Orgasm Options

[NiteOwl]

Hey Janet! Glad to hear "things" are back in order on your own! You go, girl!!

[kimberccc]

Thanks for all your suggestions, ladies. You know, I was thinking, before meno I know I had ebbs and flows of sometimes great sex and sometimes average sex but I didn't freak out about it because when you're young you just assume all will be well in the end. I think now I expect the worst and try to fix everything because I just don't have the confidence anymore that I'll be all right. My body has been surprising me in too many distressing ways.

O.K., I'll get back on the hormone hamster wheel and try to up this and decrease that and wait for my miracle. Or at least wait for the earth to move, so to speak.

You're all the best! Thanks so much for listening.

kimber

[Duch]

kimber

My testosterone and DHEA levels were very high naturally, and they're reducing because of meno but no one will prescribe any additional testosterone because my levels are in the normal range when they were in the 3x range before/at meno. (Don't ask me why, I have no idea.)

My doctor has just said, "Well, it's never going to be like it used to, so just get used to it."

I'd show this following report to the doctor:

American Academy of Family Physicians - July, 2000

In peri- and postmenopausal women, the relationship between hormones and sexuality is unclear.18-21 Nonetheless, estrogen replacement therapy has been shown to correlate positively with sexual activity, enjoyment and fantasies--the latter thought to represent desire.23,24 The mechanism of estrogen's effect on desire is indirect and occurs through improvement in urogenital atrophy, vasomotor symptoms and menopausal mood disorders (i.e., depression). This relationship helps predict which patients are likely to respond to estrogen replacement therapy (i.e., those with symptoms of hypoestrogenism) and may explain why some studies do not show estrogen-mediated improvement in sexual functioning.25

The role of progesterone therapy, which is necessary in estrogen-treated patients with an intact uterus, has not been widely studied in terms of sexuality, but one study24 suggests that it exhibits a negative impact by dampening mood and decreasing available androgens. The addition of estrogen for several weeks before progesterone therapy is initiated, or taking into account monthly symptom calendars, will help determine each hormone's influence and guide dosage and schedule adjustments.

Testosterone appears to have a direct role in sexual desire.20 However, because studies evaluate mostly testosterone-deficient, oophorectomized women or women who develop supraphysiologic levels secondary to testosterone treatment, clinical applications are limited. No guidelines for testosterone replacement therapy for women with disorders of desire and no consensus of "normal" or "therapeutic" levels of testosterone therapy exist. Many physicians are concerned about the lack of safety data on the role of testosterone in breast cancer and on hepatic side effects; however, hepatocellular damage or carcinoma is rare at prescribed dosages,26 and the development of breast cancer has not been reported clinically.27

The side effects of testosterone, which occur in 5 to 35 percent of patients, include lower levels of high-density lipoprotein, acne, hirsutism, clitorimegaly and voice deepening.27 However, these side effects on lipoprotein levels are rarely significant if estrogen and testosterone are coadministered; moreover, most other side effects are reversible with discontinuation of testosterone or a dosage adjustment.26

A role for testosterone treatment exists in selected patients (Table 7). Coadministration with estrogen therapy should be provided to prevent deleterious effects on lipoprotein levels. Before initiating testosterone treatment, physicians should discuss the potential and theoretic risks, and individual risk and benefit assessments with the patient. In general, patients with current or previous breast cancer, uncontrolled hyperlipidemia, liver disease, acne or hirsutism should not receive testosterone therapy.

Arousal Disorders
Current treatment of patients with arousal disorders is limited to the use of commercial lubricants, although vitamin E and mineral oils are also options. Arousal disorders may be secondary to inadequate stimulation, especially in older women who require more stimulation to reach a level of arousal that was more easily attained at a younger age. Encouraging adequate foreplay or the use of vibrators to increase stimulation may be helpful. Taking a warm bath before intercourse may also increase arousal. Anxiety may inhibit arousal, and strategies to alleviate anxiety by employing distraction techniques are helpful.

