Chapter 14
Sex and Sweat: Why We Need Both For Hormonal Balance
Love is the answer, but while you are waiting for the answer, sex raises some pretty good questions.
Woody Allen

Here’s what you will learn in this chapter:
• Many of us are not enjoying the sex we should
• How sex revs up our fat-burning hormones
• How sex can satisfy cravings and control our appetite
• The benefits of exercise on our hormones for fat burning and metabolism
• The common workout mistakes that slow fat loss and hamper the hormone-enhancing benefits of exercise

Now that you have primed your hormones in Steps 1 and 2, you are set to enjoy the explosive benefits that great sex and exercise have on your hormones, metabolism and weight loss. If you are not in the habit of getting physical on a regular basis, I hope this chapter will persuade you to change. When I say “getting physical,” I mean enjoying two very basic hormone-enhancing, fat-burning, stress-busting activities: sex and exercise. Both involve working up a sweat. Both have wonderful hormone-boosting effects when we engage in them regularly. And, believe it or not, when we do one, we often have more desire to do the other.

Any amount of pleasurable sex is beneficial for you, as is any amount of exercise when done properly. So, I guess in this sense, every workout counts and every make-out session counts — but doing both a few times weekly is even better! Unfortunately, the majority of us don’t exercise and just as many of us don’t enjoy sex as often as we should.

We can come up with a whole host of reasons why we don’t exercise: we’re too busy, too tired, don’t have enough time, not in the mood, don’t like it, don’t feel well enough, don’t know how to do it, don’t think we’re good at it, can’t last long enough, wouldn’t know how to start, don’t like to do it alone, don’t like doing it in public. And I suppose all of these could apply to sex too.

In my practice, I have at times begged patients to begin working out. In some cases I have actually told them not to come back to see me but to spend their money on personal training instead. One patient in particular was terrific about taking her supplements and was spending plenty of good money doing so. I told her she would probably need half the products if she would exercise.

I truly believe there is no better way to change your life than to start exercising. If there’s one thing I pray you’ll do after reading my book it’s to make exercise a part of your life, if it isn’t already. If it already is, perhaps you’ll learn something after you read the second part of this chapter that will allow you to enjoy better results from your efforts. But let’s start with sex first. It’s always a good attention grabber!

Bringing Sexy Back!

Sex is something we can get by without, whether we are in a relationship or not, but we shouldn’t have to. Sex can be a complicated issue because it involves emotions, relationships, past sexual experiences, and physical and spiritual components. It also depends heavily on our current hormonal state, although some experts say our prior sexual functions and relationships are more important variables in determining how much sex we have or how enjoyable it is for us in the here and now.

When a patient comes to see me, I ask two basic questions: How’s your energy? and How’s your sex drive? When a patient tells me either of these aspects of his or her life has changed, I know immediately there’s a bigger health problem at play. Sadly, I’ve found that a surprising number of people ignore these changes for years, simply accepting them as normal or feeling too embarrassed to deal with them.

If this scenario sounds familiar to you, I hope to inspire you to think differently and to take steps to get your “mojo” back. You may be one of the millions of adults who experience sexual dysfunction, the incidence of which appears to be at an all-time high. According to an extensive study published in the Journal of the American Medical Association, the obesity epidemic is certainly not our only concern at this point. The results revealed that about 43 per cent of women and 30 per cent of men experience symptoms of sexual dysfunction, including lack of desire, arousal issues, inability to orgasm or ejaculate, premature ejaculation, painful intercourse, lack of enjoyment, erectile dysfunction and performance anxiety.

If you think sex has fallen away just because you’re getting older, are not in a relationship or haven’t done it in a long time, think again. Pleasurable sex is something every adult should enjoy for a lifetime — with or without a partner. And remember, sex doesn’t mean intercourse alone. Masturbation (on your own or with a partner) and other forms of sexual play that get your hormones revving are definitely recommended. If you’re currently having great sex, keep at it because it’s good for you. Have sex all your life, and your body, brain, muscles and fat cells will thank you for it. Do it over and over — that’s right, don’t stop.

