Welcome back to “Ask Andi Anything!”— a blog series from The Change Is Personal. Here, you get to ask a pharmacist and Belmar’s Clinical Director of Women’s Health (me!), anything about menopause, perimenopause, women’s health, hormones, and other aging wellness questions.
In this installment, I’m answering readers’ burning questions about vaginal dryness and low libido and how they can affect your sex life.
Q: Dear Andi, This is embarrassing, but I have vaginal dryness and a burning sensation. Sex is really painful!
I tried using over-the-counter lubricants, and they helped a little but didn’t take away the discomfort. Are there any hormone therapies that might help?
Thanks so much,
Callie
A: Restoring vaginal health can help banish dryness and improve lubrication.
Asking about hormones means you’re on the right track, Callie. For many perimenopausal and menopausal women, lower levels of estrogen (and even testosterone) can lead to vaginal atrophy (thinning tissue) and dryness.
Water-based lubricants can help add moisture to reduce friction during sex. But added moisture doesn’t address other things that contribute to the discomfort—like fragility of the vaginal walls and decreased elasticity in the tissues.
Bioidentical hormone replacement therapy (BHRT) can help increase estrogen and testosterone levels. Replacing these hormones supports the body in producing more lubrication and helps the vaginal tissues become stronger and more elastic. This may improve your comfort, so sex is enjoyable again.
BHRT is available in a variety of dosage forms, like oral or sublingual tablets, transdermal creams, troches, and pellet implants. Some women use either a hormonal cream in and around the vaginal opening or vaginal suppositories. These options allow the hormones to come in direct contact with the affected area(s). Talk to your provider about BHRT and which form may be a good option for you.
Q: Hi Andi, I feel like menopause has put a damper on my romantic life. Sex doesn’t feel that great anymore, and I just don’t have the desire—at all.
I haven’t told my husband sex hurts because I’m afraid he’ll feel bad about it, so I’ve just been avoiding it. How can I get back to actually wanting intimacy?
Dana
A: Replenishing hormones can help boost libido to rekindle intimacy.
What you’re describing is a type of sexual dysfunction that often happens when you’re in perimenopause and menopause, and many women have similar experiences with libido. In fact, in a survey of 4100 women with vaginal atrophy (thinning tissue) and painful sex, 55% said they avoided intimacy. And like you, 28% of women with vaginal discomfort didn’t tell their partners because they were embarrassed or thought vaginal issues are just a natural part of growing older.
It’s totally understandable that low desire and painful sex can make you want to curl up in a ball and go to sleep. But sharing the physical struggles you’re going through with your husband gives him a chance to understand why you’re avoiding intimacy.
Men often struggle with sexual symptoms in middle age, too, so he may even be dealing with some andropause symptoms that you don’t know about. Talking about these intimate details can bring you closer as you support each other through the new territory of physical and emotional changes that come with hormonal shifts.
If you want to rekindle intimacy, replenishing your hormones may help. Compounded BHRT using a customized combination of estrogen, testosterone, progesterone, and DHEA may help restore vaginal health to help with lubrication and tissue strength. Other options, such as oxytocin, aka the “love hormone,” may be added to help with orgasm, and PT-141, a peptide, may help perk up your libido.
Questions for Andi?
Email your questions to: askandi@belmarpharmacy.com
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*The information expressed in this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding any condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read on this site.