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Hormones-Sex Connection with Ashley Koff, RD · Libido Lounge

• 0:00
  Welcome to the Libido Lounge, where we focus on all things love, lust, and libido.
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  We believe that fabulous sex is important to health as exercise and good food.
• 0:11
  Hey, everybody.
• 0:12
  Welcome back to another episode on the lounge.
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  I'm your host libido expert, doctor Diane, and I am so excited about the conversation that we
• 0:21
  are having today with dietitian Ashley Koff.
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  We're gonna have the best time.
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  We're gonna talk about all sorts of reasons for low libido and some of these that you have not
• 0:31
  heard yet on this particular show.
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  So we're gonna talk about additional hormones that you need to know about.
• 0:36
  We're gonna talk about the relationship of these new hormones that you probably have never
• 0:40
  heard of to things like blood sugar and your vasculature, your blood vessels, all these
• 0:45
  different things from a physical standpoint that are really rooted into driving low libido
• 0:51
  as well as driving a lot of other health related types of conditions.
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  So welcome to the lounge, Ashley.
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  It's so great to have you with me today.
• 1:00
  Thank you.
• 1:01
  I just wish I was laying on your couch.
• 1:02
  This feels like, let me come on in and lounge.
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  I don't think we're gonna do this in person.
• 1:07
  And we'll throw everybody over.
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  We're gonna have wine.
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  It's a whole part of the vision, so we will get there.
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  We'll invite you back for for that.
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  Thank you.
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  Let's get right in.
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  So I wanna talk I know we wanna talk about the hormone incretin and the hormone family
• 1:22
  incretins.
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  So let's kinda introduce that because I know a lot of listeners are probably hearing that word
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  incretin and, like, never heard this before, and how does this relate to them?
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  What is this?
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  How does the how are these hormones related to libido?
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  Can can you kinda set the stage with what these hormones are and why people should really be
• 1:41
  thinking about these in terms of their health and libido?
• 1:44
  Yeah.
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  So I probably wouldn't like I definitely don't think a lot of people are hearing incretin or
• 1:49
  incretin, in that space.
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  It depends on the podcast you're listening to or how people are talking to you.
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  I'm hopeful that we will start to be hearing that more often, but we're definitely hearing
• 2:00
  Zepbound, Zepi, Ozempic, Tirzepatide, Manjoro.
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  And these medications, they actually are based off of a hormone.
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  So, these medications that have been around since, like, 1995 that, you know, originally
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  studied for Alzheimer's that are now being used for metabolic health, blood sugar, and then
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  definitely where we're hearing about them in weight health are creating awareness about a
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  hormone that's actually really important for you to understand in your total libido picture.
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  So that's the journey that I hope, you know, that we can go on today where, when you when
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  you think about the or when you hear about those hormones, whatever, you know,
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  medications, etcetera, whatever you're thinking, I want you to have that moment of,
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  oh, that's right.
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  This is why I'm doing what I'm doing to make sure that I'm optimizing my hormone for those
• 2:46
  libido outcomes.
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  So the reason it's important is that those medications are a synthetic accelerated or
• 2:53
  intensified version of a hormone that our body or type of hormones that our body make in the
• 2:59
  lining of our digestive tract.
• 3:01
  So just like you could take insulin, you could take testosterone, you could use an estrogen or
• 3:05
  progesterone patch, you can now get synthetic GLP-one.
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  But the natural GLP-one in the lining of your digestive tract plays a really important role.
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  It's a switch.
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  It flips it on.
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  And when it flips things on, it turns you on.
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  So we're going to talk about the benefits of being turned on.
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  Two of those benefits are, from this hormone standpoint, are to number one, have better
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  appetite, control.
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  I hate to use the word control, but, like, just have a better sort of appetite system, if you
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  will, so you feel satisfied with what you're consuming.
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  That's the leptin hormone.
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  And the other one is your blood sugar hormone where we look at insulin in that part.