Are Our Hormones Hampering our Sex Life or Is It the Other Way Around?
The answer is both. Sexual dysfunction is a global concern, as shown by the Global Study of Sexual Attitudes and Behaviors (GSSAB). After 13,882 women and 13,618 men from over 29 countries were surveyed, the researchers concluded: “Sexual difficulties are relatively common among mature adults throughout the world. Sexual problems tend to be more associated with physical health and aging among men than women.”

Sexual Issues for Men
An estimated 1 in 5 men currently experience erectile dysfunction (ED). Although psychological reasons play strongly in cases in men 35 years of age and younger, physiological factors are the main cause for men 50 and up. But ED at any age can provide a much bigger picture about a man’s health besides what’s happening below the belt. We now know, for example, the state of a man’s penis is a very good indication of cardiovascular wellness. Problems in this area are linked to arterial disease, heart attacks, stroke and diabetes.

Ever since that now-famous little blue pill topped $1.5 billion in sales in 2001, becoming a pharmaceutical smash hit practically overnight, drug companies have been working feverishly to produce second-generation medications to deal with ED. Think about that figure — $1.5 billion! And realize at the same time that about 30 to 50 per cent of patients can’t even take Viagra because of contraindications such as heart disease. Since this family of drugs hit the market in the late 1990s, the number of American men with health complaints has increased by 50 per cent. Evidently sex is an important issue and a great source of motivation for seeking medical intervention. Viagra is certainly working wonders for many people, although in my view it represents a “quickie” solution when a “long-term love affair” with lasting lifestyle change is certainly what’s needed. That’s right, I mean the three steps.

That Viagra sales, obesity and stress rates are at all-time highs is no coincidence because the hormonal distress associated with abdominal obesity is a major contributing factor to impotence and erectile dysfunction. All healthy men experience a gradual decrease in testosterone, about 1.5 per cent each year, after age 30. (This percentage appears to be increasing, however — possibly due to toxin exposure.) Although the link between men’s testosterone levels and their desire for sex is not entirely clear, the connection between lower free testosterone and weakened orgasmic function and/or erectile function is definite, according to a 2002 study from the British Journal of Urology.
The hormonal changes men naturally experience as they age tend to happen more gradually than the ones women undergo with menopause, although they can still result in symptoms of reduced energy, poor sex drive, declining muscle mass, increased abdominal fat or irritability. These symptoms may seem uncomplicated, but they are increasingly common in my clinical practice among men in their 30s and 40s and are definite signals of high risk in the field of preventive medicine. Remember, low testosterone in men is linked to heart disease and even death.

Sexual Issues for Women
Drug companies are also scrambling to tap into the sexual dysfunction market for women. Sadly, this market is also huge and, unlike the case with men, the distribution of difficulties is fairly even among women 18 to 59 years of age. About 20 per cent of women experience problems with arousal and, as a result, experience poor lubrication. Drug companies are now looking at ways to understand the female brain and develop a means of stimulating the arousal centres. But more pharmaceuticals are not always the answer. The three steps of the Hormone Diet have the potential to create the perfect hormonal balance for both a healthy libido and successful fat loss, especially because of their wonderful ability to calm the cortisol that can crush a healthy sex drive, even under the best of conditions.

Stress is certainly quick to kill that lovin’ feeling, but menopause is often no help either. The natural dip in estrogen, testosterone and progesterone that are part and parcel of this stage of life can lead to problems in almost all areas of sexual function, including interest, responsiveness and enjoyment. These same hormones also affect mood, sleep, where we store fat and how well we lose it. Considering the incredible impact these hormones have on our life, restoring their balance — either with bioidentical hormone replacement therapy or herbal medicines — is extremely important.

Good Sex Is So Good for You
Sexual function is a lot like lean muscle — if we don’t use it, we lose it and the health and hormonal benefits that come with it. Guys, if your sex life is in the doldrums lately, you likely have less testosterone as well. The fix is pretty straightforward. Research shows if we can get you back to enjoying more frequent sex, your testosterone can, ahem, rise again. A group of Italian researchers looked at men with erectile issues and measured their testosterone status before and after treatment (though not with testosterone replacement). Those whose ED treatment was successful had higher testosterone compared with those whose treatments failed to yield improvements. If you needed a strong argument for having sex tonight, now you have one.

