BioHRT Medical News

Women are often embarrassed and feel awkward when discussing their sex drive, quality of orgasm, and satisfaction with their sex life. However, it is important to talk about what’s happening to your body, your vitality and your interest in sex itself.

In truth, a woman’s sexuality has to change in perimenopause and menopause. Instead of giving up, or trying to hold on to how things were in the past, we encourage you to welcome this change in your sexuality. You really can find your way to a sexuality that suits you now — hopefully better than ever. With no fear of pregnancy, and the kids out of the house, that’s a real possibility.

As we explore the changes in your sexuality at this time in your life, keep in mind that your sex drive reflects and helps sustain your overall well-being. It’s perfectly natural for a woman to be sexually active throughout her life. And there’s a great deal of evidence that it’s good for your health.

If sexual desire is natural, why does it go away?

Hormonal imbalance is the simplest cause of low libido. Estrogen, progesterone and testosterone are key players in the maintenance of circulation, nerve transmission and cell division, so an imbalance of these hormones can easily lead to changes in sexual response. When progesterone levels decline, the result is too much estrogen in the body, relative to progesterone, and the onset of symptoms associated with "estrogen dominance" arise, such as decreased sex drive. Declining estrogen levels common to the menopausal years can dampen nerve impulses during sex, making women less sensitive to vibration and touch. And since estrogens increase blood flow to sexually sensitive areas, decreased levels can slow or diminish the arousal response.

Testosterone is one key player in a woman’s sex drive: it affects interest, arousal, sexual response, lubrication and orgasm. Many women in perimenopause don’t have enough testosterone.

Testosterone comes primarily from the ovaries, both directly and indirectly via their production of progesterone, which serves as a building block for many hormones, testosterone among them. DHEA, a hormone from the adrenal glands, also partly converts into testosterone, and stress diverts DHEA into cortisol instead of testosterone.

Imbalances of estrogen and testosterone can cause dryness and thinning of vaginal tissue, making intercourse uncomfortable or downright painful—an effect that does absolutely nothing for libido. The key to a normal sex drive is the right balance of estrogen to progesterone. An excess blocks thyroid function which inhibits libido. A balance stabilizes mood and supports thyroid function, which enhances libido. Progesterone is also a precursor to estrogen and testosterone, so we need it in steady supply for optimal sexual pleasure.

Testosterone and DHEA also have a major impact on sex drive. Levels gradually decline in the years leading to menopause and can drop dramatically with hysterectomy, chemotherapy, surgery and radiation.

After a total hysterectomy (i.e. both uterus and ovaries were removed), women may have very low or nearly undetectable levels of testosterone. Even women who keep their ovaries may suffer this, as the surgery compromises ovarian circulation in over half the cases. Since nearly one in four women enter menopause as a result of surgery or medical treatment that causes their ovaries to lose normal function, this creates sexual issues for millions of women.

The following are also common causes for loss of libido in women:

Stress.  Stress is an enormous factor. The body naturally puts survival ahead of pleasure. Your over-burdened adrenal glands can rob your body of the building blocks it uses to make estrogen and testosterone, which are vital to desire and sexual response. Oftentimes the major sources of stress in our lives seem beyond our control. If you feel that’s true for you, we encourage you to explore several questions. How might you reduce the stress at its source? Can you cope with it another way, or shield yourself from it? Can you compensate for it by nurturing yourself? Changes in your routines, a new form of creative self-expression, help from your partner, working on unresolved problems, or just devoting time to yourself are all well worth the effort, as the positive effects can be profound.

Poor Diet. Hormonal imbalance can be caused by nutritional deficiencies and dieting. Make sure to eat a balanced diet. Stay away from low fat diets. Your body needs lipids to make hormones, including testosterone, which is important for sexual response. Remember, your body can make adequate estrogen from secondary production sites despite the decline in production by your ovaries, provided it's given adequate support. A healthy metabolism supported by good nutrition is key to maintaining good levels of testosterone throughout perimenopause and menopause.

