Not in the Mood: Hormones, Pelvic Surgery
Because my hormones are crazy
Nursing isn't the only thing that can wreak havoc with your hormones. Taking the birth control pill, going through menopause, or having your ovaries removed can disrupt the delicate
balance--sometimes dramatically.
"All birth control pills can increase the hormone called sex hormone-binding globulin," says Goldstein. "SHBG binds to the testosterone in your bloodstream, inactivating it. Birth control
pills reduce acne because they lower testosterone. For the same reason, they lower libido."
Testosterone levels also start declining naturally in women in their late 20s, and are significantly decreased by the time a woman is in her 40s. "It's not a menopausal thing," explains
Goldstein. What is menopausal: The cessation of ovulation and gradual decline of estrogen from the ovaries. The drop-off of testosterone lowers libido while lack of estrogen further
exacerbates the problem by reducing lubrication and thinning vaginal walls, making sex painful.
Having your ovaries removed, a surgery called oophorectomy, sends you into abrupt menopause because the ovaries are your body's most prolific producer of estrogen. Testosterone also
plummets after an oophorectomy. Your options for these hormonal problems:
Switch to another contraceptive
If you want to stay on the Pill, try Yasmin, which, one study found, didn't dampen libido, or look for Pills that contain the progestins levonorgestrel or norgestrel, derived from
testosterone, which may also have less impact on your sex life. Otherwise, the copper-containing intrauterine device or a new IUD called Mirena are just as effective as the Pill and don't
interfere with libido.
Ask about testosterone
Most doctors currently use compounding pharmacies to mix testosterone creams in dosages for women. But a testosterone patch for women, manufactured by Procter & Gamble, is now through
clinical testing and could be on the market as early as next year. In a recent trial of the patch in women who had their ovaries removed, researchers reported that the women experienced a
56 percent increase in sex drive and a 74 percent increase in satisfaction. (Studies of naturally menopausal women are being completed.) "What's interesting is that it didn't just raise sex
drive; it improved orgasm and arousal and all the other things that contribute to a satisfying sexual experience," says Goldstein.
Because I had pelvic surgery
The most common pelvic surgery is hysterectomy, and in some cases it can contribute to an inability to become aroused and to have an orgasm, says Goldstein. "It can lessen blood flow to the
vagina and clitoris. It can actually cut some of the nerves, including autonomic nerves that cause dilation of blood vessels and increase lubrication." What you can do:
Talk to your doc about these products
Because pelvic surgery can reduce blood flow to the genitals, this is one problem for which Viagra and its ilk (which increase blood flow) are appropriate treatments for women. The FDA has
approved a device called the EROS Clitoral Therapy Device, a vacuum pump that provides gentle suction over
the clitoris to increase blood flow and sensation. It needs to be used three or four times a week, and for some women, it may take several weeks of use to notice an improvement in the ability to become
aroused and achieve orgasm.
Goldstein also suggests a botanical product called Zestra®. A very small study reported
in the January 2003 issue of Journal of Sex and
Marital Therapy found that this oil, which contains borage-seed and evening-primrose oils plus angelica and coleus extracts, was more effective than a placebo for enhancing arousal when applied
to the genitals.
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