It’s 2 a.m. and you’re lying in bed. Suddenly your partner, happily snoring just moments earlier, slides a warm hand under the sheets. As the fingers inch closer you groan and turn away. “Sleep,” you mumble, “I need it now.” Your partner rolls over and drops back into dreamland, as you angst silently and wait for sunrise.
If a quiet evening with your mate elicits more desire for sleep than visions of champagne, music and erotica, you’re not alone. A pattern of lonely hours staring at the ceiling as you wait for an exhausted tomorrow could dim anyone’s sex drive and induce not just fatigue, but also a bit of sadness.
In my own decades-long fight to stay asleep in the middle of the night (or not wake up too early), I’ve ranked sleep over sex enough times for my patient-but-disappointed husband to feel the effects. And while sleep deprivation has never killed anyone directly, it is a significant health risk and a heinous form of torture.
Sleep and sex drive are both primal needs, yet unlike sex drive, sleep is triggered by a built-in 24-hour circadian rhythm along with what’s known as a sleep/wake homeostasis, and resets our emotional and psychological balance, thus rejuvenating our nervous, immune, skeletal and muscular systems. In our nonstop, over-stimulated culture, however, we’ve sadly convinced ourselves that sleep shortage is not only the American way, but also a celebrated sign of being productive.
Not the Usual Suspect
The list of underlying causes of sleep-onset insomnia (falling asleep) and sleep-maintenance insomnia (staying asleep) runs pages. And yet there’s a surprisingly common, often undiagnosed culprit keeping thousands of people awake at night: Adrenal fatigue can leave you “tired but wired,” one of the jittery walking dead—bone-tired but unable to sleep. If you’ve crossed the usual sleep saboteurs off your list, it’s possible your adrenals, two glands no bigger than a walnut on top of each kidney, are screaming to be heard.
“Stress and adrenal function affect sleep, particularly the circadian pattern of cortisol secretion by the adrenal glands,“ writes Dr. James Wilson, author of Adrenal Fatigue: The 21st Century Stress Problem. “Frequent or constant stress can chronically elevate these hormone levels, resulting in a hyper-vigilant state incompatible with restful sleep.” In other words, the stress that may be keeping your brain spinning can also disrupt proper physical functioning.
The adrenal glands are involved in a complex feedback loop of the hypothalamic-pituitary-adrenal axis (HPA) in the brain, and function kind of like stress shock absorbers. The outer adrenal cortex secretes the adrenal steroids cortisol, DHEA and aldosterone; and the interior secretes epinephrine (adrenalin) and norepinephrine, more familiar as the “fight-or-flight” hormones.
Adrenaline increases the heart rate and blood pressure, and boosts energy supplies; and cortisol, which helps maintain homeostasis and regulate glucose and metabolism, among other critical functions, is designed to decrease as we go through the day.
Adrenal Fatigue
Chronic stress, even the good kind of stress that makes you feel energized and excited (skydiving, new job, running a marathon) keeps cortisol levels elevated, including at bedtime when cortisol is programmed to drop (circadian rhythm), at least until about midnight. If your cortisol stays high long enough, you move into stage one adrenal fatigue, explains chiropractor Daniel Kalish, founder of a proprietary model of Functional Medicine that he teaches worldwide. If you don’t recharge, chronically high cortisol moves you into stage two.
“Think of cortisol like units of energy,” explains Dr. Kalish. “When you wake up you should have about 20 unites of energy. At bedtime, your level should be about two. The normal cortisol drop creates a feeling of a ‘normal’ day that ends restfully. But many are waking up with reduced cortisol levels, which translates to feeling exhausted despite having just slept. And many are going to bed with dramatically elevated cortisol levels, making it virtually impossible to shut down your brain and fall asleep.”
In stage one adrenal fatigue you might feel slightly sluggish in the morning and mid-afternoon, but it’s not until stage two that cortisol levels begin to fail (meaning cortisol’s natural ebb and flow rhythm is off) and you notice symptoms. Stage two is when people begin to gain weight, have trouble sleeping and their sex drive takes a dive. “This is when people just know there’s some health problem,” says Dr. Kalish.
