbara Chubak, associate professor of urology at the Icahn School of Medicine at Mount Sinai, about kisspeptin as a treatment option for HSDD.

She said she was pleased by the possibility of having another medication with which to potentially help men struggling with low sexual desire.

“HSDD is a problem that affects men and women alike, and one that can be present in the setting of normal sex hormone levels,” Dr. Chubak explained. “And HSDD — I suspect because of gender stereotyping — is the rare exception to the rule in medicine, where we actually have more treatments available for women than we do for men.”

“Currently, the only FDA-approved medications for HSDDTrusted Source are approved for pre-menopausal women; they are used off-label in men, but there is scant research data to support that use,” she continued.

“The use of testosterone to increase male sexual interest is more established, but typically unhelpful when the patient has normal testosterone level at baseline. We also often use erectile dysfunction medications (e.g. sildenafilTrusted Source) to compensate for the manifestation of low libido as [erectile dysfunction], but this can also be unhelpful, as these medications rely on the presence of sexual interest to prompt genital arousal response,” Dr. Chubak went on to say.

As for what she would like to see next in this research, she said scientists need to evaluate whether kisspeptin is a safe and effective treatment for HSDD.

“Additional important considerations for any new medication are ease of use — ideally in a form that can be self-administered by the patient themselves, rather than the intravenous bolus used in the study — and durability of effect,” she continued. “I look forward to seeing research along these lines in the future.”

Men be warned! Regular night shifts can lead to low sex drive

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Erratic working hours and various other factors can take a toll on men and lead to lower fertility rates.

Sex Drive
A reduction in testosterone can result in the production of poor-quality semen, thereby making it difficult for men to help conceive babies.

Men, take note! Irregular working hours can dampen your sex drive and lessen your chances of fathering children.

Sleep loss has always been linked to various disorders, some of them being obesity and heart disease. An average human being needs anywhere between seven to eight hours of sleep every night. In today’s times, erratic working hours, unreasonable deadlines, and other factors have taken a toll on the amount of sleep and rest that a person gets.

According to Dr. Hrishikesh D Pai, Director IVF & Infertility at Fortis La Femme Hospital, Delhi & Secretary General of the Federation of Obstetrics and Gynaecological Societies of India, men who do shift work are the worst victims. The working pattern can affect the health of employees and impact their sleep pattern, meal times, and the ability to exercise.

Apart from this, lack of sleep is also associated with urinary problems and erectile dysfunction. The reason for this is that an erratic schedule can lower testosterone levels in men. Testosterone is a hormone which helps fuel a man’s sex drive. A reduction in the level of this hormone can result in the production of poor-quality semen, thereby making it difficult for men to help conceive babies. Male fertility rates have already plummeted in the recent years due to poor diet and lifestyle and also ‘gender-bending’ chemicals present in the environment.

Too much or too little sleep can impact the body’s circadian rhythm. The circadian rhythm controls the production of the sleep hormone melatonin and cortisol, which is a stress hormone. Men who do shift work tend to constantly shift their circadian rhythm which results in the same type of ‘jet lag’ that one associates with travelling to and from different time zones.

The fluctuation in hormone levels can lead to a change in the expression of genes essential for producing sperm. Not just this, irregular sleep also increases the risk of insomnia or excessive sleepiness and causes a reduction in the total sleep time due to the work schedule.

A lifestyle that involves irregular sleep patterns also contributes to blockages or obstructions in the tubes that take sperms away from the testes to the penis. This results in complete lack of sperm in the ejaculated semen.

Here are some tips for those working in night shifts:

•Try to avoid working several night shifts in a row.

•Avoid frequently rotating shifts.

 

•Keep your workplace brightly lit to promote alertness.

•Avoid bright lights on the way home from work if possible. This will make it easier for you to fall asleep once you hit the sack.

•Ask your family to limit phone calls and visitors during your sleep hours.

•Use blackout blinds or heavy curtains to block out sunlight when you have to sleep during the day.

•Try to avoid long commutes that take time away from sleeping.

•Limit caffeine – you may have trouble falling asleep when you get home.

•Stick to a regular sleep-wake schedule as much as you can.

Technical advancements in the medical field have made procreation possible for men facing infertility issues.Some commonly known procedures available include Testicular Sperm Aspiration or TESA, Percutaneous Epididymal Sperm Aspiration (PESA), Percutaneous Biopsy of the Testis (Perc Biopsy), and Microsurgical Epididymal Sperm Aspiration (MESA).

While modern medicines and techniques help address and resolve this issue, it is important to first bring about health changes in one’s lifestyle including adopting good eating habits, following a proper sleep routine and engaging in physical activities. Having said this, sperm formation takes almost three months and therefore, along with a change in lifestyle what is needed is giving the changes adequate time to reap results.

