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Female Hormones

Sexual Dysfunction and Libido Enhancement

Our lives have become even busier. Daily responsibilities, managing both a career and family, and along with maintaining a healthy diet can sometimes make it difficult to put a smile on your face, much less to get in the mood for sex. It is more common than you know. Women have problems with libido (sex drive) or lose interest in sex entirely, especially at the onset and into menopause. A lack of intimacy may sometimes be the element that can jeopardize relationships or compromise the happiness you deserve in life.

The unfortunate condition of reduced or lost libido is an unfortunate condition that affects millions of women on a daily basis. Women both young and old can experience a lower sex drive at various stages of life: younger woman may often experience it after the birth of a child in their 20’s and 30’s; perimenopausal woman often experience symptoms during their late 30’s and 40’s; and women both menopausal and postmenopausal can experience some form of libido reduction the rest of their lives.

Loss of libido is a complex phenomenon with physical, psychological, relational, and hormonal elements unique to the women who experience them. The term libido is a general term used to describe a person’s sexual drive and desire for sex. Hypoactive sexual desire disorder is the medical term for loss of libido ie a reduction or lack of interest and desire in sexual activity. Reduction of libido is primarily thought of as a lack of interest or desire for sexual activity. Women with loss of libido may find that they are much less in touch with their sexuality or that sexual feelings come less frequently. Energy for sex drastically lower and sometimes disappears altogether.

WHAT CAUSES SEXUAL DYSFUNTION

Many factors can play a role in a woman’s drop in sex drive:

  • hormonal low levels of estrogen
  • physical such as vaginal dryness, medication side effects, chronic health
  • psychological such as loss of a spouse or partner
  • relational such as conflict, stress, mood swings

Medical conditions can play a large role in decreased sex drive. This tends to augment both psychological and emotional issues. A reduction in sexual desire is most often associated with low levels of testosterone in aging men, and low estrogen levels in women who may also be sensitive to reduced testosterone levels.

WHAT ARE THE SYMPTOMS FOR SEXUAL DYSFUNCTION

The symptoms can be mild or severe and may mimic menopause:

  • Hot flashes
  • Sleep disturbances (insomnia)
  • Emotional changes, such as mood swings or irritability
  • A change in sexual interest or response
  • Problems with concentration and memory that may be linked to sleep loss and/or fluctuating hormones
  • Headaches
  • Rapid, or irregular heartbeat (tachycardia)

These symptoms can progress to:

  • Drying and thinning of the skin, caused by lower collagen production
  • Vaginal and urinary tract changes
  • Vaginal dryness, irritation, and itching An increased risk of vaginal and urinary tract infections (UTIs)
  • Pain during sexual activity

WHAT IS THE TREATMENT FOR SEXUAL DYSFUNCTION

  • There are some medications that function to increase vaginal lubrication and relax vaginal muscles
  • Others contain testosterone to increase sex drive or estrogen to improve sensation, lubrication, and sexual interest
  • Balancing different hormones can also be the solution and if often simple to manage
  • Topical libido enhancers are good alternative to oral medications. This eliminates inconsistent dosing and possible side effects because the are applied locally to increase sensitivity and blood flow
  • Compounding companies can also custom tailor arousal creams that are applied topically and contain a combination prescribed and non-prescription ingredients to increase blood flow, vasodilators, and sexual stimulation.

WHAT IS IN A CUSTOM TAILORED AROUSAL CREAM

Here is an example of a standard cream that can be custom tailored from one of our pharmacies. It contains Aminophylline 30 mg/mL, Ergoloid Mesylate 0.5 mg/mL, L-Arginine 60 mg/mL, Pentoxifylline 50 mg/mL, Sildenafil Citrate 10 mg/mL, Testosterone 1 mg/mL

ESTRADIOL

Is often used to treat vasomotor symptoms such as hot flashes and genitourinary symptoms is topical medication is not or no longer effective.

Oral dosage for adult menopausal and postmenopausal females can vary form 0.5 mg to 2 mg PO once daily. Usual initial dose: 1 or 2 mg PO once daily. Less than 1 mg/day PO may suffice for vaginal/vulvar symptoms only

Administration is typically cycled in a 3 weeks on and 1 week off pattern.In women with an intact uterus, estrogen may be given cyclically or combined with a progestin for at least 10 to 14 days per month to minimize the risk of endometrial hyperplasia. On the other hand, taking estrogens with progestins may have additional health risks for the patient. Risk should be considered for each individual.

TREATMENT OF ISOLATED VAGINAL/URINARY SYMPTOMS

Vaginal dosage: Adult menopausal and postmenopausal females: Insert 1 tablet (10 mcg) vaginally once daily for 2 weeks into the upper third of the vaginal vault using the supplied applicator. After 2 weeks, give a maintenance dose of 1 tablet vaginally twice weekly (e.g., every Tuesday and Friday).

TREATMENT FOR OSTEOPOROSIS PROPHYLAXIS POST MENOPAUSE

Oral dosage:  Dosage range is from 0.5 mg to 2 mg PO once daily.

Only consider for women at significant risk for osteoporosis and for whom non-estrogen medications are not considered to be appropriate. Use the lowest effective dose. Therapy is generally re-evaluate every 3 to 6 months.

WHAT ARE THE RISKS OF ESTRADIOL THERAPY

It has been well documented that continuous, unopposed estrogen (not adding progesterone to therapy) administration is acceptable in women without a uterus.