Can Poor Sleep Sabotage a Person’s Sex Life?

Can Poor Sleep Sabotage a Person’s Sex Life?


What does sleep have to do with sexual performance? A lot!

Before we dive into the connection between them, let’s review the basics about the sex hormones testosterone, estrogen, and progesterone.

  • Testosterone is an anabolic hormone that helps build muscle and is critical for performance. Testosterone not only improves muscle mass, strength, and performance, but it also has important roles in concentration and memory, energy levels, bone strength, red blood cell counts, heart health, blood sugar levels, cholesterol levels, and blood pressure.
  • Estrogen is involved in the production of the feel-good neurotransmitters serotonin, dopamine, and GABA. It also impacts memory, learning, bone density, healthy moods, cholesterol levels, and vaginal lubrication.
  • Progesterone supports the relaxation neurotransmitter GABA. When this hormone is in balance with estrogen, it is calming and promotes healthy sleep.

Testosterone and Sleep

A lack of sleep can interfere with the production of testosterone. One study showed that when healthy young men get 5 hours of sleep every night for a week, their testosterone levels drop by 10-15%. Considering that the average drop in testosterone levels each year is 1-2%, sleep loss can compound the decrease and result in a level of testosterone typically seen in someone 10 years older than you. Therefore, a lack of sleep will age a man by a decade in terms of that important aspect of health. And perhaps even more alarming, research shows that men who sleep 5 hours a night on average have significantly smaller testicles than those who sleep 7 hours or more.

The drop in this vital hormone can impact a man’s sex life, as low testosterone is associated with low libido and erectile dysfunction.

Estrogen, Progesterone, and Sleep

We see equivalent drops in female reproductive health caused by a lack of sleep. It has been well-established that reductions in the sex hormones estrogen and progesterone in women trigger symptoms of menopause. Decades of research also show that women experiencing menopause suffer from sleep fragmentation. I have long speculated that these are linked: aging results in a drop in hormone levels, which causes sleep loss, which in turn decreases hormone levels, which further disrupts sleep, resulting in an aging snowball effect.

In terms of sexual activity, low estrogen is linked to a decrease in sex drive and an increase in vaginal dryness, which can make intercourse painful.

How Bob Overcame Erectile Dysfunction

Bob, a golfer in his 40s, came to see me. He led a healthy lifestyle, trained regularly, and looked younger than his actual age. Why did he need help? He had been dealing with impotence (erectile dysfunction) for a couple of years. He puzzled over what could be causing it and had worked with his primary care doctor and a urologist without success. He didn’t want to simply take medication for erectile dysfunction, so he and his wife even went to couples’ therapy.

Together, Bob and I went through a checklist of some of the common issues that can contribute to erectile dysfunction (ED).

  • Obesity: Being overweight or obese can cause ED because excess fat tissue can convert testosterone to estrogen thereby decreasing testosterone levels.
  • Alcohol: Consuming large quantities of alcohol can decrease sexual desire and make it difficult to get an erection or to climax.
  • Medications and drugs: Several drugs can contribute to ED, including antidepressants, antihistamines, blood pressure medications, painkillers, and recreational drugs.
  • Lack of attraction: No longer being attracted to a partner can dampen sex drive.
  • Poor sleep: As explained above, lack of sleep is linked to low testosterone.

Bob wasn’t overweight, was a light drinker, didn’t take any drugs, and was still in love with—and attracted to—his wife. But Bob did admit that he was one of those people who can get by on just 5 hours of sleep.

When I explained to Bob that there is a link between sub-optimal sleep and testosterone levels, he said his testosterone levels were normal. However, when I reviewed his lab results, I realized they were low-normal, which a decade ago, would have been considered low. Sadly, every decade, testosterone levels in men have been reducing, and what is considered ‘normal’ for one man, may be ‘low’ for another.

Although he was not convinced that sleep was a problem, he agreed to follow my recommendations. I advised him to aim for 8-9 hours of sleep a night and to track his sleep in a journal. I also suggested helpful supplements—including magnesium, vitamin B6, GABA, L-theanine, 5-HTP, and melatonin (found in BrainMD’s Put Me to Sleep)—and asked him to let me know how he was doing in 1-2 months.

When Bob checked in with me about 6 weeks later, he let his wife do the talking for him. She informed me about the “hard facts” of their improved sex life and told me how they were going on dates again. As the saying goes, “happy wife, happy life.”

Bottom line: When a man has issues with erectile dysfunction, one of the first things clinicians need to look into is optimizing the quantity and quality of his sleep. Similarly, when women have a low sex drive, it’s a good idea to inquire about her sleep habits.

About the Author: Shane Creado, MD, Amen Clinics Chicago 

Dr. Shane Creado is a board-certified sleep specialist, who works not only on the treatment of sleep disorders but also on perfecting and optimizing sleep. He is the host of the Overcoming Insomnia course, which teaches the best evidence-based strategies to improve sleep. Dr. Creado is also the author of Peak Sleep Performance: The Cutting-Edge Sleep Science That Will Guarantee A Competitive Advantage, available on Amazon.

This book is primarily geared toward coaches, trainers, and elite athletes, but this step-by-step guide to sleep optimization can also be beneficial for anybody who wants to boost their brain health and productivity. For updates about the book, free sleep tips, as well as special offers, follow @peaksleepperformance on Instagram.

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