His and Her Health

I am new to this forum and just want to say that I am so glad that I found it!! I have had these same problems for many years too! <P>I have been with the same man for 5 1/2 yrs and our relationship is great in every other way except our sex life. I really want to change this! <P>I have been and am currently on antidepressant medication for many years(most recently wellbutrin for ~2 years) I know that the side effects of antidepressants include a decrease in libido so that is not a surprise. However, when we first met I was on antidepressants and I had a lot of sexual desire for about the first 4 months. Do you think that this is just attributed to the "new relationship syndrome"? <P>I have just recently been put on Testosterone 1mg oral lozenge three times weekly to maybe help libido problems (my free testosterone level was 17 I think). I have heard others on this forum talk about topical testosterone but has anyone tried oral? Any results???<P>I think that my problems could be partially psychological/pharmacological in nature but A few years ago I saw a counselor for other issues and this was one issue that we talked about. I did not have much luck with increasing my libido. Do you think that an actual sex therapist could help more?<P>My poor husband is so understanding but I hate the cycle that we go through and I just want to enjoy sex with him. I think to myself, its been about a week, I should initiate sex but if it were up to me we would not have sex ever! I don't want to have to think about it, I just want to want it!<P>Sorry if this has been rambling, it's just that I am so frustrated and its good to know that there are others that have the same problem that can relate!<P>I would welcome any suggestions.<p>[This message has been edited by lechatnoir (edited 22 July 2003).]

Agggh. I had a longer post to you, but lost it from technical difficulties. I'll start here.<P>I assume you are taking MethylTestosterone 1mg. If I'm wrong, please let us know what you are taking. (Is this estratest, or some other product?)<P>MT (MethylTestosterone) has some properties that make it potencially have a greater magnitude effect than regular testosterone. Namely, it doesn't bind easily to SHBG and it also drives down estrogen and SHBG production. (SHBG = Sex Hormone Binding Globulin) Also, MT doesn't convert to estrogens like bio-identical T. For all these reasons, MT can have a greater effect for similar amounts than "regular" T.<P>Given these and other reasons, I tend to feel more comfortable with a bio-identical testosterone applied topically. If you have a provider who is well versed in using the product, it probably can be used safely. I'd just make certain your provider knows what they are doing.<P>As for it's effects. Several here and elsewhere have had good effect on MT. It tends to act more quickly than bioidentical T. (In any case, I'd give a time frame of 1-6 months before seeing dramatic changes. It might be more quickly, but potentially not.)<P>A few suggestions. Get a copy of all the blood-work you've had done! This is really important.<P>Next, if you don't mind, post those results here. A free testosterone level of 17 doesn't fit any of the ranges. Perhaps that's a total T number, and that would make more sense.<P>In any case, your provider probably should have run all these tests to eliminate all potential hormone issues.<P>Probably the most important test(s) in relation to desire disorder/ low libido, arousal disorder and sensation issues are:<P><UL TYPE=SQUARE><LI>Total and Free T by equilibrium dialysis if possible (see an explanation of this in the blood-work section of the website listed in my profile.)<LI>Thyroid Function Tests (TSH, Thyroxine/T4)<LI>Prolactin / PRL (A blood test that measures the amount of the hormone prolactin.)<LI>LH / ICSH (Luteinizing hormone) <LI>FSH (Follicle Stimulating Hormone)<LI>Estradiol<LI>SHBG (Sex Hormone Binding Globulin)<LI>DHEA and DHEAS</UL><P>So, again, getting a copy of your blood-work results will tell you if these things were checked or not.<P>Next, if Free T wasn't checked with equilibrium dialysis, the result is questionable. The only other reliable method of determining Free T is the Free Testosterone Index. This is the index of Total T/SHBG. <P><B>Notes on the FAI.</B><BR>The Free Androgen Index is calculated by taking Total Testosterone in noml/L and dividing by SHBG in nmol/L<BR>(Total T nmol/L / SHBG in nmol/L)<P>Total T is not often given in nmol/L, but ng/dl. To convert to nmol/L, multiply the value in ng/dL by 3.467.<P><B>Example:</B> Total T of 10ng/dL = 353.634 nmol/L.<BR>If SHBG was 80 nmol/L, the FAI would be 0.4333.<P>(More information is available on the website listed in my profile.)<P>Are you on any other medications. There are many that can cause problems. Further, these problems can occur at nearly any time. They are most likely to occur when you first use them, but might crop up later. Don't completely dismiss a medication from potential problems simply because you've been using it for a while with no problems. Also, problems may occur subtly so you don't notice the onset. Birth-control is one particular one. You're aware of anti-depressants. There are others. (Again, more information is available at the website listed in my profile.)<P>A couple of additional questions/thoughts. What is your arousal and lubrication like?<BR>Is your clitoral sensation good/excellent? <BR>Is sex painful at all?<BR>Do you have children/Gone through child-birth? (There seems to be a large number of women who report problems after child-birth from hard deliveries and perhaps hormonal changes other than those from nursing etc.)<P>Finally, a couple of book reccomendations.<P>I'm Not in the Mood: What Every Woman Should Know about Improving Her Libido, by Judith Reichman - Score, 9/10 <P>For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life, by Jennifer Berman - Score 8/10 <P>Resurrecting Sex: Resolving Sexual Problems and Rejuvenating Your Relationship by David Schnarch (One really doesn't need both of David Schnarch's books, but both are good and somewhat different. Resurrecting Sex discusses medical causes for sexual dysfunction, where Passionate Marriage only reviews the psychological, though it's an excellent book.)<P>You might try the first and last ones first. I think they are the best.<P>There are many here who are ready and willing to help. Ask about anything you don't understand etc. We're glad to help.<P>Best wishes,<BR>Greg<P>------------------<BR>My profile has my email address . Click on the icon at the top of this post that looks like a head with a question mark.<P>Also note, I am *not* a doctor, and this is not intended as medical advice - Please talk to your doctor about your concerns.<BR><p>[Note: This message has been edited by NEWSHE Moderator]

