Updated: 11/20/22. Midlife women are in their prime. Secure and confident in their sexual needs, they know what they want. But there’s a catch: menopause. The phases of menopause reflect an unpredictable hormone environment, creating new sexual health challenges for your patients. Unexpected shifts in libido and uncomfortable vaginal symptoms can be to blame. Without your help, the domino effect of sexual dysfunction can tumble out of control. Belmar Pharmacy’s new webpage on female sexual dysfunction is designed to help your patients identify problems early and empower women to talk about their sexual health.
Many people hear “sexual dysfunction” and their mind immediately goes to all those commercials for Viagra and other erectile dysfunction medications for men. But for women, sexual dysfunction has different root causes—and different solutions. So how can we make sure we’re treating them right?
When it comes to sexual dysfunction, the main reason men first visit the doctor is because of erectile dysfunction (ED). A low libido generally occurs later on in their lives, when their testosterone levels have dropped significantly. While both conditions can occur at the same time, it’s usually the “plumbing” issue that happens first for men.
To treat either ED or a low libido, our first step is to fix the foundation, which means correcting testosterone deficiencies. After all, ED drugs don’t address any underlying causes and won’t work as well if the foundation is broken. Plus, testosterone deficiencies can also cause other symptoms, including fatigue, lack of muscle endurance, irritability, moodiness, cognition issues, and weight gain.
Once we fix that foundation, we can move into drugs. With ED, the primary treatments are the PDE-I drugs, such as Viagra and Cialis, that address the blood flow issue. If those don’t do the trick, then the penile injectables such as BiMix and TriMix become the next steps. Other medications—PT-141, Peptides, and Oxytocin—can be used as add-ons to enhance sexual satisfaction.
Women, on the other hand, rarely have problems with their “plumbing,” and correcting their testosterone deficiencies is often the first step in treating them for sexual dysfunction. That’s because testosterone in the brain serves as the key to libido and sexual desire for women, which means that testosterone deficiencies can cause a loss of that desire.
However, some women are reluctant to start testosterone replacement therapy because they think they will start growing facial hair and taking on a masculine appearance. But with proper doses, that won’t happen. They may have to pluck a chin hair once a month or so, but that’s not a big deal—especially given all the other problems, including fatigue and weight gain and mood disorders, that low testosterone can cause for women.
To put it in perspective, I always tell my female patients, “If I gave you a million-dollar house but you had to mow the lawn once a month, would you want the million-dollar house?” And, of course, the answer is yes.
Once we’ve fixed the testosterone levels, add-on medications can be a bonus to improve sexual satisfaction for women. For example, PT-141 can increase desire and improve female sexual arousal, while oxytocin hormone supplements can enhance orgasm.
Of course, hormones and medications aren’t going to fix bad relationships or the distractions and stress that can cause a loss of sexual desire in women. But once those have been ruled out or removed, testosterone replacement therapy and additional medications just might be the solution to getting your patient’s libido back on track—and helping her achieve sexual wellness.