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  And where we're gonna go in this journey is to help you understand why that's important for
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  libido.
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  So really good for you to just know when you hear Ozempic, think GLP one and remember that
• 3:57
  that Ashley cough said to you that that's actually a hormone that you make in your body
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  in the lining of your digestive tract that has to do with your libido as well as other aspects
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  of metabolic health.
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  So it's a bigger answer, but I just wanted to trace the journey there.
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  Yeah.
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  Yeah.
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  Thank you.
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  And I wanna make sure I'm summarizing this for people because I I know there's people that
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  have heard of these words before, and then I know some of our listeners are like, what are
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  all these things that that are being said here?
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  So so to trace this journey back just to make sure that I'm following and tracking you okay
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  and that our audience is so, essentially, you're saying that GLP one is made in the
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  gastrointestinal lining.
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  Right?
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  And then we and the GLP one are going so are you so is is leptin a GLP one?
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  Is that a type of judgment?
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  No.
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  Great question.
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  So GLP-one is a peptide.
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  It's called glucagon like peptide.
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  So it is a hormone, and it is a hormone whose sole job, it literally sticks around for, like,
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  thirty seconds.
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  Right?
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  So its job is to turn on two other hormones that we know of.
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  Well, there may be other things, but that's leptin and also insulin.
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  And so those hormones, we may have heard more about, you know, leptin as leptin and ghrelin
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  as they are related to appetite, and satiety, and then insulin and glucagon as they're
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  related to your blood sugar.
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  Okay.
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  Perfect.
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  And then so and then all of these other pharmaceuticals that you are naming off, are
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  those different types of GLP ones?
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  Is that what those are?
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  Okay.
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  Yes.
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  And some of them without getting too into the weeds, some of them are GLP one alone, and some
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  of them are GLP one and GIP.
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  We don't need alphabet soup on that part.
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  You just wanna know that they're they're the synthetic version of that hormone.
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  Yeah.
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  Okay.
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  And I think this is great too because I know, like, in the weight loss world, right, GLP is
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  getting so much press all of a sudden.
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  Right?
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  So
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  Mhmm.
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  So now, you know, just helping people understand that this is something that we
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  actually do create ourselves and that that is actually controlling things like our leptin,
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  like our insulin.
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  So then let's go on from there.
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  So can you help us understand then how leptin and insulin really are related to libido?
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  Sure.
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  And this is where I was so excited to connect with you because I love your podcast for making
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  it very much easier for people to, both normalize the conversation around libido and
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  also understand where they may wanna explore.
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  Because our libido is multifaceted as you talk about.
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  So, there are things that when we have hormonal disruptions, not our sex hormones, but our
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  metabolic health hormones or our appetite hormones, is what I'm gonna call leptin and
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  ghrelin on that part, that are going to affect our libido.
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  I could be as blatant as, you know, if I if my leptin if I don't feel, satisfied with what I'm
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  eating and I overeat, then I may feel just, like, over full.
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  And my body's response is to completely move me away from libido because I just don't feel
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  either physically good about my body or emotionally good about my body.
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  When we feel full, it's a little like and especially over full, it's a little hard to,
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  like, feel groovy, right?
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  Like on on that part.
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  Okay.
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  So there's that side of it.
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  And on the flip side, if we feel overhungry, right, if we feel unsatisfied, unsatisfied, I
• 7:13
  haven't gotten what I need, then I can also be experiencing a space where that's impacting my
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  libido.
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  I work with a lot of and over the years, I've worked with a lot of entertainers and
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  professional athletes.
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  And you'd be really interested to know that actually so we use libido as a health marker,
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  which is also why a lot use libido as a health marker, which is also why I love your podcast.
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  It's so fun on that part.
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  I do really think that when your libido starts to be off or if you notice there's a particular
• 7:35
  time and one of the times that libido can be really affected is when you're, performing in
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  another capacity on a in a very intense space.