Thaks for your reply greg! I have not had all the other tests run outside of a total health profile, which was all within normal limits. The testosterone test was a free testosterone but not by ED i don;t think. maybe that was total testosterone (17) i know that she told me that normal the range for women is 15 to something and I am on the low end of normal with 17. She told me that most women feel pretty good at 25.<P>I just got an IUD a couple of weeks ago and discontinued the pill (alesse-28). i had taken the pill for about 2 1/2 years and was on depo provera for several years prior to that. maybe switching from the pill will help<P>As far as your other questions:<P>What is your arousal and lubrication like?<BR>i have no arousal, a big fat zero in that category! lubrication is not too great. if my husband wakes me up in the middle of the night by stimulating me while i am asleep then i have great lubrication. he calls it a sneak attack<P>Is your clitoral sensation good/excellent? <BR>i am able to have clitoral orgasms, usually best with a vibrator but also with oral sex<P>Is sex painful at all?<BR>it is not painful but it does not feel good either.<P>Do you have children/Gone through child-birth? (There seems to be a large number of women who report problems after child-birth from hard deliveries and perhaps hormonal changes other than those from nursing etc.)<BR>no kids yet.<P>i don;t know, maybe it is all in my head. i was a very sexually active teen and suffered from that. i also have genital herpes which i got as a teen, that put a stop on the sexually activity. so there are some issues...<P>i am a recovering addict/alcoholic but i remember that when i was drinking i had no prob with arousal and/or libido. maybe the uninhibiting effects of the alcohol? i am not willing to drink again but i heard someone talking about a dameria herb that can allow relaxation. i'd like to see about that.<P>i have been more depressed lately which only makes my sexual appetite go into the negative, but my doc said that this could be hormonal (ie testosterone) but did not check the other levels, hmmmm.. need to check that.<P>i am a fulltime student and have a fulltime job and a host of other household responsibilites so that can contribute to all of the above. however, i have had the sexual dysfunction for a long time even when i was not working and only going to school.<P><BR>does that give you a clearer picture? let me know if you have any other questions. i'll work on the bloodwork.<P>