This article is long, and I won't reproduce it here in its entirety, but it does mention that most physicians recommend one stays in the normal range. I would argue with this guy that I wanted what was normal from me, not some statistical average with an arbitrary definition of normalcy. If he doesn't play ball, collect up the notes he's made on you, and trundle off to see another doctor.

[NiteOwl]

You know, I was thinking, before meno I know I had ebbs and flows of sometimes great sex and sometimes average sex but I didn't freak out about it because when you're young you just assume all will be well in the end.

You must be quite in tune with your body! There is a complex interplay of hormones throughout the menstrual cycle and it does cause an ebb & flow to the sexual response. For normal cycle, normal hormone producing women at least... on Days 13 & 14 (during ovulation) estrogen & testosterone reaches its peak. During this time of the month it is easier to achieve orgasm, orgasms are more intense, and libido is at its highest. On Days 15 to 23 progesterone surges & testosterone decreases so libido dips & it is more difficult to climax - higher progesterone tends to block the effects of our estrogen. On Days 24 to 28 progesterone & estrogen start to plummet but this can allow testosterone to 'show through' and become dominant again even though it is still low and this can last right through to Day 5 when our estrogen rises again.

[Eriskay]

Molly, I want to tell you that I think it's great that you stepped forward and wrote what you wrote. With the proliferation of porn and near-porn TV shows and films, it seems like every woman in the world except me is having the most fabulous wonderful multiple orgasms every second for hours, can climax just being looked, screan and toss head back, etc etc etc. >:-) (I think all of this fantasy is ruining the sex lives of everyone who sees it !)

I openly admit that I almost never have an orgasm unless I use a vibrator. I am always happy to find other women who are open about their sexual "flaws" (a.k.a. REALITY).

I agree with the others who say your meds are likely to blame. I took Paxil for 6 months and it killed my ability to orgasm, not just during those 6 months but for 18 months after I stopped taking the stuff ! Never again.

TO all, I started getting hot flashes jan 13 2007 and just as suddenly as they appeared, my ability to be aroused and have an orgasm disappeared. I know I'm stressing about the symptoms. I feel crappy all day long, sleep badly (being awakened by the flashes, chills, and palpitations), I'm worried about my relationship with my boyfriend who THANK GOD lives a few hours away so we are not together every day. I'm praying that my lack of desire is due to this new stress but I'm worried it's more permanent. I've already looked into the saliva tests and I'm going to go ahead and order one this evening. If my testosterone is low, I'm going to try to acquire the lowest dose cream and see what happens. I'm new to the board and very eager to read about others' experiences.

Sandra
I have just had exactly your experience where once i started the hot flushes (5 weeks ago) i found it difficult to orgasm and the ones i have are awful....Is there a link btwn hot flushes and lack of orgasm?? Anyone know?
I have been in peri about 18mths now. Have had anxiety, been very sick, had period all over the place (mostly 4-8 week cycles). But until recently libido fine. I am in shock! Also if my periods are far apart doesn't this mean i have high estrogen levels? Had my levels checked last Dec And testosterone fine, estrogen fine low progesterone. Does it all change one minute to the next? This is driving me MAD>>>>

[Eriskay]

Molly, I want to tell you that I think it's great that you stepped forward and wrote what you wrote. With the proliferation of porn and near-porn TV shows and films, it seems like every woman in the world except me is having the most fabulous wonderful multiple orgasms every second for hours, can climax just being looked, screan and toss head back, etc etc etc. >:-) (I think all of this fantasy is ruining the sex lives of everyone who sees it !)

I openly admit that I almost never have an orgasm unless I use a vibrator. I am always happy to find other women who are open about their sexual "flaws" (a.k.a. REALITY).

I agree with the others who say your meds are likely to blame. I took Paxil for 6 months and it killed my ability to orgasm, not just during those 6 months but for 18 months after I stopped taking the stuff ! Never again.

