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June 19, 2014

Low Libido in Women: the HARSH Reality

harsh reality
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Dr. Landa’s HARSH System for Low Libido

Struggling with low libido can be a harsh reality. But, it can be fixed. Today we will discuss Dr. Jennifer Landa’s HARSH System to evaluate and treat low sex drive in women. So what is HARSH? It’s an acronym that stands for the following:

  • for habits
  • for attitudes
  • for relationships
  • for stress and emotional issues
  • for hormones

Let’s tackle each of these five areas.


Our lifestyle and habits go together. They’re basically one and the same. In our previous post we discussed the pro-libido lifestyle. The habits that embody the pro-libido lifestyle are the ones you want to develop if you don’t have them already. Studies show that changing habits can improve sex drive.  Weight loss has been shown to improve female sexual dysfunction (FSD).

Eating a Mediterranean diet in women with metabolic syndrome led to improvements in sexual desire and arousal with a decrease in pain during sex. More physically active women tend to be more sexually active as well.

Many of the critical habits to improve sex drive center around nutrition and exercise/physical activity.


What doesn’t attitude affect? Sexual desire is affected by sexual attitude and attitude is affected by self-image, other competing needs/priorities, and what Dr. Landa calls mindfulness. (I take this to mean being mentally present where you are physically). Tune out distractions and put other priorities on hold. This is a challenge these days as women are tugged and pulled in many different directions (especially those working and with kids at home).


The number one reason women report for losing their sex drive is problems in their relationship. It’s important to ask is your sex drive low for your partner? Or, is it low all together? If it’s the former, then there probably is a relationship issue that needs to be addressed. The desire to have sex is generally a good barometer at how well a relationship is functioning.

Many couples stay sexually active despite relationship problems – out of obligation so to speak. So the emphasis is on the desire component not the frequency of the actual act.

Resentment seems to be behind many relationship problems for women. Women frequently feel like they don’t have time for their own needs, and it wears on them eventually. At some point they resent doing everything for the partner and/or family with little in return.

The big motivator for women to have sex is intimacy and connection. The intimacy and connection usually must exist first for women to desire to have sex. While men may obtain intimacy from sex they typically don’t need it to have the desire. One reason women are from Venus and men from Mars. Most women will probably have to communicate this need for pre-sex intimacy to their partner (good luck on that one women – hard to teach an old dog new tricks).

Guess what resentment does? It leads to stress – the next item on our list.


Chronic stress accelerates aging, but it is also a big sex killer. It stimulates cortisol release which is detrimental to our health when chronically elevated. Getting your stress under control makes it easier to utilize your other senses and improve mindfulness to enhance the sexual experience. Dr. Landa recommends first that rate your stress level on a 1 to 10 scale and track your stress and its triggers in a journal. Try to avoid or reduce those stress triggers in your life.

Take time to pamper yourself, too. Get a massage, a facial, make quiet time for reading, or anything else that helps you to relieve stress.

Try to re-prioritize your activities and make sex a higher priority. Stress reduction techniques like deep breathing, meditation, and prayer can help significantly. Activities like yoga and Tai chi are great stress relievers. But, maybe the biggest stress reliever is sex itself. So don’t leave home without (doing) it!

Stay away from medications to manage stress (antidepressants/anxiolytics) if possible. Many of these will actually lower sex drive further and hinder sexual satisfaction. And, if you are on one of these medications you may find weaning off of them a big boost to your sex drive. But, don’t stop taking any medication without discussing first with your physician.


We’re not going to spend much time on hormones since much of the website is devoted to that topic. Adopting a pro-libido lifestyle will help to naturally balance your hormones. And, that’s important to know that. But, if low sex drive persists then have your hormone levels measured and replaced if low.

Harsh Reality: it Doesn’t Have to Be

Don’t acccept low sex drive as the harsh reality. Adopt a pro-libido lifestyle. Get your passion back! Go to Rewire Your Desire to learn more.




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Dr. Joe Jacko

Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

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