The Cortisol Connection: Sex and Sleep, Stress and Survival

An amusing quote from two women health experts on Oprah, back in February of 2001: "Sleep is the sex of the next century," (meaning this one that we're in, now), by Laura Berman, Ph.D. and Jennifer Berman, M.D.

Good sleep being equated in importance to good sex?  Ahhh, that's not just humorous, that's interesting!  And both topics are recent focuses of this blog, so we've got to dig in and discuss.

Recently, we've talking about sleep AND sex (though not necessarily at the same time, for obvious reasons ;-).  However, both are important to maintaining good psychological health and happiness -- and the reality is, they both have something to do with a topic we've recently mentioned: cortisol. 

According to one expert, "Elevated cortisol levels resulting from chronic stress" [PTSD is a chronic stress] have been associated with the following conditions: increased appetite and food cravings; increased body fat; decreased muscle mass; decreased bone density; increased anxiety; increased depression; mood swings (anger and irritability); reduced libido (sex drive); impaired immune response; memory and learning impairment; increased symptoms of PMS (cramps, appetite); and increased menopausal side effects (hot flashes, night sweats)." Oh, my goodness!  Is there anything that ISN'T on that list?

Remember, too, that increased cortisol levels such as exist in veterans with PTSD are also implicated in risk for heart disease, as we blogged about here, recently.

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Shawn Talbott, Ph.D., who has an interesting book called The Cortisol Connection: Why Stress Makes You Fat and Ruins Your Health -- And What You Can Do about It, has several pages devoted to the all-important topic of how cortisol from stress -- which veterans with PTSD have -- wrecks people's sex lives.  Since we've been discussing healthy sex and the combat veteran lately, it seems tailor-made to discuss what Talbott finds.  As he writes:

“You don’t need to read a book about the relationship between stress and disease to know that when we’re stressed out, we also have problems in the intimacy department.  For starters, menstrual cycles get all out of whack, erections are more difficult to achieve and maintain, and overall libido (sex drive) plummets.  Stress simply makes us lose interest in sex.  In males, this is due primarily to a dramatic fall in testosterone levels during stressful times.  In females, the stress-induced loss of sex drive is a bit more complicated, involving disruption in levels not only of testosterone, but also of estrogen, progesterone and prolactin.

 

(We're skipping over the part where he goes into biology class level details about how cortisol levels affect men's and women's sex drives, and going straight to his conclusion.  His book, which is worth getting, goes into details about what you can to do affect your own cortisol levels, apparently for better health.)

“So what to do?  Quit your job, move to the islands, and open a surf shop!  Your sex drive is guaranteed to increase.  (Ever wonder why you feel friskier when you’re on vacation? – Less stress!)  Not practical to move your family to Tahiti?  Okay, then at least do something about your cortisol levels…”

 

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Another part of Talbott's book I found interesting was when he talks about the three main factors that make a huge difference in stress levels of individuals.  Take a look at these and think about combat trauma in the lives of veterans you know, and wonder about these factors continue to play into their lives, from remembered combat:

 

“We know from studies of both animals and humans that at least three factors can make a huge difference in how the body responds to a given stressor: whether there is any outlet for the stress, whether the stressor is predictable, and whether the human or animal thinks they have any control over the stressor.  These three factors – outlet, predictability and control – emerge as modulating factors again and again in research studies of stress.”

It's safe to say, healthy sex could be an outlet for stress, intrustive memories of PTSD are relatively un-predictable; and veterans' ability to "control" their stressors, many of which arrive unbidden, is fairly sketchy.

 

Another aspect of Talbott's work I found interesting was when he talked about how even potentially stressful sitautions can eventually lose their "charge" over time, if only they become "expected" or "predictable."  Unfortunately, there's pretty much nothing about combat that's "predictable" (except that it will be unpredictable!) so it stands to reason why combat veterans struggle with both stress and high cortisol levels, implicated in various illnesses including heart disease.  This scenario, below, shows a great "de-fanging" of a potentially large trigger: but because it becomes "predictable" over time, it loses its intensity.  Unfortunately, probably VERY little of what combat veterans experienced fell in this category: 

"The scenario [of predictability] has been studied in Army rangers training at jump school to become paratroopers.  At the start of the training, the soldiers underwent enormous increases in cortisol levels during each jump, but by the end of the course, their stress responses were virtually nonexistent.  By making the stressor more predictable, the stress response of each soldier was controlled to a much greater degree (though skydiving will probably never become a completely stress-free activity)."

 

At the very least, Talbott's book is worth picking up because it gives many practical ideas (including exercise, relaxation and diet) for reducing cortisol levels, which ultimately should result in better health.  Since cortisol is implicated negatively in sleep and sex, as well as many other important categories, it's worth knowing more about how to modulate your own levels, to optimize your experience.