One way that stress can impact your sexual health is by decreasing libido, or desire for sex. The physiology of libido and sex drive is complex, especially for women.
In times of stress, your body releases the hormone cortisol. When men and women are exposed to a chronic stress environment, cortisol levels will also rise. This elevation in cortisol can result in decreases in testosterone in both men and women, which can negatively impact libido.
HPA axis dysfunction can also impact estrogen and progesterone secretion in women, along with thyroid hormone production—another hormone associated with sex drive. Additionally, men under stress may secrete prolactin, which is associated with erectile dysfunction.
An interesting study examined the relationship between diurnal cortisol and sexual function in men post-prostate cancer treatment. The study found that better sexual functioning was strongly associated with a healthy cortisol awakening response. Additionally, a steeper-dropping slope in the diurnal pattern of salivary cortisol was associated with a higher frequency of sexual bother, a research term describing one’s self-defined difficulty with sexual function .