Bulimia Linked To Sex Hormone Imbalance

A Swedish study has concluded that as many as 30 per cent of women with the binge-eating disorder bulimia nervosa could be suffering from an imbalance of sex hormones.

The PhD thesis is the work of Dr. Sabine Naessén of the Department of Woman and Child Health at the Karolinska Institutet, Sweden's largest medical training and research centre.

Dr. Naessén suggests that some women with the compulsive over-eating disorder may have too much testosterone, the male sex hormone. "We have shown that one third of female bulimics have metabolic disorders that may explain the occurrence of the eating disorder. These disorders may in certain cases express the hormonal constitution of the patient, rather than any mental illness", she says.

The study shows that bulimia has hormonal and genetic components, as well as the psychological element. The hormone imbalance is due to an over-abundance of testosterone and an insufficiency of the female sex hormone, oestrogen, an active ingredient in oral contraceptives.

It is thought that too much testosterone causes a person to feel very hungry and crave high-calorie foods rich in sugar and fat.

21 bulimic women were treated with oestrogen-dominated oral contraceptives. Within 3 months half of them reported feeling less hungry, and having decreased craving for fatty and sugary foods. And 3 of the women were said to be completely cured with this treatment.

Dr. Naessén suggests "this is a very strong effect. Hormone treatment may very well be an alternative to cognitive behavioural treatment."

Bulimia is usually defined as a psychological disorder normally treated with psychotherapy, with cognitive behavioural therapy being the one most commonly recommended.

According to the diagnostician's "bible", the DSM-IV-TR® Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, for patients to be diagnosed with bulimia (as separate from anorexia nervosa), they must be showing the following 4 symptoms:
- Binge-eating "recurrently", i.e. eating far more than most people normally do, together with a feeling that they can't stop or control their eating.
- Repeatedly and inappropriately compensating for the over-eating, such as over-medicating with laxatives, fasting, exercising to exhaustion, or making themselves vomit.
- Been doing these two things (binge-eating and inappropriately compensating) repeatedly at least twice a week for the last 3 months.
- Overly judging themselves in terms of the weight and shape of their bodies.

Unfortunately bulimia is very hard to spot, because unlike other eating disorders, such as anorexia, the bulimic will appear to be of normal height and weight, and because of the shame and guilt associated with the condition, have learned how to mask their symptoms. The long term effect is one of malnutrition, and it may well be a symptom related to this that first brings the bulimic to the attention of the doctor.

Women’s Sex Drive: How to Handle Top Libido Killers - 2.

Is sex the last thing on your mind these days? Does it take you forever to get aroused? Or has reaching orgasm become a herculean task? If so, you may have female sexual dysfunction — and you're not alone. An estimated 43 percent of women reported experiencing sexual dysfunction, according to findings published in the Journal of the American Medical Association, with problems ranging from not being able to have orgasms to having zero sexual desire.

Many things can interfere with sexual pleasure and function, from medical causes, such as certain medications, to psychological issues, such as relationship strife. Most often, sexual dysfunction is born out of a combination of the two. To help you pinpoint what's taken the sizzle out of your sex drive, we've pulled together 10 top libido killers and what your next steps should be to get your sex life back on track.

4. Poor body image: Feeling self-conscious about your curvy hips or less-than-ample breasts can diminish your sexual drive. "It doesn't matter if your guy is telling you you're the hottest thing," says Dr. Kellogg-Spadt. "Oftentimes the partner is raring to go and completely attracted. But if you don't feel beautiful, you're not going to be into it."

What you can do: Do a cuing analysis. Think of a time in your life when you felt sexually at the top of your game. What did you wear (for instance, your favorite little black dress or low-rise jeans), what was your workout routine, how did you eat, what perfume did you wear, what shoes did you slide on — and when was the last time you wore that, did that, ate that, etc.? These cues can help you get back into the mindset and habits of your sexy self. And if the little black dress doesn't fit anymore? It might be time to buy another dress you feel good in at your present weight or get back into an exercise routine. "Exercise has a direct effect on the chemicals in your brain that affect mood," says Jennifer Berman, MD, director of the Berman Women's Wellness Center in Los Angeles and coauthor of For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life. In addition, working out will shape up your physique and give you more energy. If these changes don't help improve your body image, it's time to consider professional counseling to get at the root of the problem.

5. Menopause: Menopause is marked by a whole host of changes in your body. There's a decline in ovarian function that leads to an abrupt drop in estrogen levels, which play a role in vaginal lubrication. What's more, testosterone production drops by up to half, which can trigger a sudden dip in your sex drive as well as diminished sensitivity in the clitoris and a weakened ability to climax, according to Dr. Berman. Growth hormone levels, which are associated with sexual function, energy, memory and mood, also decrease. "Touch perception changes and alters as we age," adds Dr. Berman. "It takes a little more touch to feel the same amount of erotic arousal." Add to that weight gain, fatigue and difficulty sleeping, and sex can become the last thing on a menopausal woman's mind.

What you can do: First and foremost, speak with your doctor to check for a medical cause, such as high blood pressure or cholesterol. If that's been ruled out, there are many options, including starting a doctor-approved exercise regimen to improve blood flow, using the botanical gel during foreplay, self-pleasuring to promote genital blood flow and incorporating fantasy work, such as doing some erotic reading or watching erotic videos 20 to 30 minutes three times a week. "This doesn't have to be done in the presence of your partner — sometimes it's better not to — but it's to put erotic thoughts back into your daily thoughts," says Dr. Kellogg-Spadt. To combat vaginal dryness, start exercising to improve blood flow and use a water-based lubricant that feels natural to you. Your doctor may prescribe a topical estrogen therapy, which increases vaginal lubrication and elasticity. Have open communication with your partner and explain to him that your body is changing. "Let him know that it doesn't mean you're not turned on by your partner just because you have to use a lubricant," she says. Using a vibrator, which is more intense than the human hand, can also help with dulled arousal. In some cases, physicians may prescribe testosterone (in pill, cream, suppository or lozenge form) to older women with low levels of the hormone who experience a loss of well-being. Oral and topical testosterone may help increase sexual urges, although no preparations are FDA-approved yet.