Interpersonal Relationship Issues. Partner performance problems, lack of emotional satisfaction with the relationship, the birth of a child, and becoming a caregiver for a loved one can decrease sexual desire.

Sociocultural Influences. Job stress, peer pressure, and media images of sexuality can negatively influence sexual desire.

Medical problems. Mental illnesses such as depression, or medical conditions, such as endometriosis, fibroids, and thyroid disorders, impact a woman's sexual drive both mentally and physically.

Medications. Certain antidepressants (including the new generation of SSRIs), blood pressure lowering drugs, and oral contraceptives can lower sexual drive in many ways, such as decreasing available testosterone levels or affecting blood flow.

Age. Blood levels of androgens fall continuously in women as they age.


The drop in estrogen during perimenopause can create dryness, and thinning in the vaginal and urethral tissues, resulting in the production of less moisture and painful intercourse. These changes can lead to such discomfort that some women come to dread sex, because of the pain. In addition to Bio Identical Hormone Replacement Therapy, we recommend:

  • Try using vaginal lubricant during intercourse.
  • Avoid antihistamines, as they dry out mucus membranes.
  • Vitamin E suppositories. Vitamin E vaginal suppositories used twice weekly can help enormously.
  • Water-based lubricants. There are a number of water-based lubricants to reduce friction during intercourse that are highly effective.
  • Increase use of phytoestrogens, such as soy.
  • Drink plenty of Water. Hydration is an easy remedy that is often overlooked. The best way to moisten any of the mucus membranes in the body is from within, so drinking plenty of water daily needs to be a long-term regimen.

Most women, once their hormones have been balanced, experience a return of sexual desire. BioHRT is designed to help achieve this. Natural progesterone cream is especially helpful because it's a precursor to testosterone, cortisol, and estrogen. The body can use it as a building block, to convert it into the derivative hormones it needs, when needed. The conversion may be relatively quick or it may take a month or more, but the resulting hormone balance will be long lasting.

If you have a loss of interest in sex, saliva testing to measure levels of estradiol, progesterone, testosterone and DHEA-s can establish probable cause and a rationale for correcting the imbalance.

In addition to BioHRT therapy, you may find Kegel Exercises to be beneficial.

What is a Kegel Exercise?

A kegel is the name of a pelvic floor exercise, named after Dr. Kegel who discovered the exercise. These muscles are attached to the pelvic bone and act like a hammock, holding in your pelvic organs.

How do I do the Kegel Exercise?

Over one-third of women start out squeezing the wrong muscles. Therefore, it is helpful to work with a doctor or nurse who can teach you the correct technique. You can also check yourself by placing a finger in your vagina and squeezing around it. When you feel pressure around your finger, you are using the correct muscle. Try to keep everything relaxed except the muscles right around the vagina. At the same time, do not bear down or squeeze your thigh, back or abdominal muscles. Breathe slowly and deeply. At first you can do the exercises with your knees together (lying or sitting).

We recommend using the following regimen:

  • Tighten a little – count five
  • Tighten a little more – count five
  • Tighten AS HARD AS POSSIBLE -    count five
  • Relax in reverse steps, counting five at each step

 How Often Should I do a Kegel Exercise?

Be sure you are doing them correctly before you start. We recommend doing the exercises for five minutes twice a day. With practice it will become easier as the muscles get stronger.

Is there anything I should change once the Kegel Exercise becomes easy?

Once the exercises become easy, you can further strengthen the muscles by squeezing to a count of eight and relaxing to a count of eight. Repeat this for five minutes two times a day. It will also work the muscle more to do the exercises with your knees apart.

How long do I have to do the Kegel Exercise?

Once you have attained your goal, you can do the exercises for five minutes three times a week.

Helpful Hints

Listen to music when you do the Kegel Exercises- this can make it more fun! Keep a log and give yourself a check mark or star each time you do the exercises. This will help you keep track of when you started and keep you motivated. If you stop doing the Kegel Exercises, start again! Just remember it takes regular practice to see results.

View BioHRT's Low Libido Treatment Programs

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