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  So that could be like any of us where if we're performing as a parent, if we're performing at
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  work, you know, if we're if things are very stressful, you know, and and that kind of
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  thing.
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  And so we've actually looked at libido there, and one of the things that we actually noticed
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  is that when people are undernourished, that they're feeling hungry, that the right nutrient
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  balance hasn't happened, that their satiety hasn't been hit, or maybe their genetic design
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  is that it's harder for them to feel satisfied, that's that leptin resistance, then that can
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  actually be affecting their libido.
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  And you're the expert there.
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  We can, you know, dive definitely dive deeper into it.
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  But that's one of the reasons that this GLP-one hormone is really important because another
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  reason that if your body isn't producing GLP-one so say that I'm somebody, and this is
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  true, I'm somebody I took a lot of antibiotics as a kid, or maybe I'm was diagnosed as celiac
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  later, you know, and it went through a period of time where I had stomach irritation, or
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  maybe I've had to take I've either chosen to take birth control oral contraceptives, or I've
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  had to take steroid medications, or maybe I have, ulcerative colitis or IBS or SIBO.
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  Any of these things will be affecting the lining of the digestive tract, which will
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  affect the diet the production of GLP-one, which if we stick with me, will affect leptin
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  being turned on.
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  So again, I may overeat or I may not feel satisfied by what I'm eating and as a result
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  that can directly affect my libido.
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  So one of the things I wanted us to take away from today is if you are someone where you're
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  experiencing either a history of digestive or currently things are digestively not feeling
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  like they're good on that part, or you're just kind of like, I always feel hungry even if I
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  eat and then right after eating, you know, or I eat an amount that somebody says is like better
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  for me or I should be full with that amount and I'm not experiencing that.
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  We may want to explore your natural production of GLP-one.
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  And the upside of optimizing that is actually going to be to make it easier for you to
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  support healthy libido?
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  So that's that whole circle, you know, and that's just the one side.
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  I'll get to blood sugar in a second, but anything around that appetite piece that you
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  feel like, you know, sort of from what you've explored or kind of how you think about libido
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  or, or that poses a question for you?
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  Yeah.
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  One of the things I think that people might be wondering.
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  So, like, what I'm tracking here for people is, okay.
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  Well, how you know, what kind of things are gonna cause GLP to be low.
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  Right?
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  So some of these examples you gave around chronic digestive things, antibiotic use, like,
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  those are some of our causes.
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  Right?
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  So we wanna go.
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  We wanna fix the gut.
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  We wanna fix the microbiome in that scenario.
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  Is there, from a standpoint of, like, we know we can test leptin and blood work.
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  We know we can test insulin, fasting insulin and blood work.
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  Is there a reliable test for GLP, or do we more have to kind of extrapolate that based upon,
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  hey, what leptin and insulin levels are doing?
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  Yeah.
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  I I love that you asked.
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  Remember I described it as it's about thirty seconds.
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  Right?
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  So it is a quick shot on that part.
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  There are a lot of jokes that come to mind for me right now, but it's it just it just flipped
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  on like a light switch.
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  That's right.
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  Exactly.
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  Yeah.
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  I'm the daughter of a urologist, so I'm so used to them on that.
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  So in that space, there actually isn't because of that.
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  So we tested in labs, because you can you know, somebody's forced to be sitting there.
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  We're using lab animals, you know, or looking at at cells on that part.
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  If some to date, so as the time of recording this, there isn't anything that I would feel
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  comfortable saying to use.
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  And so that's why we've looked at a variety of these different symptoms.
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  And it's actually why one of the things that I look at with libido, again, as a marker of
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  health, just like I love fertility as a marker of health, is to come back to, hey, if your
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  challenge if you're we're working to optimize your libido, let's ask those questions about
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  your appetite, your satiety as a part of your overall digestive health evaluation so that we
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  can understand because the other pieces are things like alcohol.
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  So if we drink alcohol, that's going to increase our the inflammation around that
• 12:00
  lining of the digestive tract.