Low Sex Drive? What Your Hormones Have To Do With It + How To Improve Libido

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Dr. Sara Gottfried is a Harvard-trained MD, best-selling author, and leading expert on hormones. That’s why we’re thrilled to team up with her for a new series this week on balancing your hormones for better health. If you’re inspired to learn more, check out her new course, How to Balance Your Hormones for Glowing Skin, Deeper Sleep & Better Digestion.

How Your Hormones Really Affect Your Sex Drive + What To Do About It Hero Image

This statistic troubles me: 57 percent of women prefer Facebook to sex. While the data doesn’t come from a scientific source (Cosmopolitan), it reflects a general feeling of “meh” that many of my patients have toward sex.

I see it daily in my functional medicine practice, and the symptom points to a larger, more disturbing problem.

I consider sex drive to be the canary in the coal mine of overall physical and mental health—and sadly, the state of women’s health, longevity, and happiness is declining in many ways. As a result, low libido is common, but few understand that the root cause is hormonal, not some intrinsic problem or lack of love and connection. Or people know hormones and sex go together but don’t really know which hormones matter or how they interact to create sexual interest, toe-curling orgasms, or robust health. Or even more important: what to do about it.

I believe that sexuality is a portal to other areas of your life, and when you optimize your sex life, there are many downstream benefits that you may not realize. You’ll find freedom in other aspects of your life where there once was struggle. And when you upgrade your sexual energy, you heal from the inside out, which is far better and more sustainable than seeking the latest Band-Aid. This is true for single folks as well as people in long-term relationships.

After years of working with people who want to get their mojo back, I know that low sex drive, poor energy, lousy sleep, skin problems, and bloating aren’t diseases that can be fixed fast with a pill or shot. These are usually hormonal problems, meaning our bodies are trying to tell us that something is wrong.

The Root Causes of Low Sex Drive

I’d estimate that 70 percent of low sex drive cases are due to misfiring hormones. Of course, there are other considerations, such as communication and intimacy, emotional currency, sexual variety, mismatch of expectations and style, frequency and type of sexual connection. For a healthy, deepening sexual connection, these areas need to be explored, mined, and renegotiated.

Many women believe as I did that they don’t have to worry about their hormones until menopause, but the truth is that your hormones start to change in your 20s. DHEA and testosterone begin to decline. Cortisol, the main stress hormone, can start to climb and rob your other sex hormones. For some women, estrogen and/or progesterone can drop, leading to estrogen dominance or PMS. You may experience high testosterone (such as with polycystic ovarian syndrome) or low testosterone (as a result of excess stress or aging). Or your thyroid may start to sputter.

Other hormones get in on the act—including oxytocin, insulin, and ghrelin—but these are the main hormonal problems I see daily as part of the story of low libido. Here, I’ll share what symptoms you might experience with each hormone. Note that I’ve included only a partial list for each—to learn more, check out my new mindbodygreen course.

1. Cortisol is too high, too low, or a combination.

It’s important to understand that dysfunctional stress in the body is the root cause of most, if not all, hormone imbalances. You may or may not be aware of how stress is being generated in the body, and one of the earliest signs can be lower sexual interest or desire.

The underlying reason for wayward cortisol varies from person to person, but it’s important to know if cortisol is off for you. For me, cortisol crashed in my mid-30s after having a baby—I was trying to be all things to all people, running myself ragged as a working mom and OB/GYN, and chasing a dream that didn’t belong to me as a surgeon and academic. My poor husband felt neglected and rejected as my libido tanked, and it took taking on my own hormones to understand the central role of cortisol in sex drive and my more global energy.

Signs of unbalanced cortisol:

  • Feeling wired but tired
  • Running from task to task, feeling overwhelmed
  • Sugar or carb cravings
  • Difficulty falling or staying asleep
  • Feeling burned out or fatigued, particularly under stress
  • Increased belly fat or weight gain
  • Unstable blood sugar—too high, too low, or both
  • Skin conditions, such as eczema

2. Estrogen is too high, too low, or a combination.

Estrogen is the main female hormone. It causes the female body to grow breasts and hips (in men, too much can lead to man boobs and estrogenic fat deposits at the hips). When it’s in balance with its counter hormone, progesterone, your period arrives on time, your skin is clear, and your mood is stable. When it’s too high or low, you may experience one or more of the following symptoms.

Signs of unbalanced estrogen:

  • Bloating or water retention
  • Abnormal Pap smears
  • Heavy or excessively light (even absent) periods
  • Breast tenderness or cysts
  • Mood swings or PMS
  • Rapid weight gain, particularly at the breasts or hips
  • Migraines
  • Red flush of the face, or rosacea
  • Vaginal dryness or atrophy

3. Thyroid is too low.

When your thyroid gland in your neck is underperforming, you feel flat and lackluster in most areas. Your hair thins, particularly eyelashes and the outer third of the eyebrow. The origin varies from person to person, and could stem from autoimmune destruction (Hashimoto’s thyroiditis) or be secondary to high cortisol, or even result from exposure to endocrine disrupters like bisphenol A or flame retardants.