TO all, I started getting hot flashes jan 13 2007 and just as suddenly as they appeared, my ability to be aroused and have an orgasm disappeared. I know I'm stressing about the symptoms. I feel crappy all day long, sleep badly (being awakened by the flashes, chills, and palpitations), I'm worried about my relationship with my boyfriend who THANK GOD lives a few hours away so we are not together every day. I'm praying that my lack of desire is due to this new stress but I'm worried it's more permanent. I've already looked into the saliva tests and I'm going to go ahead and order one this evening. If my testosterone is low, I'm going to try to acquire the lowest dose cream and see what happens. I'm new to the board and very eager to read about others' experiences.

Sandra
I have just had exactly your experience where once i started the hot flushes (5 weeks ago) i found it difficult to orgasm and the ones i have are awful....Is there a link btwn hot flushes and lack of orgasm?? Anyone know?
I have been in peri about 18mths now. Have had anxiety, been very sick, had period all over the place (mostly 4-8 week cycles). But until recently libido fine. I am in shock! Also if my periods are far apart doesn't this mean i have high estrogen levels? Had my levels checked last Dec And testosterone fine, estrogen fine low progesterone. Does it all change one minute to the next? This is driving me MAD>>>>

[Perimeno]

Testosterone is the major driver for libido - the interest in having sex. But it is estrogen that is responsible for lubrication, clitoral sensation, and the ability to orgasm. If your estrogen is too low, your natural testosterone may become the dominant force causing an increase in interest but leaving you frustrated when you cannot achieve an orgasm. Estrogen can restore the ability to orgasm but too much in relation to the other hormones can cause you to lose your interest (libido) for sex. It is a balancing act but if you have lost your ability to orgasm you may want to supplement your estrogen hormones first, then add testosterone only if your interest in sex is too low.

difficulty reaching orgasm is a very common issue of low estrogen, testosterone may have to do with your drive, but your actual ability to orgasm is affected by estrogen loss.

I went through a time where my orgasms turned to barely there gasms.
arginmax helped me tremendously but it took time.
I don't think it can help though if your orgasm is completely non existant I think you would need a bit of estrogen replacement.

[NiteOwl]

difficulty reaching orgasm is a very common issue of low estrogen, testosterone may have to do with your drive, but your actual ability to orgasm is affected by estrogen loss.

I went through a time where my orgasms turned to barely there gasms.
arginmax helped me tremendously but it took time.
I don't think it can help though if your orgasm is completely non existant I think you would need a bit of estrogen replacement.

Yes, that was the point I was trying to make! Some of messages here sound like women do not understand that loss of libido and loss of ability to orgasm are two separate issues. You can have a problem with one or the other, or both. If you have a low libido you may have a low testosterone level. If you have lost the ability to orgasm your estrogen level may be too low.
Two different problems - two different causes - two different treatments.

[NiteOwl]

Is there a link btwn hot flushes and lack of orgasm?? Anyone know?

Yes, they are both symptoms that can occur with low estrogen levels.

[Duch]

Is there a link btwn hot flushes and lack of orgasm?? Anyone know?

Yes, both are symptoms or results of low levels of testosterone.

Low levels of testosterone are known to cause both flushing, both day and night, both in women and in some men


If your libido and your orgasms have tanked, and if your pubic hair has noticeably thinned, its probably low testosterone.
- If you're suffering dryness and tearing of the tissues, and if Premarin isn't working as well as you'd like, it's likely to be low testosterone.
Low levels of T can be responsible for loss of muscle to (those Keglar exercise help overcome this bit) and loss of bone density.Testosterone is created in the ovaries and in the adrenal glands. When your ovaries shut down, you loose that source. If you have adrenal fatigue...

Its widely known that testosterone is the 'hormone of desire'. Its also the hormone that packs the greater punch for sensitivity in the genital area - and in particular, clitoris.

Low levels of testosterone diminish or extinguish orgasms, raising the level of testosterone may increase the intensity of the orgasm.