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  Right?
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  Stress I mentioned before, immune health or if you have an autoimmune disease like that.
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  So there are a number of factors.
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  We put together a free quiz, that, you know, I can direct people to just to ask the question,
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  do I need to be optimizing my GLP-one?
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  And so we can kind of ask those questions.
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  And then as you mentioned, we can also start to trace to what would be the best way for us to
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  assess where you are and then set goals so that we I always like to have a goal plan for, you
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  know, for our treatment, you know, on on that part.
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  But there isn't a reliable measure.
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  Yeah.
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  Okay.
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  That's helpful.
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  And Yeah.
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  Can we put the quiz for that in our show notes here?
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  Absolutely.
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  Yep.
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  Okay.
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  Awesome.
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  So, everybody, we'll
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  make sure we get that in the show notes for you as far as how to analyze that.
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  And let's move on now to the insulin component and the blood sugar component.
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  And I you know, we've talked already in in various episodes on this podcast around blood
• 12:56
  sugar and its impact on libido or even blood sugar's impact when it's too high for too long
• 13:02
  on the vessels and that leading to low libido as far as low blood flow.
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  Right?
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  Yeah.
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  But let's let's also bring in, so how can you talk more about how is that related to the GLP,
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  the insulin, as well as can you tie in any hormone relationship there as well for
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  us?
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  Yeah.
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  Absolutely.
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  So insulin resistance, often occurs, or one factor that can be, one of the things that can
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  be a factor in insulin resistance is blood what we'll call blood sugar dysregulation.
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  So that can be highs and lows.
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  It could be a period where it's very high.
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  I usually say peaks and valleys versus rolling hills, but you could still have rolling hills
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  just above where we want you to be.
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  So if you're rolling hills are in, say, the one twenty to one fifty space, rolling hills being
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  better than peaks and valleys, but I still want it to come down to that sort of 70 to one ten
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  range.
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  So it's really important for us to understand just insulin, and the insulin response in a
• 14:00
  whole picture of metabolic health, because it is going to be that thing that we look at, you
• 14:05
  know, that has such a play with cognitive function.
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  And so we know a big part of libido is also related to cognitive.
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  Maybe a little bit more with women than with men, you know, when we see that piece, but, it
• 14:19
  still is something that we do, you know, sort of need to be able to explore on that part.
• 14:24
  So one of the things you again, going back to our GLP one is one of the incretin hormones and
• 14:29
  it's produced in the lining of the digestive tract.
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  And its role there is to actually turn on to flip the switch in the presence of carbohydrate
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  and fat primarily, to say, oh, that's there.
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  So now I'm gonna send insulin out.
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  So for a long time, we've just been focused on the insulin side of things, and saying to
• 14:50
  people, let's give you insulin or let's work on ways to improve your insulin.
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  Let's mimic insulin even with things like cinnamon and, you know, making sure that we've
• 14:59
  got enough chromium in our diet so that the cells can bring the insulin in.
• 15:04
  But we haven't been paying attention to what actually, like, yells out the window and says,
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  hey, insulin, time for you to go.
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  That's the GLP one hormone.
• 15:12
  So if you go back to all of the other episodes where there have been those different pieces
• 15:17
  where we've looked at insulin, that's just gonna be a great reminder for you to say that
• 15:23
  especially too if you feel like I get this all the time where people have, you know, feel like
• 15:28
  I've been working on my diet, I've taken those supplements, I'm doing these, you know, I'm
• 15:32
  exercising after I eat, like, kinda trying all of these things.
• 15:35
  And they feel like they're not seeing better blood sugar results And there might be two
• 15:39
  different things that they you know, they might be looking at an a one c, which I tend to not
• 15:43
  like to look at.
• 15:44
  I like to look at a fasting insulin, and I like to look at, continuous glucose monitoring to
• 15:48
  see where, you know, in your day, or in your evening.
• 15:51
  You know, this could be a factor while you're sleeping.