The 17 (ng/dl I assume) that you talk about sounds right for a Total testosterone value. It would probably be at the lower end of the "normal" range. (Normal is deceptive. It's basically an average (Middle 95%) of all the values of all the tests done by that lab. So, in basic, if the population who were tested were all the people who had a reason to believe there was a problem with their T levels, the "Norm Ranges" would be skewed.)<P>But Total T is deceptive. Free T, is the amount of T that isn't bound to SHBG and available for the body to use. Knowing the SHBG values would give us a better idea of exactly how low your Free T values are. (This is a rough guess, but if SHBG levels are above 25 nmol/L then it's likely that your Free T levels are pretty low. (I wouldn't be surprised to see your SHBG levels double that, but only a SHBG test will tell.) Your SHBG values are likely to go lower now that you're off the pill. This should free up more T. (You might give it a few months and then retest Total T, Free T and SHBG to see where things are then. Everyone's response to the pill etc is different. Some the effects are small, others massive.)<P>Lubrication and arousal are issues that can be affected by low T. So is mild depression or blunted mood, as your doctor mentioned.<P>I'm not sure what to say about some of the other issues you experience.<P>Let me ask a couple of other questions. Are there things that you think are inhibiting you? (Body image, religeous beliefs, societal pressures, etc.) This might be part of the issue.<P>I tend to think of people with low T this way... It's like trying to blow up a balloon. If you can't generate much pressure, getting the balloon full of air isn't going to happen. Having the requisite amount of T is like ensuring you have enough air pressure. But having said that, there are a whole host of other issues than can also prevent one from filling the balloon, so to speak.<P>Can I recommend one other book?<P>Getting the Sex You Want, a Woman's Guide to Becoming Proud, Passionate, and Pleased in Bed by Sandra Leiblum, Ph.D. and Judith Sachs.<P>This can help deal with inhibitions and other issues that might prevent you from getting what you want. (I've read all the books I've recommended and they're pretty good.)<P>I think, in general, you're headed down the right road. There might be a few tips we can give you and knowledge you can learn to better assist in your own care, but in general it sounds as though you're making good progress. I'll email you a few links that you might find interesting.<P>More questions, just ask.<P>Best wishes,<BR>Greg<P>------------------<BR>My profile has my email address . Click on the icon at the top of this post that looks like a head with a question mark.<P>Also note, I am *not* a doctor, and this is not intended as medical advice - Please talk to your doctor about your concerns.<BR><p>[This message has been edited by distressed_12345 (edited 24 July 2003).]

The herb is damiana and you can get it at most drugstores over-the-counter.<P>It can't hurt to get your hormone levels checked, especially free T, but I think there's something else involved here too. If you are able to enjoy sex waking up in the middle of the night, most people would say "psychological, see a sex therapist." But I think, especially with the past history of alcoholism that it might be a brain chemistry thing. Do you smoke or drink a lot of coffee, tea or Coke? Those things might be shooting up your serotonin levels during the day, and the middle of the night might be the only time they drop down to a good level for sex.

zane blue<P>could you tell me more about the serotonin connection to caffeine? i don't smoke but i do drink some caffeine daily. thanks!<P>Tracy

My pet theory is that in addition to high free T levels and good circulation and sensation, a woman needs the proper balance of serotonin and dopamine in the brain to feel connected to herself and have good libido and easy orgasms. This is a tricky thing to achieve since many substances in modern society cause serotonin to shoot up high. Not that I'm saying women should have low serotonin levels; that would cause depression. I think women should have stable decent serotonin levels and high levels of dopamine. Caffeine causes a spike in serotonin (and then later a crash).<P>I'm conducting a study on this very thing. There are some serotonin spikers that are hard to control for; there are some behaviors that also spike serotonin--gambling, compulsive shopping, videogame playing, even compulsive housecleaning. So if a woman is determined to raise her serotonin levels, she can. But generally eating high-carb, lowfat, low-protein meals, drinking caffeine, taking some herbal stimulants, and smoking will spike serotonin levels. Smoking and drinking alcohol also raise dopamine levels, which sounds like a good thing, but the problem is the spiking and then the crash afterwards. Cocaine too. Healthy ways to raise both serotonin and dopamine are long, moderate aerobic exercise and fish oil. And my personal favorite (although it does contain caffeine) dark chocolate.<P>This is probably way more than you wanted to know, but like I said, I'm really interested in this.<p>[This message has been edited by zaneblue (edited 31 July 2003).]