I say may increase, because there are so many factors involed in the female orgasm. Nite Owl points out estrogen levels can affect the intensity of orgasm, but testosterone does too. And in addition to the sex steriods:



Another cause of weak orgasms is low levels of oxytocin. This is released at the point of orgasm. Oxytocin is produced not by hormones, but by the neurotransmitter, dopamine.

Lack of dopamine is the root problem of Parkinson's. Turns out, meds for parkinson's which are geared towards increasing the availability of dopamine in the brain causes hypersexuality.

Now we all know anti-depressants are notorious for squashing libido etc. SSRIs, for example raise levels of seratonin, but high levels of seratonin turns off the dopamine cells, which we need to orgasm aaaaand there's evidence that high levels of seratonin reduces the level of testoterone in your body.

- Nursing mothers frequently have troubles in bed, too. It's the prolactin. Once mom is through nursing, prolactin declines. Drugs used to reduce prolactin also cause hyper sexuality.

Just to add to the problem:

Antihistamines switch off the sexual side of us. Antihistamines prevent the histamine cells from working. Guess where some of the histamine cells are located... Yup, in the naughty bits, ie, the cervix and surrounding tissues that causes those contractions after orgasm.

[Juliann]

Thanks Duch!

Thank you for such great information. I suspect that as we age we do lose our "dopamine" levels (along with everything else).

In my first two years of peri, nothing much changed in the area of "orgasms", all was well with me, then last year, suddenly the problems started. Yes it is very shocking how you are fine one minute and EVERYTHING changes the next.

The days of quick easy and powerful are gonzo!

I have been using replacement estrogen and also trying out Testosterone cream. I do think that the T cream is very helpful, using it on the C area before sex does help, but the "O's" still remain like a short fizzle. Has anyone had any huge success with it??? And how???

I think T cream gives me good energy, but have to be very careful, it can also produce acne on my face if I use to much, that is my first sign that I have over done it. I then back off and don't use it for a few days.

Is there anything that gives us more dopamine???

Juliann

[NiteOwl]

Juliann -
I'm sure there are a number of theories out there and like so many things, what works for one doesn't always work the same for another. All I can speak to is what I've read - that orgasm problems often develop when the estradiol level dips below the 60's - and to relate what I have experienced myself.
I started BHRT including testosterone cream of 3mg daily and had plenty of interest but continued to have little to no orgasms after 6 months. A check on serum levels showed my estradiol was still in the mid-30's...a normal menopausal reading for someone that is not using hormone therapy. I stopped the testosterone cream because it hadn't helped & was causing acne, and we changed the estradiol route & dose. Within a couple months my orgasms were back...we checked the estradiol level again and it was well over 100.
That was in December and I've added back a bit of the testosterone again to keep my interest up, but only a dab...maybe 1mg, and no more than 2-3 times a week. Sometimes I'll forget to use it for a week or two and it hasn't diminished the orgasms for me...just the libido.
Duch has given you quite a few leads and I hope you find what works for you. I know how distressing it was to lose this part of life and after 3 years I wasn't sure it was even possible to get back. But if nothing helps, and you haven't had your estradiol level checked lately, you might want to consider asking your dr. just to see where you are with it.

[Duch]

Hi Julian -

you're welcome. Those meds for parkinson's inhibit, that is slow down the process of dopamine reuptake which means the dopamine is more likely to re-attach to the next neuron. the other way is to introduce more dopamine into the brain.

Cheese contains tyrosine, and health store here sell l-tyrosine tablets. Thyrosine is metabolized into L-Dopa, which is a molecule small enough to cross what is called the blood-brain barrier. Once the brain has the l-dopa, it is synthesised into dopamine.

I read somewhere that a high protein diet is particularly good for meno, but I don't recall why.

Hi NightOwl

I hope I didn't give the impression that estrogen has no role in all this. It certainly does, and it s the first line of defence for us. I meant to say that testosterone is important when estrogen doesn't do the trick entirely, because the individual is missing both estrogen and testosterone, and both need to be replaced

I also wanted to point out that there are a myriad of factors involved in reaching nirvana. The more I read on the topic, the more p.o. I become as the medical community does vertually dick for women. I can't tell you how many studies I've read with the phrase "In a study with X number of men..." The truly nutty thing is, this is a situation that happens as we age, and as we age women outnumber men. So why are they ignoring us..

sorry. damn soap box just slid straight under my feet!

