Libido: Desire, Drive, Sparkle

Elyse Averdick
Let’s discuss the role of hormone balancing for sexual satisfaction and performance in men and women. Despite the thinking that Bio-identical Hormone Replacement Therapy (BHRT) is a hot new topic, some of us have been doing this for twenty or thirty years, safely and effectively. This combined experience serves you well.

LIBIDO – Let’s talk desire, drive, sparkle. Twenty years ago, I was struck by the reality that libido and orgasm were NOT ninety percent in the mind. And that many marriages were breaking up over a biologic difficulty, not an emotional one. At least it started as biologic, then became emotional.

I found that if a woman had no testosterone in her system, she would have no libido, and be unable to reach orgasm (or at least have extreme difficulty). Having measured thousands of patients of all ages over the years and comparing the results with their symptoms, I found this to be true in most cases. So the excuse “I have a headache,” often unknowingly (on both sides of the marital fence) really means, “I have little or no testosterone.”

As a Family Nurse Practitioner, I set upon the task of saving marriages and am happy to report great success.

Case in point #1:
Mrs. Smith came in with a very low testosterone level. Her progesterone and DHEA were low as well. Three months after balancing her hormones, she excitedly ran up to me in the office, exclaiming “I never knew what my husband was missing. I feel so awful to have deprived him all these years. It’s WONDERFUL!”

Case in point #2:
Mrs. Jones, a seventy-year-old woman, had recently remarried. Despite still desiring sexual relations with her husband, she was completely unable to have orgasm. Mrs. Jones was also found to have extremely low testosterone. Once we replenished her supply, never going over what is physiologically normal for a woman, they were back making love three or four times each week, with renewed ability to have orgasm.

Testosterone, however, is not always the answer. All hormones need to be accurately measured and symptoms assessed. Balancing such things as DHEA, estrogen, progesterone, and pregnenolone are paramount. The thyroid and adrenal glands are major players as well.

As an example, DHEA, which you will hear advertised as the youth hormone, is often the first to become depleted. People who come in feeling “old”, “tired”, “no sex drive”, as well as patients with chronic illness, frequently have low DHEA levels. Sometimes increasing those levels can pull women out of menopause, their energy and desire both improving. (Please do not use DHEA without a laboratory measurement. Do not assume this is what you need. It is all about balance. If the level becomes elevated, it can get you into trouble.)

Another example is women who have a low progesterone compared to estrogen ratio. These women are prone to PMS, endometriosis, and heavy bleeding. They may have anxiety and insomnia. Progesterone is our natural tranquilizer. Their libido may be low as well.

Has your man become a couch potato? Are you having trouble getting him up – in more ways than one? Is he gaining weight? Has he lost his desire and perhaps his full erection? And I’ll bet he doesn’t want to talk about it.

When men’s testosterone levels drop, these are some of the symptoms he experiences. Men are quick to seek Viagra as an immediate solution, not realizing testosterone and other relevant hormones help with their moods, help them build muscle and lose fat, improve concentration, irritability, and stamina. Ask your man if he knows where the most testosterone receptors are: the penis or the heart ?

When men are aware of “low T” as it’s being called these days, they are quick to want a prescription and get on with it; kind of like a “magic bullet.” It’s much more complex than that. Testosterone has to convert from “total” to “free” to be available for the body. When men are overweight, testosterone can be converting to estrogen. The problem is not “low T”, it is the conversion. Rather than giving more testosterone, correct treatment would be to stop the conversion. Voila. Man feels better and loses weight. Woman happy.

One last thought. Before considering BHRT, make sure your healthcare provider has a plan for ensuring safety. Testing can be done to check for efficient hormone metabolism through the liver, as well as knowing the exact breakdown metabolites. In other words, it is important to know what our body is doing with those hormones.

After 25 years of helping men and women balance their hormones using a comprehensive, individualized approach, it is clear we can safely and effectively bring people renewed life and vitality.


Elyse Averdick has been a Family Nurse Practitioner for over 20 years. Realizing the limitations of conventional medicine early in her career, she expanded into what was then considered “alternative” medicine. She has since utilized the best of both worlds—prescribing hormones and using other regenerative technologies to help men and women reach their optimal health. She can be reached at, or Phone 828.707.8741. Visits by appointment only.


Sandi Tomlin-Sutker
Written by Sandi Tomlin-Sutker