Sex and hormones

By Erika Schwartz, MD

I was just at a women’s empowerment retreat in Malibu and much of the talk among the 50-plus high-profile women there was about sex – how we do it, how often we do it, who we do it with and why we don’t do it or at least don’t do it enough.

I can’t get away from the subject.

When women and men come to see me in the office, they often need to get their malfunctioning sex machines fixed. Whether it’s their heads, as in “I don’t like my relationship and my partner is no longer a turn-on,” or their bodies (men with erectile issues and women with dry vaginas feeling old and unloved), everyone, it seems, needs help.

Sex is ubiquitous, like eating and sleeping, and yet, we understand so little about it.

Scientists know that much of our sex drive and its implementation (in the younger, more passion; in the older, more cuddling and companionship) depends on the amount of sex hormones our bodies make.

If we are young and full of energy, most likely our libido is going through the roof and we assume it’s all because we are full of sex hormones, so all we want to do is find someone to have sex with.

When the sex hormones – estrogen, progesterone and testosterone in both men and women – flag as we age or other toxic things diminish their production, our sex drive seems to plummet.

It’s not exactly difficult to understand. Look at the steaming bodies on the large and small screen and the je ne sais quoi that makes chemical sparks fly when the eyes of sexual humans lock on screen or even in the street. We are surrounded by a never-ending push toward sex.

Sexual prowess belongs definitely to the young and healthy who are making hormones galore but are also on an anthropological mission to perpetuate our species.

Forget about relationships, forget about what happens later. When you are in your teens and 20s, life is all about sex. The law of attraction brings people together to procreate and also to have fun. Hormones help implement the master plan.

And let us not forget pheromones. They are hormones our bodies exude that at a subliminal level attract the opposite sex faster than a flower does a hummingbird.

But that’s not all. Even with hormones in balance and aplenty, we still have to feel the attraction and the desire.

How many young people come into my office, complaining of lack of desire, you ask? What do you think? Well, more than you would ever imagine. In our world replete with drugs and bad hormones (from food, the environment and what’s often prescribed), our hormonal balance often goes awry, leading to more problems than solutions.

Young men who take anabolic steroids (to make muscles grow faster when working out), testosterone and growth hormone only find they decrease their sex drive, shrink the testicles and decrease sperm count. Hence the high use of Viagra in young men.

Young women on birth control pills lose their sex drive as well. It’s a side effect of taking synthetic hormones that throw off our body’s natural cycle. In vitro fertilization, so popular these days, robs women of the last shred of desire and turns them into baby-making machines, leaving often permanent hormone damage behind.

So much interferes and so much contributes to our sexual penchant that scientists and therapists spend entire lifetimes trying to understand our sexuality and helping us sort our sex versus love conundrum. Sometimes they help, but often we have to figure it out on our own or just give up.

Could it all be about hormones?

If it were that simple, how do you explain the 60-year-old woman who has been in a sexless relationship for decades and becomes a sexual being again after meeting a new partner?

Masters and Johnson studied what makes us sexual for decades and came up with only a small part of the answer.

The truth about our sexuality lies somewhere between our ears; with the hormones made by ovaries and testicles under the rule of the master gland, the pituitary; and most of all, with the socio-cultural input of the world we live in.

So for now, let’s enjoy sex if we have it and know we are not dead if we don’t.

For more information, email Dr. Erika at


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