The Stress-Sex Connection | Ep 29

Welcome to the Libido Lounge: The Stress-Sex Connection

Dr. Diane: Welcome to the Libido Lounge, where we focus on all things love, lust, and libido. We believe that fabulous sex is as important to health as exercise and good food.

Hey everybody, welcome back to another episode of the Lounge. In today’s episode, we are talking about glucocorticoids—we’re talking about stress, really. We’re talking about stress, its impact on sex hormones, and what you can do about it.

Beyond Sex Hormones: The Full Libido Picture

Dr. Diane: One of the things I always like to remind people—because I hear this so much—is there’s so much more to libido than just sex hormones.

When we fix sex hormones—estrogen, progesterone, and testosterone—we find that not only does libido turn on in many situations, but we gain muscle, brain clarity, cardiovascular benefits, improved bone health, confidence, body image, and so much more.

There are many good reasons to work on sex hormones. But sometimes, even after we fix them, it’s not enough to turn libido back on. Other times, it is. But for many women, sex hormones are just one piece of a larger picture.

Hormones Talk to Each Other

Dr. Diane: The body is so deeply intricate. Hormones work by communicating and impacting each other. Testosterone is our building hormone—it fuels libido, energy, and muscle. It’s really hard to build muscle without enough testosterone. It’s one of the reasons men can build muscle so much more easily.

I’ve seen women go on a small amount of testosterone and suddenly their workout intensity and results change dramatically. It’s an amazing hormone! But too much isn’t good either—then we can get unwanted body hair or male features. That “just right” amount is critical.

Cortisol and Testosterone: A Complicated Relationship

Dr. Diane: Stress impacts testosterone, which brings us to cortisol. A lot of people think cortisol is the bad stress hormone, but it’s not all bad. Without it, you’d literally die. It’s essential to daily survival.

We don’t want too much—it can cause weight gain. But too little cortisol makes you fatigued, unmotivated, and unable to function. So we’re always aiming for that sweet spot.

When cortisol is out of balance, it can lower testosterone. On the flip side, testosterone can raise cortisol. So there’s this inverse relationship.

If we go to the gym and do high-intensity interval training, testosterone increases, and so does cortisol. But if we’re dealing with chronic stress, cortisol can lower testosterone. That’s why with stress, we gain weight, lose muscle, and libido drops.

Brain Fog, Overwork, and Low Libido

Dr. Diane: When we’re stressed, our brain isn’t present. We get into this overwork mode. And yes, that’s cortisol at play. Low libido from stress can happen both mentally and hormonally—because cortisol lowers testosterone, and testosterone is that hormone that gets us revved up and ready for intimacy.

Estrogen, Progesterone, and the Cortisol Connection

Dr. Diane: Estrogen can raise cortisol levels, particularly in postmenopausal women. But when estrogen is combined with progesterone, that rise doesn’t happen. This is another example of how these hormones do a delicate, intricate dance.

Progesterone helps balance estrogen, especially its proliferative effects. In conditions like endometriosis—where uterine tissue grows outside the uterus—low progesterone is often present.

Progesterone, when at healthy levels, can prevent these issues and also help prevent the cortisol rise that can come from estrogen alone.

Go Deeper: Hormone Testing & Hormonal Harmony

Dr. Diane: I go into this more in episode 24, where I talk about hormonal harmony and the importance of testing—specifically a urinary hormone test. That test helps us understand how all these hormones interact. Cortisol affects estrogen, progesterone, and testosterone—and vice versa.

The Adrenal Rhythm: Timing is Everything

Dr. Diane: Cortisol has a natural rhythm. It should rise in the morning and fall throughout the day. The urinary hormone test I mention in episode 24 can show this rhythm. You pee into a sample four times a day, and it maps your cortisol curve.

It’s useful for treatment. If cortisol dips at noon, you might take an adrenal glandular then. If it spikes at night, Magnolia bark can help lower it.

From a libido standpoint, this rhythm is crucial. Many people find they have energy dips—say at 3 PM or 6 PM. Knowing your energy highs and lows can help you schedule sex when you’re most energized.

The Power of Scheduled Intimacy

Dr. Diane: Just like I always work out in the morning—because that’s when I have the most energy—you can apply this to sex. If your cortisol (and energy) peaks at 10 AM, plan intimacy as close to that time as possible, at least on weekends or flexible days.

This is especially important as we age. Evening sex gets harder due to fatigue, and it often gets pushed aside. Scheduling a sex date can make it more fun, more effective, and way less stressful.

And yes—maybe that means hiring a babysitter for a few hours! There are ways to get creative.

Making It Work for You

Dr. Diane: It’s not about being rigid—it’s about finding the overlap in you and your partner’s natural rhythms and choosing the best day and time for intimacy. It’s about eliminating the mental chatter: “I’m tired,” “I have to get up early,” “I want to work out in the morning.”

Scheduling sex helps remove those roadblocks and lets you be present.

One More Thing: DHEA for Libido Support

Dr. Diane: Finally, a quick word about DHEA. It’s a precursor to estrogen and testosterone and can be a game-changer for libido. I’ve seen great results with liquid topical DHEA applied to the vulva—it really helps with desire and other symptoms. More on that in episode 24 as well!

Final Thoughts

Dr. Diane: This has been another episode of the Lounge. Thanks again for tuning in. This is Dr. Diane reminding you to stay classy, stay sexy, and always be a little badassy.

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