Our sex life has suffered

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1 comment

  • rdunsmoorsu

    First of all, thank you for posting this. So many women ask me this everyday, but are afraid to say it out loud. 

    Sex life and libido are difficult topics to "fix" as they are very complex in women. A woman's libido is generally ( not always, there are exceptions) "responsive" or reacting to intimacy and a feeling of closeness. Men more often generate closeness with sex. SO we are always coming at it from different angles. When you were cycling there was sometimes a peak of hormone that might drive down your inhibition, but now in menopause that is gone. HRT is helpful for some women here, but not all.

    When dealing with this in my clinic I review the state of the relationship (relationship stress will raise inhibition), the state of a woman's life ( menopause can be a high stress time), The state of how she feels about her body (a lot of women stop feeling "sexy"), and then we approach the problem with an eye to solutions. The most common recommendation I give is to start with a book, "A tired woman's guide to passionate sex" written by Dr Laurie Mintz. You can reclaim passion, but it just might take reframing it and making some concrete changes. You can also listen to Dr Mintz's recommendations on our podcast and webinars, she is often a guest with us, and is a great speaker.

    Last thing, please don't fall down the rabbit hole of testosterone. While there is limited data for testosterone helping libido in premenopausal women, the effect is brief. Providers then tend to start escalating the dose to reclaim that feeling. BUT, and this is a big one, this is an anabolic steroid, a controlled substance and comes with some big risks. As a provider I worry about the cardiovascular harm it causes women, including MI, vascular disease, strokes and even heart failure. From a symptom perspective it can give you acne, a beard, male pattern baldness, a drop in your voice and even make the clitoris grow into a small phallus (and many of these effects are permanent). The risks far outweigh the benefits for this medication.

    I hope this helps. This is a big topic and we've addressed it a few times on our podcasts and webinars, so certainly go seek out those great conversations.

    Dr. Rebecca

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