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Issue 005: S-E-X

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I’m an MD, MPH, MSCP (Menopause Society Certified Practitioner). I’m a working mom, a kickass wife, a weight lifter, an avid reader, and a dance mom. Most importantly, I’m in perimenopause, just like many of you.

Hi, I'm dr. meagan

From the desk of Dr. Meagan

During an initial visit, new patients will often laundry list their symptoms, which include all the *usual suspects*:  hot flashes, night sweats, mood swings, and weight gain. However, one thing they always list last is their lack of libido. And it’s usually prefaced by a nonchalant phrase like, “Oh, and by the way, I never want to have sex. Like never.” 

Sex (and I’m being overly general here) is ideally good for you. Mentally and emotionally, consensual intercourse with a loved one has been proven to lower cortisol levels, boost your mood, improve body image, enhance cognitive function, and foster a greater sense of happiness and fulfillment. Physically, it can strengthen your immune system, improve blood circulation, ignite endorphins to alleviate chronic pain, and reduce the risk of incontinence by strengthening the pelvic floor muscles.

I’d be remiss not to recognize the small percentage of perimenopausal women I know that say lack of libido is “Fine by me, I should have been a nun.” But to those of us not chasing a life of celibacy–it sucks.

Which brings me to today’s PERI-ODICAL issue: Testosterone…

Testosterone is the number one way I treat my low libido ladies–and, more often than not, it works. But this *dudes-only* hormone also gets a lot of heat for being what it is and what we think it’s going to do. <<Read: grow chest hair.>>

There is no magic bullet. Everybody is different, so naturally, hormone therapy works differently for everyone. But study after study, and more importantly, patient after patient, testosterone has helped women not only return to the bedroom in the mood and raring to go but feeling more confident, less stressed, and straight-up sexy again. 

And, by the way, that’s something to think about.

Dr Meagan

Testosterone: The Myths and Benefits

Myths

  • Speaking of chest hair: Under the care of your provider and with individualized dosage, unwanted side effects like voice deepening and hair growth–facial or otherwise are avoided. 
  • I’m already pissed all the time: The typical dosage for a woman is 1/10th of the dosage men receive. Becoming aggro shouldn’t be a concern.
  • Beyond the boudoir: It might be because we’re *getting it on* more, but research suggests that testosterone can positively affect other important areas of your life, such as mood, energy, cognitive function, and more.

Benefits

  • Enhanced mood & well-being: Testosterone has shown remarkable efficacy in alleviating mood-related symptoms, reducing anxiety, and improving overall emotional well-being.
  • Improved cognitive function: Some studies suggest that testosterone may enhance cognitive abilities like concentration and memory, alleviating crummy brain fog and helping women feel more focused and sharp.
  • Increased energy & vitality: Many patients experience a significant boost in energy levels and overall vitality, which helps combat the fatigue often associated with perimenopause.

PubMed search for 2024 studies on hypoactive sexual desire disorder (HSDD), aka low libido. In men: 189 results. In women: 2 results​

Turn me Loose: A guide to slip n slide

Having a dry vag is the pits, so if perimenopause has *blessed* you with this symptom, and you’re not keen on vaginal estrogen (my #1 treatment), good news: there are a few non-hormonal things that can help you get back in action and feelin’ good. One of which is lube. Again, not a super sexy topic, but oh-so necessary. I tell all my patients to make lube their new best friend. 

So, to prevent you from sliding down a slippery slope online (hahaha), here’s a short list of a few to try:

Aureum Lubricant by Tabu: water-based with aloe and hyaluronic acid, includes botanicals like peony root and passionflower. Safe to use with latex and polyisoprene condoms.

Infinity Silicone-based Lubricant by pjur: FDA-approved and fragrance-free, this lube is compatible with latex condoms and is here for the long haul (your body doesn’t absorb it, but it is washable with soap and water).

Hydratant D’Amour Lubricant Spray by Glissant: It’s travel-friendly and packaged in a beautiful 1-ounce spray bottle. Water-based and fragrant-free, it doubles as a moisturizer for your lady bits.