Men and woman as they age, often lament the loss of sexuality and its components (desire, enjoyment, performance, and intimacy).  In a man’s youth he will experience erections daily, but at 70, he is lucky to have one once or twice a month and may not be able to complete it.   Woman, lose their sexual desire through a number of mechanisms.


Achieving Hormonal Balance

When low levels or imbalances of hormones occur, the ability to engage in healthy sex is challenging.  Sex can be unsatisfying, difficult, or even impossible.  Correcting these imbalances achieves rejuvenation of the body and the brain.  There is no better way to make you feel 15 years younger than to enjoy frequent, long-lasting sex.   This will also have a welcome spin-off effect, not just in heightened sexual desire and performance, but in improvements of all health-related aspects of your life as sexuality is a marker of overall health.  Sexual activity ideally should never fall to less than once weekly if we want to stay young.


Healthy sexual function has strong connections to a vital vascular system, as well as good psychological health and is a cornerstone of general anti-aging strategy.  Healthy sexual function requires proper balance of neurotransmitters, hormonal and nutritional balance.  Age related factors which contribute to sexual dysfunction can be prevented and treated allowing active sexual life to continue into advanced age having one or two events per week to maintain active health.


Aging affects all parts of the body linked with sexual function.  Men may need greater physical stimulation to attain and maintain erections while orgasms are less intense due to brain, hormonal, and vascular factors.  In women, menopause contributes to sexual decline both as a result of its physical symptoms (dryness, hot flashes, and weight gain) and mental symptoms (mood swings and irritability). Mental changes play a large role in both men and women.   Andropause is made of three issues, physical, mental (mood) and erectile.


Virtually any disease can have significant negative effects on healthy sexuality.  For men, problems like heart disease, diabetes, hypertension, and renal failure can produce erectile dysfunction.  In women, diabetes in particular has been shown in various studies to lessen desire, arousal, lubrication, and orgasm.  Diabetes damages nerves in the clitoris and penis that decrease the ability to experience sensuality.


Other factors like sleep disorders, dementia, slower metabolism, and aches/pains associated with aging decrease sexual desire and performance.  Obesity is associated with lack of enjoyment of sexual activity, lack of sexual desire, difficulties with sexual performance, and avoidance of sexual encounters.   Obesity affects women’s arousal, lubrication, orgasm, and satisfaction.


External factors like smoking, substance abuse, stress, and side effects from almost any medication (particularly antidepressants) can impact sexual arousal and response at any age; their effects are even more marked in older people with erectile dysfunction.

While well-known treatments like Levitra®, Viagra®, and Cialis® may work temporarily, they mask the underlying problems.   These drugs work best at treating vascular forms of erectile dysfunction (i.e., reduced blood flow to the penis, but this is rarely the result of vascular trouble alone.  Thorough medical testing is needed to determine the root cause of erectile dysfunction.  It is important to note that, erectile dysfunction can itself indicate more serious health problems and has been identified in many studies as a predictive precursor of cardiovascular disease, and a proven risk factor for diabetes, hypertension, and angina.


Of course, there is also the brain and mind to contend with; a healthy brain leads to a healthy attitude, and a positive outlook is required for an active sex life.  Significant psychological and physical factors that affect loss of sexuality are too often trivialized.  They can be remedied with hormones and nutritional agents that help restore figure, physique, and psychological well-being.


The Biochemistry of Healthy Sex: Hormones and Neurotransmitters

In both men and women sexual activity and performance is determined by the levels of neurotransmitters and hormones in the brain and body. Hormones are biochemical compounds produced in the brain and in other organs and glands that regulate specific systems in the body.  Like tiny chemical messengers hormones carry signals from one cell to another.  Similarly, neurotransmitters convey information between nerve cells and other cells.  Many brain neurotransmitters and hormones are associated with sexual and reproductive function, for example, the neurotransmitters dopamine, acetylcholine, gamma-aminobutyric acid (GABA), and serotonin and the hormones estrogen, progesterone, and testosterone.  These chemical messengers are crucial not just for sexual health, but for our overall health.


Taken to its most basic level, sexuality in humans can be broken down into four components: desire, arousal, orgasm, and resolution.  Each phase is governed by a corresponding brain biochemical, along with contributing hormonal influences.  The result is simple mathematics in conjunction with a balancing act: when the brain experiences a chemical deficiency in any of the four primary areas due to normal aging, the desire for sex correspondingly diminishes.  Sex doesn’t seem so enticing, and the physical act itself will leave one lacking.  Likewise, diminishing hormone levels with aging contribute to declining sexual function in older adults.