In the days of early man our adrenal glands kept us alert to predators about to pounce. Today, while the dangers are less immediately life threatening, we’re exposed to a nonstop barrage of perceived threats (traffic, demanding bosses, bills, screaming kids, blaring televisions) that keep our adrenals on alert, whether the threat is real or not. Add to the daily stress any trauma or emotional upheaval, illness, food allergies and sensitivities, birth control pills, environmental toxins, fluctuating blood sugar levels and extreme exercise, and it’s no wonder our adrenals are overburdened.
There are three to four phases of adrenal fatigue, Dr. Kalish notes, but mainstream medicine recognizes only the two extremes—Cushings syndrome (high cortisol) and Addison’s Disease (low). “In the conventional medical context,” he explains, “when they think about the adrenal glands, they really think only about these extreme medical conditions that are not going to be what most suffer from. They do a conventional medical test [to] determine whether you have one of these rare endocrine disorders or not…[but there] are problems that are not going to send people to the hospital, but are more disrupting in your day-to-day life—fatigue, depression, weight gain and problems with sleep.”
Because permanently elevated cortisol levels are a largely invisible syndrome (you might look fine other than dark bags under your eyes), many people shrug off its symptoms of low-level depression, lack of energy and a waning libido, attributing these not to a medical condition, but to “a busy life everyone deals with.” They might amp up with more coffee and other stimulants (that overtax the adrenals) just to get going in the morning or to stay alert during the day.
While short-term stress can increase sexual response in some women, chronic stress can do just the opposite. The stress response is controlled by the HPA axis and the sexual response is controlled by a related system, the hypothalamic-pituitary-gonadal (HPG) axis, explains Dr. Lise Naugle an associate of Dr. Wilson. “The hypothalamus is a part of the brain that controls the “four Fs” of our most basic instincts: fighting, fleeing, feeding and … mating. The hypothalamus directs the pituitary, or “master gland,” which is found as a small protrusion off 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 [or both]. Stress hormones can impact and interfere with sexual function at all three levels of the HPG axis: at the brain, pituitary and gonads.”
The adrenal glands also produce a sex hormone called DHEA, a precursor to testosterone and estrogen, explains Dr. Naugle. While testosterone is higher in males, it’s also part of a woman’s cascade of hormones and thus has a major effect on libido. “After menopause, the adrenals become critical to a woman’s supply of these sex hormones,” says Dr. Naugle. “If a woman has adrenal fatigue, not only will her production of stress hormones decrease, but her testosterone [and estrogen] and her libido will too.”
High levels of stress can decrease overall sexual functioning as well, she continues. In a study, “Women who had higher levels of cortisol (the stress hormone) and lower levels of DHEA (which breaks down into, among other things, the two sex hormones) experienced less physiological arousal after watching an erotic movie than women with a lower cortisol/DHEA ratio did. Prolonged stress has been shown to decrease sexual response in women, and women with greater levels of chronic daily stress report more sexual complaints.”
If you suspect you have adrenal fatigue, find a physician familiar with the varying stages of decreased adrenal function. You’ll likely be asked to take specific saliva and/or blood tests—easy and relatively inexpensive The results will determine what holistic approach—lifestyle, supplements and nutrition—might be effective in restoring your adrenals, and may also include medication.
Adrenal fatigue is a common undetected thief in the night of restorative sleep and sex drive, but once you recognize the symptoms, you’re on your way to recovery. Be patient, however. In severe cases, full recovery can take months or even years. My own optimistic physician told me on my first visit, “Your adrenal glands didn’t get this way overnight, so don’t expect to restore overnight. But we will, indeed, restore them.” With the right health practitioner and a commitment to healing, your slumber and sex drive will sneak back under the covers with you in no time.
—Writer Laura Owens specializes in wellness, psychology, human potential and empowered living.
Target Your Adrenals
A healthcare professional should be consulted for specific guidance on adrenal challenges, as optimal remedies will be unique for each person. Specialist Dr. Michael Lam, who publishes an adrenal fatigue newsletter, often recommends:
• vitamin C with bioflavonoid and synergistic co-factors
• intravenous glutathione (or by liposomal oral delivery)
• vitamin B5 (pantothenic acid)
• vitamin E
• vitamin D
Additional nutrients to consider: beta carotene, selenium, magnesium, lysine, proline, glutamine, DHEA and pregnenolone, ribose, CoQ10 and collagen. Helpful herbs may include ashwagandha root, licorice root, Korean and Siberian Ginseng, ginger root and ginkgo leaf. Caveat: In advanced adrenal fatigue these may act as stimulants.
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~ The Sex Drive Roller Coaster
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