Improving Libido In Women
The majority of women who see me in my practice for natural hormone replacement complain of having a low sex drive. They often tell me that sex is painful due to vaginal dryness. They have difficulty achieving orgasm and they could care less if they have sex with their partner or not. This can cause a debilitating strain on relationships. But it doesn’t have to be that way. I have helped hundreds of women regain their sex drive using bio-identical hormones and a few other tricks that only doctors who have been doing this a long time know about.
What is the main hormone imbalance that causes low libido in women?
If your low sex drive is truly hormonal, the number one hormone imbalance I identify in blood work is sub-optimal or deficient testosterone levels. The “normal” reference range for a woman age 40 or greater is 3-41 (for the total) and 0.0 - 4.2 for the free level of testosterone. The normal range is very deceiving because of the way labs determine these reference ranges. They take 1000 women in their 40’s or 50’s and check their testosterone levels. Some women will have levels of 0.0 and others will have levels of 4.2 (for the free, which is the most important). However, if you were to check 1000 girls aged 16-20 you would find the average range somewhere between 80-120 for the total, and 4-8 for the free. Therefore, the majority of women in their 40’s would have deficient levels of testosterone if compared to when they were 18, which is when they report looking and feeling their best. A secondary hormone that I found can improve libido is called DHEA, and optimal levels are in the 200-300 range.
Other than testosterone, what else do you do to improve libido in women?
It is pretty clear from the medical literature that balancing estradiol, progesterone, and DHEA levels is important in maintaining the health of the vagina and uterus. Sex is simply not going to be enjoyable without enough moisture. When we balance estradiol and progesterone, the vasculature to the vaginal walls improves. This improves the bacterial flora of the vaginal canal, which in turn improves vaginal dryness. Many times we also prescribe vaginal suppositories or something called the ESTRING to improve vaginal dryness.
Additionally, we have a few magic bullets to enhance orgasm and clitoral sensitivity in women. I routinely prescribe something people refer to as, “Scream Cream” to women. This is a topical cream consisting of arginine and Tadalafil (Cialis) which enhances sensitivity of the labia and clitoris during sex. The feedback that I get from women is that this cream “is amazing”, and “is called scream cream for a reason.” The other thing that works relatively well (more hit or miss) is oxytocin nasal spray for enhancing orgasm intensity. Oxytocin is a hormone produced in the brain in women, but when used in smaller doses intra-nasally (spray), it will increase the intensity of orgasm. I have found that this works well about 50% of the time.
What else is important to libido in women?
I have treated thousands of women with low libido and the one thing that natural hormone replacement can not overcome is a genuine dislike for your spouse, or not having any attraction toward them. I will often say to women, “If your husband treats you terribly and you are not attracted to him sexually, testosterone is not going to all of sudden make you want to have sex with him.” There still has to be some courtship, emotional connection, and attraction for all of this to work. In addition, women who have had trauma, such as a rape, molestation or abusive past relationships tend to have libido issues until those traumas are dealt with. I have a very specific treatment protocol for these women that I have found works incredibly well. But in my experience, if you love your spouse, are attracted to them and they still treat you fairly well, then this should work great.
Low libido is a very common complaint in women experiencing perimenopause and menopause, and is often mistreated by doctors. By correcting hormone imbalances using testosterone, estradiol and progesterone with natural hormone replacement, we often see incredible results. It is important that you find the right doctor who understands the importance of hormone optimization.
If you would like more information and make an appointment to get your hormone levels checked, please call my office at 877-721-0047.