Estrogen and sex

It feels good to see progress.

I opened my email yesterday and saw that the North American Menopause Society (NAMS) had issued a new position statement on hormone use for women with hypogonadism (menopause).

Normally, I find NAMS to be inaccurate, misleading, and insensitive to women struggling to find effective treatment for hypogonadism (menopause), so when I saw something that was actually scientifically accurate about menopause I was very pleased.

According to NAMS

Sexual Function Local ET is excellent for dyspareunia (painful intercourse). There is little evidence that ET or EPT will aid sexual desire disorder, so the latter is not an indication for ET/EPT. What is sexual desire disorder? Hypoactive sexual desire disorder - (Sexual Anhedonia) The ongoing lack of sexual fantasies or thoughts. A woman suffering with hypoactive sexual desire disorder does not have a desire for sex and is not interested in the sexual advances of her partner. This may also be called loss of libido.

Translation, taking estrogen therapy alone (ET) or estrogen and progesterone therapy (EPT) will not restore sexual function after ovarian failure (menopause).

Why is this important to know? It is important for many reasons. Now you and your doctor both know that estrogen and progesterone alone will not restore sexual function. What can you and your doctor do with this information? Add testosterone. For women with ovarian function (pre-menopausal) 1-2 mg of compounded testosterone cream nightly and for women without ovarian function (post-menopausal) 2-6 mg compounded testosterone cream nightly.

It makes perfect sense. Would we think a man could have satisfactory sexual function if all he had was normal levels of estradiol and progesterone and very low levels of testosterone? Of course not. So why would we think a woman would be any different. A human being needs appropriate levels of all of their hormones to function sexually.

Why else is this information important?

Maybe now the cruelty will end in menopause trials. Now when women are recruited for menopause trials they will know up front that a hormone preparation that does not contain testosterone will not restore sexual function.

Keep in mind that the ovaries produce many more hormones than just estradiol. They also produce progesterone and testosterone and dhea. So while adding testosterone is a giant step in the right direction, you still may not feel as you did when you still had ovarian function (pre-menopausal). My non-profit foundation is working to develop the information needed to fully replace ovarian function in healthy ways.

You can learn more about replacement options on my website http://www.diamondrf.org/education/recommendedlevels.php