Loss of sexual desire is very common in women with premature ovarian insufficiency (POI) and early menopause. Female libido is complicated and there may be lots of things to address from the physical to the psychological! Here are some steps you can take to improve your sex drive:
1) Make sure you are getting enough estrogen
Estrogen is a very important hormone for sexuality so its important to make sure you are getting enough estrogen from your HRT. If you have low libido and are also getting other symptoms of low estrogen such as vaginal dryness, hot flushes and night sweats then you may need a higher dose of estrogen.
2) Treat vaginal dryness
Vaginal dryness is a common symptom of POI and this can cause sex to be painful as the vagina is not well lubricated. Vaginal moisturisers (such as Replens® ) can be helpful and its important to use the right kind of lubricant during sex (such as Yes® or Sylk®). Even if you are on HRT – some women need extra vaginal estrogen to treat vaginal dryness. This comes as pessaries or cream and can be prescribed by your doctor.
3) Consider what type of HRT you are taking
Sometimes when people start the oral contraceptive pill or oral HRT, they notice they are less interested in sex. This is because oral estrogen can lower your natural testosterone levels. If you have noticed this after starting oral estrogen – sometimes changing to patches or gel can help as these routes don’t affect your testosterone levels.
4) Consider testosterone replacement
Testosterone is a really important hormone in women and low testosterone can cause low libido, lack of energy, poor concentration and headaches. Women with POI have lower levels of testosterone than women their age who haven’t got POI. If you have had a surgical menopause you are even more likely to have low testosterone. Testosterone replacement can be prescribed to improve low libido but usually needs to be done by a hospital specialist. We’ll try and cover testosterone replacement in more detail in a future blog.
5) Think about the psychological side
Getting a diagnosis of POI can be really tough and can affect your self-esteem, body image, mood and relationship amongst other things. All these influence sex drive and so its important to consider your mental health as well as the physical side. Many women benefit from psychosexual counselling to help address these issues.
More information on testosterone can be found here.
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