If menopause is causing a reduction in your sex drive, don't despair. Here's an overview of what is happening in your body, and what you can do about it.
Among the many changes your body undergoes during menopause, reduced sexual desire is one of the most common. For some women, the problem becomes large enough that it’s identified as a condition known as hypoactive sexual desire disorder (HSDD).
“As women age and go through menopause, the ovaries lose their ability to produce a variety of hormones, including estrogen,” says Michael L. Krychman, MD, executive director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach. “The effects of lower estrogen levels are that the vaginal walls, clitoris, and vulva lose their pliability and elasticity and are often noted to be dry and easily irritated. Estrogen deficiency commonly causes vaginal dryness, which may result in uncomfortable intercourse and may also affect orgasmic intensity.”
Testosterone is another hormone that plays a critical role in sexual desire, and it, too, tends to drop off due to menopause. “One common misconception is that women do not have testosterone in their bodies, only men do. That is not correct,” says Dennis K. Lin, MD, physician-in-charge of the Psychosexual Medicine Program at Beth Israel Medical Center in New York. “Both men and women produce testosterone in their bodies, but at different levels. And in both men and women, testosterone is an essential hormone. An adequate level of testosterone is associated with a healthy sex drive, and low testosterone is definitely a cause of HSDD.”
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The Role of Hormone Replacement Therapy
The good news about menopause and hypoactive sexual desire disorder is that one of the primary treatments for other menopausal symptoms also helps with the low libido associated with it. And that’s hormone replacement therapy, or HRT.
However, you have to work with your doctor in selecting the right type of hormone replacement therapy for your menopausal symptoms, including HSDD. According to Kent Holtorf, MD, a board-certified endocrinologist and founder of the Holtorf Medical Group in Torrance, Calif., bioidentical hormone replacement therapy (BHRT), which uses hormones that are exact copies of those produced by the body, is proving to be a lot more effective than the synthetic hormones (Premarin, Prempro) that were traditionally used.
“In our medical practice’s experience, treating literally tens of thousands of women for more than a decade with bioidentical hormone replacement therapies (BHRT), HSDD is safely and effectively improved — or eliminated completely — in 90 percent of the cases,” says Genie James, executive director of the Natural Hormone Institute and chief executive officer of Dr. Randolph’s Ageless and Wellness Medical Center in Jacksonville Beach, Fla.
Other Treatment Options for Hypoactive Sexual Desire Disorder in Menopause
Of course, hormone replacement therapy isn’t the only course of action for treating hypoactive sexual desire disorder related to menopause. “Past sexual experience, as well as how a woman views herself as a sexual being, can also influence the sexual experience,” says Dr. Krychman. “A woman is so much more than the sum of her hormones.”
Other treatment strategies include:
- Attack it with antidepressants. “The antidepressant buproprion (Wellbutrin) has shown some efficacy in treating HSDD,” says Dr. Lin.
- Try therapy. “Couples therapy is also effective by teaching couples skills in conflict resolution and [helping to] work through differences in non-sexual areas, which often contribute to sexual problems,” adds Lin.
- Viva Viagra. Though Viagra is usually viewed as a drug for men, it can help women, too, says Dr. Holtorf. “[It] can effectively improve the cascade of arousal in women and can increase libido and sexual satisfaction for about 30 percent of women,” he says.
- It all comes back to diet and excercise. Sometimes the advice is simple, and when it comes to HSDD, good old diet and exercise can help, says James. “Some foods are sexy superstars: Flaxseed and flaxseed oil, dark leafy veggies, oily fish — such as salmon, herring, and mackerel — liver, oysters, and whole grains can work through the digestive system to naturally increase the body’s testosterone levels while eliminating some of its age-related overabundance of estrogen,” she says. “Exercise has been found to naturally boost lagging testosterone levels in women and men.”
- Experiment with Zestra. “Zestra is a topical product that has been clinically proven to improve arousal, desire, and satisfaction for women,” says Krychman. “Zestra consists of a patented blend of natural oils and botanical ingredients. It is applied three to five minutes before sexual activity and works within minutes to help women feel more pleasurable sensations.”
The best route for dealing with menopause and lack of sexual desire is to communicate with your doctor.
Learn more in the Everyday Health Sexual Health Center.