Signs of low thyroid:

  • Fatigue, particularly in the morning
  • Weight gain
  • Mood problems, such as low-grade depression
  • Headaches
  • Dry, strawlike hair that tangles easily
  • Hair loss or thinning (particularly lashes and outer third of eyebrow)
  • Decreased sweating
  • Cold hands and feet, or intolerance of cold
  • Constipation

4. Testosterone is too high, too low, or a combination.

Testosterone begins to decline in your 20s, which is why you don’t respond to weight training with the same gusto that you did as a teenager. But the worst culprit when it comes to low testosterone is taking oral contraception. The Pill raises your sex-hormone-binding globulin, which is like a sponge that soaks up the free (and therefore biologically available) testosterone in the body. As a result, you may experience low sex drive, vaginal dryness, and even pain with insertion. Even worse, the problem may not resolve when you go off the Pill: One study showed that up to one year later, your hormones may still be out of whack.

High testosterone is one of the defining characteristics of polycystic ovarian syndrome, which affects about 10 percent of American women. Low testosterone is very common with age, contributing to depression in both men and women, low sex drive, and grumpiness—but it doesn’t have to be.

Signs of unbalanced testosterone:

  • Acne or greasy skin
  • Rogue hairs, especially on face, chest, or arms
  • Skin tags
  • Anxiety or depression
  • Fatigue
  • Loss of confidence and agency
  • Poor muscular response to high-intensity or weight training
  • Irregular menstruation (every 35 days or less often)
  • Infertility or subfertility

How to Regain Your Sex Drive

For far too long, there has been this prevailing belief that declining sex drive is simply inevitable, that it’s a part of being a modern and busy woman (or man), that it’s part of aging, that it’s part of life after childbearing years, that it’s part of long-term monogamous relationships, etc. I disagree. It’s not normal.

Nothing annoys me more than a doctor who brushes aside pain points like low libido as simply a “symptom of aging.” I believe it’s both possible and important for a woman to maintain a strong sex drive long past her childbearing years. It takes a little work—maintaining balanced hormones, trying some proven botanicals, a little self-love, and a steady diet of quality orgasms—but is more than worth it in the long run. Of course, libido will naturally wax and wane. Ultimately, it’s your choice.

Every day we hear about a different method to boost your sexual energy, your life force, your libido. Take this supplement! Read 50 Shades of Grey! Increase variety! Drink green tea. Don’t have any caffeine. Have sex in the morning only! Try this fantastic new lubricant! Eat fewer carbs. Eat more carbs. Eat carbs before protein. Eat carbs at night. Eat oysters! Drink less. Drink more. It’s totally confusing and often not based on any scientific research.

Instead, here are some of the most proven ways you can rev up a flagging sex drive:

1. Add an adaptogen.

If your cortisol is too high, too low, or both within the same day, I recommend taking a double adaptogen like ashwagandha. I mix a pure organic powder with hot water and drink it twice per day as a tonic for stress.

2. Change up a boring sexual routine.

You may need to bring in some variety along with resetting your hormones. My favorite is orgasmic meditation (OM), a cross between mindfulness and genital stroking, for 15 minutes as popularized by Tim Ferriss in The 4-Hour Body.

I find that OM is a wonderful practice for people who are tired of sex, or tired of how fat they feel, or just tired. It fills your tank with oxytocin, and we all need more of that! Oxytocin raises testosterone in men and lowers cortisol. In women, it raises estrogen and helps the thyroid work better.

3. Make a medicinal maca shake.

I’m a fan of occasionally drinking your nutrition, especially if you’re on the go and find it hard to eat well. I found during my hormonal recovery that my blood sugar is most stable when I started my day with yummy protein shakes. (You can hear more about my personally formulated medicinal shakes in my new mbg course.)

Maca is a libido-boosting herb native to Peru that’s proven to nourish endocrine glands. Studies show that it raises sex drive in women and reduces anxiety and depression. It’s my herb of choice for women with low estrogen.

4. Visit your health professional.

If you’d rather mop the floor than have sex, there’s a good chance there’s a hormone problem. Get help with sending a search-and-rescue operation after your lost libido by visiting a collaborative functional medicine doctor who will work with you to identify the root cause and find a natural solution.

Sometimes the culprit is overwork and high stress; sometimes it’s a medication, like the Pill or an antidepressant. Get the help you need to test your hormones and come up with a smart plan.

My hope is that you prefer sex to Facebook, and that starts with getting your hormones back on track. It’s important to your health that you make sexual pleasure a priority but not the stuff of Hollywood movies. Instead, choose the real, organic, yummy approach to sex that is your birthright and underpins optimal physiology.

Keep your focus on the natural remedies, the proven potions that truly work for you and that truly stick. Then it’s a matter of keeping your hormones in balance so that you can keep the fire stoked.