By Leigh Lewis, ND, L.Ac.
Many women experience changes to their libido and sexual function due to changes in hormones that occur throughout life. Post-partum and perimenopause are frequent times when hormones plummet and this can causes lower desire and changes to the vaginal tissue that can cause discomfort with intercourse. Other hormonal, like thyroid, or nutritional, like iron, deficiencies can contribute to this issue as well and should be screened for.
Medications can be a cause of sexual function issues, notably birth control and antidepressants, and there may be alternatives that have less impact. Alcohol and marijuana use can have negative impacts as well. Finally, it is important to consider relationship factors that may be playing a role; a couple of sessions with a qualified therapist can greatly help investigate & address this area. If discomfort is deep in the pelvic area, a specialized physical therapist may be able to assist you.
There are several ways you can address these issues on your own before consulting a physician:
For vaginal dryness or pain with intercourse: RepHresh or Replens, both available OTC at many pharmacies. These products are not lubricants, but actually restore vaginal tissue health without hormones. Try for twice a week for one month and see if the improvements decrease your symptoms.
For low libido: Maca (Femenessence) is a Peruvian herb that has been used traditionally to improve libido. Try 1000mg per day for a month to see if you notice an effect.
If these do not help, consider making an appointment here at ilumina to discuss pharmaceutical options. After ruling out any contributing factors, we can discuss possible hormonal therapies like bio-identical estrogen, testosterone or DHEA. These hormones have all been shown to be helpful for improving libido, orgasm and/or decreasing vaginal discomfort by improving tissue integrity. There are topical and oral forms available and some options are covered by insurance. If vaginal tissue atrophy is the main concern, I have been very successful using both hormonal & non-hormonal compounded combinations. Finally, a brief word about safety: most low dose topical hormone formulations used to treat local vaginal issues are not absorbed systemically and therefore are not considered to carry the same risks as menopausal hormone replacement therapy, even for breast cancer survivors.
Another pharmaceutical option is Addyi (flibanserin), a daily medication that has been shown to improve sexual desire. The side effects are generally minimal and it should not be taken with alcohol, but it may be good options for those women for whom none of the above has been helpful.
Most importantly, seek help:
though this is a sensitive topic, we are here to help you with all facets of your health and that includes sexual health & wellbeing.