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Women's Health

Sexual Wellness

During the menopausal transition, many women struggle with vaginal dryness, pain with sex, libido, arousal, and orgasm. All of these 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!

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A common, treatable concern

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.

Learn more about Genitourinary Syndrome of Menopause →

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

Bupropion

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

Addyi

Addyi

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

Vyleesi

Vyleesi

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, and can be used up to 8 times per month.

Testosterone

Testosterone

Transdermal testosterone supplementation has been shown to improve libido in postmenopausal women. There is no FDA-approved form for women, so compounded medications are often used at 1/10th of the male dose. Labs should be monitored and levels kept within the normal premenopausal range to avoid side effects. Testosterone pellets should be avoided — they can result in dangerously high levels.

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This information is for educational purposes and is not a substitute for individualized medical advice. Please consult Dr. Stone about your specific situation.