Sexual Wellness

During the menopausal transition, many women struggle with vaginal dryness, pain with sex, libido, arousal, and orgasm. All of these things can cause us to lose our groove in the bedroom. But, sex is not just for twenty-somethings! Great sex is for women in perimenopause and menopause as well!

Pain with Sex

Decreased estrogen levels in perimenopause and menopause can lead to thinner vulvar and vaginal tissues as well as less lubrication, which can cause vaginal dryness and pain with sex. There are many treatments for this. The most common is topical vaginal estrogen.

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Low Libido

The ovaries make not only estrogen and progesterone, but also testosterone. So, this also decreases during the menopausal transition. There are also many medications and medical conditions that can affect our libido as well as relationship issues. Traditional menopausal hormone therapy does not help with low libido. However, there are safe and effective treatment options!

Bupropion

This is an atypical antidepressant that can be used off-label for low libido. It is especially helpful in women with low libido or difficluty with orgasm due to being on other antidepressants such as SSRIs or SNRIs.

Addyi

This medication is FDA approved for low libido in premenopausal or perimenopausal women with low libido not due to a medical condition or medication. It is taken orally at bedtime. Side effects can include fatigue and low blood pressure.

Vyleesi

This medication is FDA approved for premenopausal or perimenopausal women with low libido not due to a medical condition or medication. It is injected under the skin 45 minutes prior to sexual activity. It can be used up to 8 times per month.

Testosterone

Transdermal testosterone supplementation has been shwon to improve libido in postmenopausal women. There is no FDA approved form of testosterone for women, so compounded medications are often used. The dose is 1/10th of the male dose. Labs should be monitored, and the testosterone level should remain within the normal premenopausal level to avoid side effects. Testosterone pellets should be avoided as they can result in super high levels that are dangerous.