Menopause and Healthy Aging

Available Therapies for Menopause-related Sexual Health Concerns
Update: The 2022 Hormone Therapy Position Statement of The North American Menopause Society, a Position Statement for women trying to make decisions about using hormone therapy for healthy aging.
Problem Possible therapies or actions to consider
Low libido / low sexual desire
  • First and foremost, examine your relationship and situation: What are the turnoffs? How can they be addressed?
  • Identify medications that may curb desire (such as certain antidepressants or blood pressure drugs) and talk with your provider about lowering the dose or switching to alternatives
  • Sex therapy/counseling
  • Certain testosterone-containing products (not government-approved for treating low desire in women)
  • Bupropion (not government-approved for treating low desire)
  • Yoga
Vaginal dryness / atrophy
  • Regular sexual activity or stimulation (promotes vaginal health and blood flow)
  • Vaginal lubricants (for temporary relief of dryness before and during sex)
  • Vaginal moisturizers (for longer-term relief from dryness)
  • Low-dose vaginal estrogen therapy in cream, ring, or vaginal tablet form (reverses underlying atrophy and dryness)
  • Higher-dose hormone therapy throughout the body via pills, patches, and other preparations (reverses underlying atrophy and dryness, but generally reserved for women with bothersome hot flashes)
Arousal difficulties
  • Topical treatments for vaginal dryness/atrophy (see above)
  • Vibrator or other mechanical devices (eg, clitoral therapy device)
  • Sex therapy/counseling
  • Bupropion (not government-approved for treating arousal difficulties)
  • Viagra-like drugs (PDE-5 inhibitors) to increase blood flow to the clitoris (not government-approved for treating female arousal difficulties)
  • Yoga
Orgasm difficulties
  • Sex therapy/counseling
  • Yoga
Pain during sex A variety of therapies are available depending on the source of the pain:

  • Vaginal moisturizers, lubricants. If pain doesn’t improve, see your provider.
  • Vaginal estrogen
  • Sex therapy/counseling
  • Vaginal dilators
  • Pelvic floor physical therapy
  • Kegel exercises
  • Symptom-specific medications (eg, steroid creams for vaginal inflammation, antibiotic creams or pills for vaginal infections)
  • Yoga

Dr. Serena McKenzie

Dr. Serena McKenzie, ND, IF, NCMP has been working in healthcare since 1995. She is an evidence-based, holistic primary care physician and an expert in sexual medicine, menopause and pelvic floor dysfunction.

NAMS Menopause Practitioner

Request More Info

Phone: (425) 398-9355
Fax: (833) 905-2316


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