Most of us women have known or suspected that sexual desire after menopause is a much more complicated affair for us women than sexual desire for men is.

The million dollar question is, What can women do about it?

There is no doubt that changing hormone levels along with fatigue, vaginal dryness, weight gain and hot flashes all combine to make us feel anything but sexual.  Our recent poll on Female Menopause Mentors confers that vaginal dryness is the most troubling problem interfering with sex, followed by lack of desire.

In this post, I am going to tell you what medical providers and researchers are trying to do to help solve this problem. It is important to note that there is no single product or medication that will solve or treat this problem as completely as Viagra and other such drugs have treated erectile dysfunction in men.

The experts of the publication, The Medical Letter, have reviewed the latest drugs and products which have been shown to help (to some degree) sexual function and arousal in women.

What is the Medical Letter? It is a well respected journal providing unbiased reviews on medication and treatment for medical conditions. It analyzes clinical trials and literature and presents information not funded or backed by a pharmaceutical industry or special interest group.

Here is the latest review on medication for sexual function improvement in women:

1. Estrogen: Both systemic and vaginal estrogen has been shown to increase the thickness and elasticity of the vaginal walls as well as help with increased secretions. All of these effects can increase sensation and response. Systemic therapy is very helpful with hot flashes, sleep and energy; but carries the increased risk of blood clots, growth of estrogen dependent cancers of breast and uterus. Vaginal estrogen is not associated with these risks, but does little for hot flashes, fatigue and sleep. Oral estrogen may also increase sex hormone binding globulin which in turn decreases free/unbound testosterone. This may cause decreased libido.
2. Testosterone: The relationship between testosterone and libido in women is not clear to researchers at this point in time. Some women who have used testosterone with estrogen following surgical menopause (hysterectomy with ovaries removed) have shown some increase in desire. Treatment with testosterone patches up to 300 mcg/day in post menopausal women was shown to significantly increase libido regardless of whether they were on estrogen therapy also. This study did not continue past 6 months, therefore the safety and efficacy beyond this point is unknown. Testosterone therapy does come with some adverse effects. This includes increased facial and body hair (hursuitism), acne, hair loss on scalp, possible liver inflammation and lower HDL cholesterol levels. In short, this hormone may help but may have too many adverse side effects to make it feasible to women.
3. Bupropion: Brand name Wellbutrin, this is a medication used for depression. Many depression medications will decrease libido, however this is one that does not. In a few small drug trials, Buproprion has shown some increase in sexual arousal and success in achieving orgasm. It is necessary to take daily to achieve these results, this medication can cause dry mouth, agitation and insomnia, as well as increases chance of seizures.
4. Sildenafil: brand name Viagra, has been studied in women and shown to increase blood flow to the genitals. It does not appear, however, to significantly benefit desire or arousal and has not emerged as a helpful treatment.
5. Experimental/new/unavailable in US: there continues to be research and trials of different medication used for different medical conditions; none have been promising thus far. A urethral suppository use by men (Muse) has been formulated into a cream for women, this caused mixed results and resulted in localized discomfort and burning. Phentolamine has been used as both an oral tablet and vaginal solution, apparently helped with arousal in a small group of women. It is not available in US.  Flibanserin initially showed some promise and was close to release when final results of drug trials revealed very little benefit and worrisome side effects. Bremelanotide was initially developed as a tanning agent, was noted to increase sexual desire in experimental rodents. Because of this, it was developed into a nasal spray to be used 45-60 minutes prior to intercourse. It increased sexual arousal, satisfaction and orgasms! Side effects included nausea, flushing, headache and sleepiness; despite these side effects, it was felt to be a promising agent until further trials and analysis revealed increases in blood pressure. Further trials have been suspended by the manufacturer.
6. Zestra: This is an OTC oil made from plants that increases sensation in the genital area. It is meant to be applied prior to sexual activity, to the external genitalia and clitoral area. In trials, it had good results with increasing sexual arousal and desire. A small portion of women in the study (15%) experienced mild to moderate burning and 5% of women in the study discontinued use of Zestra because of this.

As all of the studies suggest, sexual desire and arousal in women is not a simple problem solved with a single agent. Perhaps you have one aspect of problems with sex that can be solved or helped with a single agent. It is important to analyze what may be your particular issue and discuss it with your partner and your medical provider to come to an effective treatment plan.

One recent study found that placebo therapy was somewhat effective in increasing libido. Why would taking a non-drug increase your sexual desire? Most likely because it signifies to you that you are doing something to solve a problem. You are taking action, you are gaining control of something that is troubling you.

What has been your experience? What are your thoughts about this topic? Let us know if you want me to write more about this subject by leaving a comment in that section below. Do take me up on my offer of a membership gift bu using the form on this page.