Navigating Menopause

Many women develop physical symptoms that make sex uncomfortable, difficult or even impossible during and after menopause. Two of the most common symptoms are low libido and painful during sexual activity. The good news is that there are many effective treatment options available and our medical practitioners can help you decide which modality is best for you.

Learn more about these symptoms and the treatments that are best suited for what you are experiencing.

Low Libido and Hormone Insufficiency

The physical factors of low libido often include hormone insufficiencies, which are most commonly associated with post-menopausal women. Since hormones are a critical component of normal sexual response, low levels of testosterone-related hormones, estrogen and DHEA-S, can have a significant impact on a woman’s sex drive. Even younger women may have low hormone levels, which can result in a surprising and disappointing lack of desire for sex and intimacy.

Pain and Vaginal Dryness

Post-menopausal women often experience vaginal atrophy which is the thinning of the walls of the vagina caused by decreased estrogen levels. This can cause vaginal dryness and burning as well as pain during intercourse. A woman suffering from vaginal atrophy may experience mild or severe pain in almost any area of the vagina or pelvic region including pain upon penetration, sudden pain after intercourse, deep pain during thrusting, or burning pain anywhere in the pelvis.

How are these symptoms treated?

The most common treatment for menopausal symptoms is hormonal replacement therapy (HRT). HRT medications include estrogen and progesterone. Women who have had a hysterectomy (had their uterus removed) can use estrogen alone, but women who still have a uterus need to take progesterone in addition to estrogen. Progesterone protects the lining of the uterus from estrogen-induced overgrowth which can increase the risk for uterine cancer.

HRT or systemic estrogen can come in a variety of forms: skin patches, gels, creams, vaginal rings and tablets. The dosing can range from small amounts to greater amounts depending on symptoms and what dosages are needed to control them. Our medical practitioners can help you decide which modality is best for you but all the products we use are bioidentical.

Occasionally, menopausal symptoms will suggest the use of testosterone treatment as well. In cases where there seems to be significant problems in sexual functioning, such as lack of desire, problems with arousal or orgasm challenges, our practitioners might suggest the use of testosterone in addition to estrogen, which can be administered through creams, gels, or pellets.

If the primary problem is a painful vagina, our practitioners will recommend local estrogen replacement or treatment with the MonaLisa Touch® laser, which is a hormone-free, non-surgical and painless procedure many women are finding highly effective.

Menopause can be a time of significant changes, physical as well as psychological and emotional. Our Certified Menopause Practitioners can help you weather these changes more easily. Read some of our success stories here.

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