[Juliann]

~ NightOwl~ When you said that you switched the estrogen route, what were you on and what did you switch over to??? I am currently using estrogel. I have no idea what my levels are, I should bug my lazy doctor and have her order me a test. Last time I asked her for a hormone panel, she ordered my FSH, that was it!!!! BTW the fsh was 39.1.


~Duch~ I agree that we need more information as women, and it slow going for us to get any answers, I am practically self treating my own symptoms because my doctor doesn't know what to offer me, I have had to educate her! Thanks again for all your insight!


Juliann

[Duch]

Juliann

I'm sort of in the same boat. My doc has been great over the years, but his philosophy on menopause is ADs over hormones. And they only work up to a point. And that point is far short of acceptable.

[NiteOwl]

Juliann -
I started on estradiol (generic Estrace) 2mg daily but either I didn't metabolize it well or I'm a fast metabolizer...I timed the blood draw for when the estradiol dose should be peaking and still came out at 37pg/ml. So I switched to Estrogel 3.0mg daily and had the level rechecked with much improvement...152pg/ml.
I'm guessing I'm a fast metabolizer because whether I used the full dose at once or split it into two doses every 12 hours I could feel it wear off completely after 9 hours or so...like suddenly hitting a brick wall. I'm pretty active & walk miles daily and that does make a difference in how fast you 'chew' through it. I've found one dose every 8 hours works best for me so I'm actually using a total of 2.25mg Estrogel daily now.

[Juliann]

~NightOwl~ Thanks for that info. I am taking my estrogel twice daily, I start with morning dosage of .75 ( 1 pump) and another pump at night. Total is 1.5mg daily. I sometimes add a bit more if I feel like I'm just not feeling well. The worst part for me is when I add the progesterone, then I tend to feel awful, so I don't use the P every month. Maybe I will start using it every 8 hours and see if that helps me sustain a better E level. My last period was in December, so I'm sure that I am hitting complete menopause, so I have been feeling very off lately.

~Duch~ My doc's tried pushing AD's for me a couple years ago and I said NO THANK YOU. For me personally, I don't want to take AD's at all. But for those that are truly in the grips of deep depression, I can understand the need. I find the T cream to be very helpful in many ways. When I first started to use the T cream it felt so awesome, then it kinda leveled off (darn). My libido is so gone right now, but I am having some really bad stress issues and that could be part of my numbness with life. Thanks for your input.

Juliann

[njw753]

For every doctor that says: live with it, it's a part of life. You have an old vagina, forget about sex or orgasm and all the other horrible and untrue things they say, I'd like to string them up by their balls or well, don't know what to hang a woman from and beat the you know what out of them.

We are NOT dead. We are in menopause. We DESERVE to feel good, have hot sex and orgasm frequently.

But I know what it's like having no sex drive, not caring if I had sex, or touching myself during sex, finding orgasms elusive, never wanting to masturbate . For 16 years I had no sex drive. Because not one doctor ever told me that I needed testosterone. 16 YEARS!

That's why I'm so passionate about the bioidentical hormone pellets. They literally gave me back a life full of hot sex, wonderful orgasms, the desire to be more creative and wild in bed, in the pool, in the spa, in the shower, in the living room...you name it! I love to masturbate frequently. I have a big box full of toys that we both play with. I hope I'm this way until I die.

They work so much better than the creams, gels, patches and pills. I get the implanted under the skin of my hip every 3-4 months by my gynecologist. I get estrogen and testosterone.

There are other options for a low or non-existant sex drive. I'm living proof!

I'm 54 years old and had a total hysterectomy 20 years ago. I've had the pellets for 4+ years.

Regards,
Nancy