6. Medical conditions: Health problems such as high blood pressure, high cholesterol, diabetes, thyroid disorders and autoimmune disorders like lupus can all change a woman's sexual desire by affecting blood flow, nerve signals and hormone levels. A recent study of 417 sexually active women ages 31 to 60 found that women with high blood pressure were twice as likely to have sexual dysfunction than women with normal blood pressure. What's more, the older the women were and the longer they had had high blood pressure, the greater the chance of sexual dysfunction.

What you can do: Let your doctor know that you are feeling a change in libido. He or she may prescribe medication to treat the health condition, which generally limits sexual side effects. In the aforementioned study, women who took drugs to treat their high blood pressure but did not reach their target goal were more likely to experience sexual dysfunction compared with women who were not taking medication. However, women who had good control of their blood pressure through medication were much less likely to have libido problems. Your doctor may also recommend lifestyle changes, such as exercising regularly and eating healthfully, which may allow you to cut back on medication. To counter vaginal dryness, use a water-based lubricant or talk to your doctor about using a topical estrogen.

Women’s Sex Drive: How to Handle Top Libido Killers - 1.

Is sex the last thing on your mind these days? Does it take you forever to get aroused? Or has reaching orgasm become a herculean task? If so, you may have female sexual dysfunction — and you're not alone. An estimated 43 percent of women reported experiencing sexual dysfunction, according to findings published in the Journal of the American Medical Association, with problems ranging from not being able to have orgasms to having zero sexual desire.

Many things can interfere with sexual pleasure and function, from medical causes, such as certain medications, to psychological issues, such as relationship strife. Most often, sexual dysfunction is born out of a combination of the two. To help you pinpoint what's taken the sizzle out of your sex drive, we've pulled together 10 top libido killers and what your next steps should be to get your sex life back on track.

1. Oral contraceptives: The trouble with the Pill is that what keeps you from getting pregnant — stopping ovulation — is also what can sap your sex drive. "The medication puts your ovaries to rest for three out of four weeks each month, but there other functions of ovaries beside making eggs — and that is making hormones," says Irwin Goldstein, MD, coeditor of the textbook Women's Sexual Function and Dysfunction: Study, Diagnosis and Treatment. The second problem is that the Pill causes the body to produce a protein called sex hormone binding globulin (SHBG), which binds itself to sex hormones, in particular testosterone, essentially sucking them up. Testosterone plays a role in vaginal blood flow and sensitivity in the opening of the vagina, so lower levels of the hormone can lead to sexual problems. What's more, the thinking was that once you stopped the Pill your body returned to its original settings, but Dr. Goldstein's research shows the Pill's effect and the SHBG protein production can continue to be higher in former Pill users than in non-Pill users.

What you can do: If you've noticed your sex drive isn't what it used to be and suspect it may be because of your birth control pill, talk to your gynecologist. He or she may switch you to another type of Pill (especially if you're on an ultra low dose, or 20 microgram, pill, which is one of the biggest offenders) or a different birth control method, such as the Mirena IUD or condoms.

2. Medications: Antidepressants — in particular, selective serotonin reuptake inhibitors (SSRIs) such as Prozac or Paxil — are one of the best-known offenders for low libido and impaired orgasm. "Certain chemicals in the brain stimulate sexual activity, such as dopamine, norepinephrine and oxycontin, while other chemicals are inhibitory, such as serotonin," says Dr. Goldstein. SSRIs raise serotonin in the blood, which can affect libido. (Case in point: SSRIs are used "off-label" to treat men with premature ejaculation since it slows down their sexual excitement, according to Dr. Goldstein.) Other culprits include prescription blood-pressure-lowering drugs, which can interfere with nerve signals, and antihistamines, which dry up not only a runny nose but your vaginal lubrication as well, making sex uncomfortable.

What you can do: Talk to your doctor about your sex drive. He or she may be able to adjust your medication regimen, for example, keeping you on the antidepressant while adding a botanical oil that, when massaged into the clitoris, labia and vaginal opening during foreplay, enhances arousal and orgasm. This method has been tested and found to be effective on SSRI patients. Your physician may also be able to switch you to a different antidepressant medication, such as Wellbutrin, a dopamine reuptake inhibitor, which often improves sexual function. However, Wellbutrin can have its own side effects, including insomnia, changes in appetite, heart palpitations and dry mouth. If your antihistamine is to blame, try using a water-based lubricant during sex.

3. Depression: This mood disorder is characterized by feelings of sadness, emptiness, worthlessness and fatigue that interfere with everyday life, as well as changes in sleep and eating habits. One of the hallmarks of depression is a lack of interest in sex. Although it's not fully understood why depression affects sex drive, part of the reason may be that not feeling good about yourself and your worth, in addition to having low energy levels, dampens the desire for pleasure.

What you can do: Seek help right away, especially if you have thoughts of death or suicide. Exercise can help with mild to moderate depression by boosting mood, self-esteem and energy levels while improving blood flow, including to the genitals. For moderate to severe depression, professional counseling and prescription antidepressants can help, says Dr. Kellogg-Spadt. The irony is that some of the same medications used to treat depression can reduce your sex drive (see "Medications" above). Let your physician know if your lack of sex drive doesn't change (or worsens) with treatment.