• 15:54
  But now we know there's a third area, which really, like, we've kind of been like you and
• 15:59
  I, the the type of practitioners we are, we've been talking about this because it's your
• 16:03
  digestive health.
• 16:05
  And even beyond it being the digestive health, like not just the microbiome, but it is very
• 16:11
  much the lining of the digestive tract.
• 16:13
  And that, you know, when we look at the lining, when we look at the mucosal layer, we have to
• 16:18
  think that this is where nutrients are absorbed.
• 16:21
  This is where our immune response immune response is deployed.
• 16:25
  So there's a lot of hormonal interaction, thyroid interaction, vitamin d, which I
• 16:30
  consider a hormone is going to be a factor, things that I know you've talked about in other
• 16:34
  episodes.
• 16:35
  I'm not gonna, you know, beat them over the head.
• 16:37
  But what's really also interesting is when it's this is often packaged together.
• 16:43
  So insulin is often packed gets together in something we call metabolic syndrome, where we
• 16:48
  look at blood pressure and we look at, risk of heart disease.
• 16:52
  So we look at heart health, and then we look at insulin and and our blood sugar.
• 16:56
  And when we look at that in totality, we really need to understand that we've gotta be in this
• 17:01
  space of optimizing all of these.
• 17:04
  So we wanna look at, you know, what's better for my blood sugar is also needs to be better
• 17:09
  for my the the, the vessels, the blood vessels, you know, that what we've talked about on that
• 17:14
  part.
• 17:14
  You can't have sugar in those tiny little capillaries blocking things up where blood is
• 17:19
  supposed to flow or we're not gonna get responses as quickly, you know, as as we'd like
• 17:24
  them to.
• 17:24
  We talk about that in our eyes and our kidneys, but we need to talk about those in in areas
• 17:28
  that are where we're trying to get the response, you know, for libido.
• 17:32
  So that's gonna be really important.
• 17:34
  And then the other piece that's important is when we we want to really be focused on
• 17:39
  interventions.
• 17:41
  When your digestion is not better, it can often throw off hormones, testosterone, estrogen,
• 17:47
  progesterone, etcetera.
• 17:48
  We talked about thyroid, vitamin d.
• 17:50
  But also, when those hormones are not better, they can throw digestion off course.
• 17:57
  So one of the things that I often see is that when somebody is being treated for ED or
• 18:02
  treated for low, estrogen or adding in progesterone and kinda, you know, trying to
• 18:07
  navigate your or even DHEA and cortisol and these sorts of things.
• 18:11
  If you don't focus on the GLP one and the digestive restorative part, you're probably
• 18:17
  missing a piece that is going to bring this all together.
• 18:20
  So what I want us to do is, I'm old, so I think of that trivial pursuit where it had all the
• 18:25
  different colored pie pieces.
• 18:27
  Oh, yeah.
• 18:27
  And we just wanna remember that one of those colored pies is GLP one, and we haven't been in
• 18:33
  that space.
• 18:34
  So I have people who are, you know, dealing with ED, and they may be doing, you know,
• 18:39
  focusing on testosterone, and they're trying to get in protein, and they're, you know,
• 18:43
  exercising.
• 18:44
  Maybe they're even eating an anti inflammatory diet, but we haven't done the repair work and
• 18:49
  the focused work on the GLP one side, and it's not all coming together optimally.
• 18:54
  So that's kinda how it all ties together.
• 18:56
  That was a mouthful, but, does give you some indication there.
• 18:59
  Yeah.
• 18:59
  Oh, it's so perfect.
• 19:00
  It's so perfect.
• 19:01
  I think it's like we've covered so much said, and I think it allows people to really come
• 19:06
  back to one of the points that you started with, which is, like you said, we have a mutual
• 19:10
  feeling of this, of of low libido is it's a it's a symptom.
• 19:14
  Right?
• 19:14
  It's a symptom of an imbalance.
• 19:16
  And Yeah.
