Q: I’m in menopause and sex is no longer pleasurable for me. In fact, it’s downright painful, and my lack of interest is starting to affect my marriage. I’ve seen a lot of ads about a new drug. Could it help?
Painful intercourse and low libido are major issues for women in menopause, and sometimes even pre-menopausal women experience these symptoms. Declining levels of estrogen and testosterone (yes, women have it, too) are the problem. From a sexual aspect, testosterone fires our desire. When levels dramatically decline, so does our sex drive. Estrogen helps keep tissues moist and plump. Low estrogen levels cause our skin and mucous membranes to become drier and thinner, which can make intercourse painful. Hormone replacement therapy, or HRT, can help relieve these symptoms and restore desire. However, not all hormone replacement options are the same.
Currently there are lots of ads for drugs like Osphena and Premarin. While Osphena claims to be a non-estrogen option, it’s actually a synthetic designer estrogen (class of drug called selective estrogen receptor modulators “SERM”) that acts on tissues that respond to estrogen, and I believe the side effects and risks far exceed the benefits. First, it’s taken orally and processed through the liver, so it raises risk for blood clots and stroke. Second, if you have a uterus it can potentially cause hyperplasia, or build up of the uterine lining, raising the risk for uterine cancer. Premarin Vaginal Cream is a better option because it’s not taken orally. However, it’s also a synthetic designer estrogen made from “natural sources” (pregnant mares’ urine). There are much better options available, which is why I only use and recommend bio-identical HRT for my patients. Bio-identical hormones are safer, more effective and have fewer side effects and health risks. Unlike pharmaceuticals, they are biologically identical to the hormones your body is lacking, so your body metabolizes them in the same way it would your own hormones. There are many delivery methods including creams, gels, and pellets, which I consider the gold standard for hormone replacement therapy. Good luck!
Are you experiencing painful intercourse or other symptoms of menopause? We can help. Call 480.619.4097 today.