Menopause and Healthy Aging

Understanding the Difference: PeriMenopause vs Menopause?

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.