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Where’s My Libido?

Dr. Diana E. Hoppe, MD

Dr. Diana E. Hoppe, MD

“What can I do for my libido?” is a question that Diana E. Hoppe, a medical doctor and board certified obstetrician/gynecologist, has frequently been asked by many of her patients during three decades of private practice in San Diego. The author of Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life, Hoppe is also the medical director and principal investigator of the Pacific Coast Research Center, in Encinitas, which conducts international clinical research trials in the field of women’s health.

Hoppe’s involvement with research on menopause, perimenopause and libido, as well as her physician/patient relationships, piqued her interest in the issue of women’s sexual desire and motivated her to provide help for women who suffer from some form of sexual dysfunction.

“I realized that my patients were no different than the 43 percent of American women—many in the prime of their sexual lives—who would rather choose sleep, a good book or a soothing bath over having sex with their partner,” says Hoppe, who recruited some of her patients for clinical trials conducted by Pacific Coast Research Center. “One of them was a young woman who told me that if Brad Pitt walked into her bedroom, she would ask him to babysit her children, because she was tired and needed a break,” she quips.

According to Hoppe, women need to become more aware of the significant connection between their libido and the quality of their life, which often suffers due to overwhelming stress. Referring to a statement made by the American Psychological Association, which claims that two-thirds of all doctor visits are for stress-related problems, Hoppe cites her own findings from her practice. “As many as 85 percent of my patients tell me that they experience stress from child care, career, health issues and the economy,” she says, adding that the “super-stress” of having a baby, moving or assuming care for a sick relative can put women, “over the edge.”

Hoppe suggests that one reason why women are generally more stressed than men may be that they are the “air traffic controllers” for their families and do too much multi-tasking. Organizing family events, taking charge of household duties and arranging schedules for pick-up/after-school activities, among a multitude of other tasks, can become overwhelming and fatiguing. “Yes, women are good at multi-tasking, but it will benefit them greatly if they learn to prioritize each task and then deal with each independently, in a conscientious manner,” advises Hoppe, who notes that juggling multiple tasks can be both a burden and a gift.

Contraceptives that contain hormones, such as the pill, the patch and the ring, can also significantly interfere with a woman’s mood and may be associated with decreased libido, arousal disorder and vaginal dryness. “These effects occur because the majority of hormonal contraceptives (combined synthetic estrogens and synthetic progestins) are designed to prevent pregnancy by inhibiting ovulation; they lead to hormonal changes,” explains Hoppe. These synthetics decrease the ovarian production of certain androgen hormones such as testosterone, which in turn directly influences sex drive and pleasure.

“A second reason for less sexual mojo is that combined hormonal birth control methods increase the production of a protein called sex-hormone binding globulin (SHBG), which binds free testosterone,” advises Hoppe. Studies have shown a link between high levels of SHBG and decreased sexual desire.

“If you are on any type of combined hormonal contraceptive—the pill, patch or ring—and are experiencing lowered libido, talk to your health care provider about viable alternatives,” suggests Hoppe. “For instance, barrier methods of birth control, such as condoms, diaphragms or the new FemCap cervical cap; or forms of intrauterine contraception, such as ParaGard IUD and Mirena IUS, may have a less negative impact on your, ‘urge to merge.’”


Dr. Diana Hoppe is the founder of Dr. Diana Hoppe, M.D. Inc., a private gynecology practice located at 317 North El Camino Real, Ste. 310, Encinitas 92024. For more information about her book or practice, call 760-635-5600 or visit DrDianaHoppe.com.

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