How Stress Affects Sexual Health

When a person experiences stress, his or her body releases cortisol, a steroid hormone. Cortisol belongs to a class of hormones called glucocorticoids, which are present in almost every vertebrate animal cell, and is produced from cholesterol in the two adrenal glands located on top of each kidney. In addition to being released during times of stress, the body releases cortisol after a person wakes up and during and after exercise.

Cortisol and the hormone epinephrine, which is also known as adrenaline, work together in “fight-or-flight” responses. After an individual is faced with stress, the adrenals secrete cortisol, which in turn floods the body with glucose (a simple sugar used as a source of energy in living organisms) that supplies immediate energy to large muscles. Cortisol causes this glucose release when it taps into protein stores in the liver.

Cortisol’s focus is on supplying the body with glucose for quick energy which is why cortisol blocks insulin production as well. Insulin is a hormone produced in the pancreas that regulates the amount of glucose in the blood. Lack of insulin causes a form of diabetes.

As cortisol narrows the arteries, epinephrine increases heart rate. Both of these occurrences force blood to pump harder and faster through the body. Once the stressful situation is resolved, hormone levels return to normal.

All this sounds very simple in theory, but many health experts theorize that our fast-paced lifestyles with ever-present stress causes our bodies to pump out cortisol almost constantly, which can have a negative impact on our health in general and on our sexual health in particular.

Since cortisol stops the effect of insulin, this creates insulin resistance in cells. When cortisol levels are chronically elevated, the body produces glucose as it remains in a general insulin-resistant state. These high glucose levels can lead to increased blood sugar levels and thus increase the risk factor for developing type 2 diabetes.

Patients with type 2 diabetes can experience a decrease in libido (or loss of sex drive), extreme fatigue, lack of energy, depression, hormonal changes and emotional health issues including anxiety, stress and relationship issues. Diabetic neuropathy, which is nerve damage that causes numbness and pain in the extremities, can create a lack of feeling in the genitals as well, which can inhibit orgasm or cause pain during sexual encounters. Erectile dysfunction is a common problem for men with type 2 diabetes.

Abnormally high glucose levels can lead to nerve damage in the sphincter muscles, which encircle passages and openings of the body. In men, this can cause retrograde ejaculation, in which all or part of the semen is ejaculated back into the bladder instead of out the tip of the penis through an opening called the meatus.

Women with type 2 diabetes can experience vaginal dryness, which results from issues with blood flow to the genitals or from hormonal changes, and vaginal infections and inflammations, which can make sex painful.

Nerve damage to the bladder can result in incontinence, or loss of bladder control; leakage from the bladder due to incontinence can occur during sexual intercourse. Some women with type 2 diabetes experience urinary tract infections, which can cause pain and discomfort during sex in addition to pain and burning sensations during urination.

Repeated elevation of cortisol can lead to weight gain. Cortisol mobilizes triglycerides, a type of fat found in the body, and relocates them to visceral fat cells, which are found deep in the abdomen under the muscle. Cortisol then aids in the transformation of the relocated triglycerides into adipose tissue, which is fat. In addition, high triglyceride levels can lead to coronary heart disease and heart attacks.

Another way elevated cortisol levels may cause weight gain is through the glucose-insulin situation. Consistent insulin suppression leads to cells that are starved of glucose. These cells cry out to the body for energy, thus increasing hunger signals sent to the brain, which can lead to overeating. To add insult to energy, unused glucose is eventually stored as body fat.

Elevated cortisol can compromise digestion and absorption of food. The result can be indigestion and ulcers, which is an irritation and/or inflammation of the mucosal lining in the stomach or in the beginning of the small intestine. Irritable bowel syndrome and colitis, which is inflammation of the colon, flare up during times of stress. Mucosal inflammation leads to an increased production of cortisol, which can perpetuate the problem indefinitely as ulcers are formed one after another.

Consistent higher-than-normal levels of cortisol can lead to erectile dysfunction in men and to the disruption of normal ovulation and menstrual cycles in women. The androgenic sex hormone testosterone is produced in the adrenal glands along with cortisol and epinephrine. Normal production of testosterone could be hampered by over-production of cortisol, which could lead to fertility problems.

According to health experts, the best way to keep cortisol levels at bay is by optimizing our diets and by mastering stress management. By doing these two things, a person can contribute positively to his or her sexual health.

Strategies for optimizing our diets include reducing or eliminating caffeine and alcohol consumption, eating foods lower in glycemic index, reducing or eliminating consumption of trans fat and eating a fiber-rich diet.

Strategies for stress management include getting more and better sleep, utilizing breathing exercises or meditation, partaking in regular acupuncture or massage sessions, getting daily exercise (cardio, resistance or relaxation) and addressing psychological and emotional issues. The latter may require routine visits with a therapist or counselor. Some people benefit from daily masturbation and/or sex toy play as a form of stress relief as well.

Reducing stress will reduce cortisol levels in the body, and this will only help improve a person’s general health. Good physical, mental and emotional health are all contributing factors of positive sexual health. It is wise to keep our sexual health in check so that we can continue to enjoy our sexual encounters, no matter our age.


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