• 19:17
  You know, so I hope everybody is really taking this away that, you know, the imbalances could
• 19:21
  be, you know, blood sugar, cardiovascular, as well as gastrointestinal, but also really
• 19:29
  taking this first step because I think a a missing link that a lot of people are not
• 19:32
  talking about yet is this GLP.
• 19:35
  So I really hope that that everybody will go and take your GLP quiz.
• 19:40
  Is there anything else you want everybody as we wrap up here to know about how to get ahold of
• 19:44
  you?
• 19:45
  I don't think so.
• 19:46
  You know, we're over at the Better Nutrition program with the goal of being able to
• 19:49
  complement whatever you're doing with your other practitioners, but to be able to come in,
• 19:54
  sometimes it's just support that you need to figure out how to do the recommendations, you
• 19:57
  know, that they're recommending, or sometimes there's a missing piece that, you know, as we
• 20:01
  were talking about.
• 20:02
  And based on the quiz, we actually give you some targeted next steps.
• 20:07
  And if you ever have any questions, we also really try to just have a human response.
• 20:11
  You can just chat us and see, hey, where do I go from here?
• 20:15
  And I will there was one final piece.
• 20:17
  I do think it's really important that we maintain a differentiation between GLP one, the
• 20:23
  hormone in your body, and the GLP one medications.
• 20:28
  We are hearing there is definitely not enough research in the weight loss space around the
• 20:33
  medications to understand if they are if if there are side effects, to libido and to
• 20:39
  perform it to sexual performance.
• 20:42
  But if you are deciding to go down that path or if you are on one of those medications, and
• 20:48
  you're seeing results, then we know your natural GLP one needs to be optimized.
• 20:53
  So you're still going to benefit from this approach, probably as a way of reducing side
• 20:58
  effects, you know, associated with it.
• 21:01
  And the main thing is talk to your practitioner if you're on one of those medications and have
• 21:06
  a plan from the start of tracking your libido as one of the factors that's included there so
• 21:13
  that you don't you aren't surprised six months later with, my libido's in the toilet kind of
• 21:18
  thing, or it's tremendously accelerated, which may feel like a win, but also could
• 21:22
  metabolically mean other things.
• 21:23
  You know?
• 21:24
  So I do I do think that's an important distinction.
• 21:26
  Yeah.
• 21:26
  I appreciate that as well.
• 21:28
  And also just a reminder to everybody to, you you know, go back and always figure out those
• 21:32
  root causes.
• 21:32
  Right?
• 21:32
  So it's like if you know if you take your quiz, if they go and take your quiz and come up like,
• 21:37
  oh, GLP is low, likely then it's like, well, why?
• 21:40
  And just always as a reminder, just going back to the whys.
• 21:44
  And
• 21:44
  Yeah.
• 21:45
  I wanna thank you so much for being on the lounge with me today, and I wanna remind all of
• 21:51
  our listeners here that at the end of the year, we are inviting the top few people that had the
• 21:57
  highest performing shows back for a longer episode.
• 22:01
  So if you're super excited about this conversation with Ashley like I am, make sure
• 22:05
  you download, you share it to your friend with your friends.
• 22:08
  Don't keep us a secret because that will position her to come back and be able to answer
• 22:13
  more of your questions and spend more time with us.
• 22:15
  So thank you again for listening.
• 22:17
  Remember that you can always find me at my libido doc and take my own quiz libido quiz.
• 22:23
  Please make sure you go take the GPL quiz that's in the show notes from Ashley.
• 22:28
  And this is doctor Diane here reminding you to always stay classy, always stay sexy, and
• 22:34
  always remember to be a little badassy.
• 22:36
  We'll see you next time.
• 22:38
  Thank Thank you for listening to the Libido Lounge.
• 22:40
  Please don't keep me a secret.
• 22:41
  Please share this with your friends.
• 22:43
  You can find me on YouTube, on Instagram, as well as how to work with me at mylibidodoc.com.