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Monster Time

Monster Time The week never goes by without someone asking something about their life situation and a health need that makes me wonder, "Why is that so important?" A woman in her mid-forties was telling me her chronological history of her illness. It was very detailed. And as you might expect, I like detailed information. She had created a two page single spaced biography of her medical maladies. It took about a half hour to visit each individual complaint and how each one lead to the next one. I suspect most physicians would give up after two lines or more, but the truth of the matter is the patient must tell their entire story so one can start to make sense of their thermography and blood work results. As she finished, she sat back for a moment. Then she moved toward the desk as she announced, "The one thing I left out. I have no desire for sex. I want to have that desire more than anything."At that moment, I thought I might have to reorder the priorities of her healing. She was still menstruating, so she was not in menopause. I asked her, "Are you married?" She smiled, "No. But I want to want to have sex." I asked politely, "Do you have someone in mind you wish to have sex with?" She answered, "Not at the moment. Men are dogs." I looked up from my glasses, "Yep. Men are dogs. I know. I'm a man. There are good dogs and bad dogs. Which do you prefer?" She smiled and said, "All I've had is bad dogs, I want to be with a good dog." I guess she was wanting to prepare for her next sexual encounter, hopefully with a good dog.First off, stress displaces female libido. After going through her history of illness, I recognized that she was under a tremendous amount of stress. Her tasks at work were tedious and difficult. She had a female micromanaging ogre for a boss. Her illnesses gave her brain fog so she needed to spend twice as much time completing her assignments as other people in her office. She was at odds with her family members and she had an ex-husband who periodically threatened her when he was in an alcoholic rage. She claimed she was not depressed or anxious, she was pretty happy most of the time. She got her work done which gave her a sense of success. And she felt she had accomplished a fair amount in her life. She was neatly dressed, was on time to her appointment and complimented me for having an office far away from the center of the city. "It felt good driving in the country."  Then an alarm bell went off in my mind, this woman has a repressive personality. She's a planner, ritualistic, and shows little emotion. She lives in a black and white world. She has the greatest desire to walk the right hand path, she desires social conformity and she sees things in absolutes. I lost track of the number of times she said never and always.One thing about repressive personality types, they have markedly elevated glucocorticoid levels. And her extremely high cortisol result was in accord with being a repressive personality type. I suspect her body was going on overdrive just to maintain her strict boundaries, keeping everything unsettling, challenging and vibrant out of her world. Her illnesses were impairing her ability to maintain her life's structure.I was not sure how wanting a libido back would benefit her, since she had no sexual partner and no prospect of having one. But with the high cortisol level, she was suppressing her adrenal and ovarian function. Negative feedback loops abound in our emergently controlled bodies. She had menstrual cycles, but they were erratic and unpredictable. (Further stressing her control of self.) Her estradiol and testosterone levels were very low. Blood cortisol elevations will suppress ovarian and adrenal functions which explains her low sex hormone levels. Woman tend to get most amorous when they ovulate. She was not ovulating. Estrogen and testosterone play a role in female human sexuality, but it is a weaker factor than social and interpersonal ones. There is no debate about the effects of estradiol on a woman's genitals and breasts, since these areas have ample amounts of estrogen receptors and are made more sensitive to tactile stimulation by the hormone. The brain has areas that have estrogen receptors which influence sexual desire and when these areas are flooded with estradiol, sexual desire greatly improves. Testosterone also has an effect on a woman's libido, but not nearly as pronounced as in a man. Stress greatly suppresses female adrenal testosterone manufacture. But one of the most powerful suppressors of estradiol secretion in female primates is social subordinance. It can be as powerful as removing their ovaries. I have never talked to a woman who felt powerless in a subordinate position who wanted to have sex with anyone regardless of their health. So let the science fair project begin. I will adjust her hormones and see how she feels. But if she doesn't get that ogre of a boss off her back, twelve hours of subordination a day may just keep her from having any sexual desire what-so-ever as well as healing from her chronic active autoimmune diseases. Might be time to visit Monster and look for a new job.Doc.  
Posted by Amanda Sanders at 8:58 AM
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