What can you do to restore youthful sexual function?

One of the first steps to achieving a balanced life and a better sex life is to understand which of your neurotransmitters could be brought back into better balance.


SUMMARY:  Aging shows loss of sexual interest, enjoyment and performance, but maintaining healthy sexual function is crucial to the anti-aging strategy.  Health concerns (illness, menopause andropause) may take a toll on function as can medications, so one must address the existing medical problems, while restoring the body’s neurotransmitters and hormones.  Optimize dopamine to maintain desire, acetylcholine to support arousal, GABA for sexual release, and serotonin for resolution.  Optimizing levels of estrogen, progesterone, testosterone, dhea, pregnenolone, and melatonin is crucial to sexual health. Nutritional, hormonal, and pharmaceutical therapies can help balance neurotransmitters.




Dopamine and Desire

Dopamine is a neurotransmitter that acts on the sympathetic nervous system to control libido, aggression and power.   At medication levels it can raise blood pressure and heart rate.  Low levels of dopamine typically result in loss of libido, reduced interest in sex, decreased energy for sex and decreased sexual arousal.  Any medications that block these dopamine receptors can cause decreased libido.  The good news is that everyone’s libido can be greatly enhanced.


Acetylcholine and Arousal

Arousal is determined and initiated by acetylcholine.  Low acetylcholine levels are known to decrease cognitive functioning, especially memory, attention, and creativity. People with acetylcholine deficiencies may find themselves unable to concentrate and focus on sex.  A loss of acetylcholine particularly affects sexual arousal.  Acetylcholine also regulates internal moisture.  Low levels can cause dryness, affecting vaginal lubrication in women—which leads to lowered desire for sex.  Lower moisture levels can also adversely affect semen volume in men.



Enhancing Orgasm with GABA

Orgasm release is controlled by the body’s levels of gamma-aminobutyric acid (GABA).  GABA is considered to be one of the most important neurotransmitters helps inhibit excitatory neurotransmitters that can cause anxiety if the system is overstimulated.  This is important, since chronic anxiety can lead to loss of sexual interest and sexual dysfunction.  GABA is responsible for regulating sexual tone and plays an important role in brain function.  Therapeutic drugs that increase the available amount of GABA have relaxing, anti-anxiety, and mood-soothing effects.  When GABA becomes depleted it is difficult to relax and let go of fear/negative feelings.  Hence, the orgasm becomes difficult.  GABA-enhancing compounds could help increase dopamine levels to enhance sexual satisfaction.


Improving Resolution with Serotonin

Resolution is related to serotonin, another neurotransmitter.  Serotonin is synthesized from the amino acid tryptophan.  Serotonin modulates anger, aggression, body temperature, mood, sleep and sexuality.  Low serotonin levels can result in a lack of joy and decreased feelings of intimacy.


In common with GABA, serotonin taken orally does not pass directly into the central nervous system because it does not cross the blood-brain barrier.  However, tryptophan and its metabolite 5-hydroxytryptophan (5-HTP) from which serotonin is synthesized can and do cross the blood-brain barrier.  These agents are available as dietary supplements and may help promote sexual satisfaction.


Cholesterol is a precursor of all sex hormones.  Estrogen, progesterone, testosterone, pregnenolone, androstenedione, and dehydroepiandrosterone (DHEA) all come from cholesterol.  All of these hormones in tandem play some role in sexuality.  As we age, our bodies’ cholesterol levels naturally raise, but the ovaries, testicles and adrenal glands cannot convert cholesterol into hormones.  The result is reduced sexual motivation and the self-image of feeling “less sexy.”  In men, erectile dysfunction is a frequent result, while women tend to lose interest in sex.  Numerous nutrients, natural treatments and hormones can boost GABA, acetylcholine, dopamine and serotonin in deficient individuals to improve all modes of sexual dysfunction.






Dr. Pugen's Anti-Aging Clinic

Clinical and Aesthetic Medicine

G1-3215 Hwy 7 East, Markham, ON L3R 3P3

OFFICE: (905) 475-9433

FACSIMILE: (905) 470-6214


Copyright ©2016 Dr. Gregory Pugen

This website is for informational purposes only and is not a substitute for medical advice, diagnosis or treatment.