Following the ISSWSH process of care, we begin with education and modification of potentially modifiable factors. Our treatment approach is individualized and comprehensive, addressing the root causes we identify through your assessment.

Dietary Approaches

Nutrition plays a foundational role in hormone production and neurotransmitter function:

For Hormone Balance:

• Include healthy fats (omega-3s from fish, flaxseeds, walnuts) to support hormone production
• Consume adequate protein for neurotransmitter synthesis
• Eat cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) to support estrogen metabolism
• Include zinc-rich foods (pumpkin seeds, oysters, beef) for testosterone production
• Add flaxseeds daily—research suggests 2 tablespoons can improve vaginal lubrication by supporting estrogen metabolism

For Blood Sugar Balance:

• Stabilize blood sugar with balanced meals containing protein, healthy fats, and fiber
• Minimize refined sugars and processed carbohydrates
• Eat regularly to prevent blood sugar crashes that trigger cortisol release

Anti-inflammatory Diet:

• Emphasize colorful fruits and vegetables rich in antioxidants
• Include anti-inflammatory spices like turmeric and ginger
• Reduce inflammatory triggers like alcohol, excess caffeine, and processed foods

Herbal and Nutritional Support

Evidence-based natural therapies can effectively support sexual health:

Adaptogens for Stress and Hormone Balance:

• Ashwagandha (Withania somnifera): Clinical trials show that ashwagandha can significantly improve sexual function by reducing stress, supporting hormone balance, and enhancing neurotransmitter function. Studies demonstrate improvements in arousal, lubrication, orgasm, and overall sexual satisfaction after 8 weeks of use.
• Maca root (Lepidium meyenii): Research indicates maca can improve sexual desire in both premenopausal and postmenopausal women, with particularly strong effects in postmenopausal women. It appears to work by supporting the hypothalamic-pituitary axis.

Hormone-Modulating Herbs:

• Vitex (Chaste tree berry): Can help balance progesterone levels and reduce prolactin, particularly beneficial for women with cycle irregularities or PMS
• Fenugreek: Studies show fenugreek extract helps balance estrogen and testosterone levels while improving energy and libido. It’s particularly effective for managing perimenopausal symptoms like hot flashes and low mood.

For Vaginal Health:

• Black cohosh: May help with menopausal symptoms including vaginal dryness
• Red clover: Contains phytoestrogens that can support vaginal tissue health
• Local vitamin E application: Can improve vaginal tissue health and comfort

Neurotransmitter Support:

• L-tyrosine and L-phenylalanine: Amino acid precursors for dopamine production
• B-complex vitamins: Essential for neurotransmitter synthesis and energy production, particularly B6, B12, and B3
• Vitamin D: Supports mood regulation and hormone production; optimal levels are crucial for sexual health
• Magnesium: Supports stress response, sleep quality, and hormone balance

Bioidentical Hormone Therapy

When indicated, bioidentical hormone therapy can be extremely effective for treating low libido:

Topical Estrogen: For women experiencing vaginal dryness, atrophy, or pain with intercourse, low-dose vaginal estrogen can dramatically improve comfort and sexual function without significant systemic absorption.

Bioidentical Progesterone: Can help restore hormone balance, particularly in perimenopause or in cases of estrogen dominance.

Testosterone Therapy: Research consistently demonstrates that testosterone therapy improves sexual desire in postmenopausal women. While not FDA-approved specifically for this indication in the U.S., it can be prescribed off-label as compounded bioidentical testosterone cream. The ISSWSH recommends considering a 3-6 month trial for postmenopausal women with low testosterone levels who are comfortable with this approach. Unfortunately NDs in Ontario are not currently able to prescribe testosterone.

DHEA: Can be used orally or as a vaginal suppository to support overall hormone production and vaginal health.

Lifestyle Modifications

Simple but powerful changes can significantly impact libido:

Prioritize Sleep:

• Aim for 7-9 hours of quality sleep per night
• Establish a consistent sleep schedule
• Create a calming bedtime routine
• Address sleep disruptions with natural therapies

Stress Management:

• Practice daily mindfulness or meditation (even 5-10 minutes makes a difference)
• Engage in regular yoga or gentle movement
• Try breathwork exercises specifically for pelvic floor awareness
• Schedule time for activities that bring you joy and relaxation

Movement and Exercise:

• Regular physical activity improves circulation, including to the pelvic region
• Exercise naturally boosts mood-enhancing endorphins
• Strength training supports healthy testosterone levels
• Pelvic floor exercises can enhance sexual sensation and function

Cultivate Intimacy:

• Prioritize quality time with your partner
• Communicate openly about your needs and desires
• Explore non-sexual physical affection and touch
• Consider scheduling intimate time (yes, it’s okay to plan!)

Mindfulness and Body Connection:

• Practice pelvic floor breathing: spend 5-10 minutes daily breathing deeply into your pelvic space
• Explore body awareness exercises that help you reconnect with physical sensations
• Challenge negative self-talk about your body or sexuality

Complementary Therapies

Additional natural therapies that may support sexual health:

Acupuncture: Research shows acupuncture can improve libido and lubrication, particularly for women experiencing medication-induced sexual dysfunction.

Aromatherapy: Studies indicate that certain essential oils, particularly neroli oil, may enhance sexual desire when used regularly. Inhaling neroli oil for 5 minutes twice daily showed remarkable improvements in postmenopausal women’s sexual desire.

Pelvic Floor Physiotherapy: For women experiencing pain or tension, working with a pelvic floor physiotherapist can be transformative.

Counseling: Individual or couples counseling can address psychological factors, relationship dynamics, and past trauma that may be impacting libido.