But in the case of PTSD, the accelerator pedal stays in overdrive for a long period of time. As a result, the body becomes a cortisol production factory.
How Excess Cortisol Screws Up Sexuality
When I searched the scientific literature, I found a lot of research on how men and women respond differently to stress, and what types of stressors trigger HPA-Axis dysfunction in men and in women.
But I didn’t find a lot of scientific research on how HPA-Axis dysfunction affects male versus female sexuality. What exactly happens to male and female sexuality when stress doesn’t go away? We know that cortisol is the main hormone of the HPA-Axis and the primary stress hormone.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323517/
“The stress response is controlled by the hypothalamic-pituitary-adrenal (HPA) axis. The hypothalamus directs the pituitary, or “master gland,” which is found as a small protrusion off of the hypothalamus. The pituitary controls the secretion of hormones throughout the body. Depending on the messages it receives from the hypothalamus, it may signal the adrenals to secrete cortisol, a stress hormone, or the gonads to secrete sex hormones. Stress hormones can impact and interfere with sexual function at all three levels of the HPG axis: at the brain, pituitary, and gonads.” https://adrenalfatigue.org/lets-talk-about-sex-and-stress-the-effects-of-stress-on-sex-drive/
We also know that cortisol reduces the production of the male sex hormone testosterone. For most people with long-lasting stress or PTSD symptoms, testosterone production is reduced.
According to Norwegian doctor, psychiatrist, and clinical sexologist Haakon Aars, “Testosterone is the sex hormone with the greatest significance to sex drive in both men and women. This means that your sex drive decreases due to completely logical physiological reasons.”
https://www.gottman.com/blog/3-reasons-stress-is-affecting-your-sex-drive-and-what-to-do-about-it/
How Stress and PTSD Affects Female Sexuality
A recent study of women complaining of low or absent sexual desire found their low desire may be linked to hypothalamic-pituitary-adrenal (HPA) axis dysregulation.
There is a prevailing belief that low testosterone is linked to low sex drive in both men and women. One research showed that it is low DHEA that is linked to sexual dysfunction in women.
“In contrast to the extensive research investigating, but not finding an association of women’s sexual desire with their testosterone levels, many studies have found lower serum levels of DHEA in women reporting low or absent sexual desire.” https://www.contemporaryobgyn.net/view/low-stress-hormones-linked-low-sexual-desire-women
“However, in addition to stress hormones, the adrenals can also produce DHEA, a sex hormone. DHEA is a precursor to both testosterone and estrogen. Although testosterone is often thought of as a male hormone, women also have it in smaller amounts, and it has a strong impact on libido.
In menstruating women, the ovaries are the major source of testosterone, but the adrenals contribute via their production of DHEA. After menopause, the adrenals become critical to a woman’s supply. If a woman has adrenal fatigue, not only will her production of stress hormones decrease, but her testosterone—and her libido—will too.
Higher stress is associated with reduced sexual functioning in general. Women who had higher levels of cortisol (the stress hormone) and lower levels of DHEA (the sex hormone) after watching an erotic movie experienced less physiological arousal than women with a lower cortisol/DHEA ratio.
Winning the War on PTSD