Ladies, the same principles apply to you. Women who enjoy more love in the bedroom have increased estrogen and testosterone. When present in the proper balance, these hormones add fire to sexual desire, give us more sex appeal, improve mood and memory and can even prevent abdominal fat gain. A little precoital cuddling, however, is also very important. Scientists at Simon Fraser University measured the level of testosterone in women before and after sex, cuddling and exercise. Although the women’s testosterone was higher both before and after sexual intercourse, cuddling gave the biggest testosterone boost of all.

Sex Busts Stress
Do I really need to go into detail on the benefits of sex for stress relief? Most of us know that a healthy sex life can help knock the pants off stress. A great orgasm also encourages the release of oxytocin, which makes us feel calmer, more relaxed and can even lower our blood pressure. Orgasms also spark an antiaging surge of DHEA. So having at least two orgasms a week can slow the aging process and indirectly support fat loss, while also offering some protection from the adverse effects of cortisol.

Wait, there’s more. Depending on the duration and “energy level” of the session, sex can help us burn calories and improve the fitness of our heart. Sex (including masturbation) improves our sleep and reduces the risk of depression, both of which are essential in preventing fat gain and improving hormonal imbalance. It also causes the release of endorphins, which can help ease pain and boost immunity. Some research even suggests sex 3 times a week can slow aging and prevent wrinkling around the eyes. Sounds better than any eye cream I’ve ever tried.

Sex Can Curb Your Appetite
Sex is a basic human need, just like food and shelter. You won’t be surprised to learn, then, that our desire to “get some” is controlled by the hypothalamus, which also regulates our appetite, body temperature and circadian rhythms. I once heard Sam Graci, author of The Path to Phenomenal Health, speculate that Mother Nature may start selecting against us when our sex engines cool, simply because of the basic laws of evolution or survival of the fittest. This ideal resonated with me and has certainly motivated me to stay active — and I don’t mean in the gym.

Our libido (that’s scientific lingo for sex drive) is determined by a set of complex physiological processes that involve delicate interactions between our brain, body and hormones. For instance, an appetite-suppressing compound in the brain controls our sexual arousal as well by stimulating the release of oxytocin. Also involved in sexual responsiveness and orgasm, the hormone oxytocin counteracts stress and depression by combating the harmful effects of cortisol.

Frequent hugs between spouses/partners are associated with lower blood pressure and higher oxytocin levels in premenopausal women. Having regular massage can also help to stimulate oxytocin.

The dose of dopamine we get from sex, which increases steadily to the point of orgasm and then declines, also helps curb our need to feed. Apparently, the dopamine pathways in the brain involved in stimulating desire for both sex and food are shut down by the hormones released immediately after we have an orgasm. Can you imagine better news for appetite and craving control?

So if you remember nothing else after reading this book, I am certain this little snippet of advice will stay with you: have more sex. If you satisfy your sexual appetite, you can satisfy your growling stomach and your need to nibble on candy too.
There’s No Pressure, Though
Perhaps you are like many women and men with a lowered sex drive who find the idea of “jumping” into an active sex life hard to imagine. This can change, however, if you want it to. Following the recommendations of the Hormone Diet will help to improve your hormone balance and overall well-being, which will help a languished libido. But you can also fuel sexual desire further with visualizations or small acts of intimacy. For instance, try thinking of positive words on waking — even if you don’t feel positive — like love, joy, peace, strength, happiness, beauty, etc. Next, tailor this simple exercise to help your lowered sex drive by adding words you find sexy — like hot, sensual, sultry or touchable. You can also slowly bring intimacy back into your life with activities to help you feel close and connected again, such as back rubs, foot rubs or date nights.

The Challenges of Sex and Aging
As we age, we tend to have less sex. A good deal of research suggests this decline is caused by hormonal changes that naturally occur with age. But at the same time we know less sex alters our hormones. It’s a real Catch-22.

Experiencing both a decrease in the desire for sex and changes in sexual responsiveness is common for both men and women. As we age, women may notice vaginal dryness or discomfort, decreased lubrication and even pain with intercourse, whereas men may experience more difficulty achieving an erection or erections that are not as firm as they once were. Orgasms may also become less intense for both sexes. All these symptoms are due to the inevitable hormonal shifts that come about as we age. They will occur more rapidly if we stop having sex because we lose all the wonderful hormone-enhancing effects sex has to offer.