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REV UP Your Waning Sex Drive

Hot flashes, night sweats, depression – sometimes it feels like there’s nothing in women’s bodies that menopause doesn’t turn haywire. And apart from the well-publicized symptoms, menopause and aging also contribute to a decreased sex drive – impacting women as young as age 40.

As a woman ages, so do her ovaries and the hormone-producing glands housed within them. Most women know that this decrease in estrogen is the chief culprit for menopause. What many DON’T know is that decreasing testosterone is what may have the greatest impact on the loss of interest in sex.

Here’s how your hormones may be working against your sex life.

Low T – Not just a man’s problem: Aging ovaries slow down the manufacture of testosterone, just as they do estrogen, or estradiol, and, like men, women’s testosterone serves as a critical driver to libido. Unlike men, women’s testosterone impacts libido, AND clitoral and “G” spot, or vaginal, orgasms.  

Vaginal dryness: Low estrogen levels reduce natural lubricants in the vagina, which can make sex dry and painful.

Add to this the reality that women are choosing to become mothers later in life, and you’ve got a menopausal woman with low libido, pain with intercourse and a set of 8-year-old twins hanging off her arms. “Women are hardwired to take care of their children’s needs first before those of their spouse,” says Virtua ob/gyn and bioidentical hormone replacement therapy (BHRT) provider, Colleen McCleery, MD. “Add that into the mix, and it will feel like your sex life is doomed.”

But it doesn’t have to be.

How to Keep an Active Sex Life

Dr. McCleery believes that women can maintain a satisfying sex life as long as they pursue a healthy lifestyle that allows them to feel good about their image; communicate with their partner about their bodies’ changes; and maintain a loving relationship.

Dr. McCleery also recommends over-the-counter lubricants to temporarily relieve vaginal dryness. But for a long-term medical solution, she suggests addressing the root problem by replacing lost estradiol and/or testosterone. Here, she gives us a run-down of the delivery options.

  • Creams and gels: “These are good for estrogen delivery when vaginal dryness is an issue but they usually aren’t absorbed systemically enough to help with hot flashes, insomnia or night sweats,” she says.
  • Pills: Available for estrogen replacement therapy, pills got a bad rap in the early 2000s when a Nurses’ Health Study found them to increase risk for breast cancer. Today, Dr. McCleery says the medical field supports their short-term use if the patient is healthy overall.
  • Patches: Again, this delivery mechanism is only available for estrogen, but Dr. McCleery recommends the patch over pills.
  • Injections: Given for testosterone replacement only, many women respond well to injections but controversy continues over whether they’re as beneficial as more traditional estrogen and progesterone therapies.
  • Bioidentical hormone replacement therapy (BHRT): Dr. McCleery believes BHRT to be the future of hormone replacement therapy – so strongly that she has dedicated her practice to it. An individualized amount of bioidentical hormones is delivered through a pellet placed under the skin. These hormones, derived from plant-based compounds identically matching human hormones, are released into the body as the body needs them to achieve a proper hormonal balance. As opposed to other therapies that use equine estrogen or synthetic testosterone, bioidentical refers to estrogen and testosterone that “looks” exactly like that of humans.  “Women feel great on this therapy – and report how terrific it is for their sex lives,” Dr. McCleery says.
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