Does anyone know the actual facts about the role of estrogen in libido apart for obviously being required for vaginal health?
I have been doing lots of googling to try to find out but there is so much contradictory stuff out there!
Some of it says that estrogen binds up testosterone and reduces libido, which is why some ladies on HRT find they need additional testosterone. It is suggested that some ladies have an actual increase in libido after the menopause because their estrogen levels drop down but testosterone levels remain constant. Then there is other stuff which says that in order for testosterone to be effective, estrogen has to be present. I am so confused and trying to work my way through my own libido problems. I do not use HRT as I had endo cancer but have used testosterone in small amounts to bring sexual sensations back. It has done but I have noticed that my really feminine loving feelings have gone and that although I can have strong orgasms I do not feel womanly in the same way that I did. Is this just a natural consequence of aging or is it because I have very little estrogen in my system? I do have little estriol cream for dryness but it seems to affect me systemically and makes me feel awful.

janet c

Hi again Janet,

I'd be interested to know the answer to this one too. Louann Brizendine in her book 'The Female Brain' when discussing menopause says that estrogen is one of the hormones responsible for nurturing behaviour in women, that aspect of 'being female'. She gives case studies of women whose attitudes changed dramatically at menopause, usually towards their husbands. I can't remember exactly how she expresses it, but she says something to the effect that libido and sexual response depend on a subtle cocktail of the sex hormones.

Furthermore, I think that the different kinds of estrogen might not all be equally effective as regards sexual response. For example I think the strong estrogen, estradiol, might be more instrumental. I have no specialist knowledge here, I'm just trying to recall (imperfectly) things that I've read!

From my experience, when I was on HRT which contained estradiol, my sex drive and certainly my sexual responsiveness were much stronger than they are now that I've been without systemic estrogen supplementation for 2 years. This was despite the fact that I wasn't supplementing with testosterone, so if estrogen binds testosterone, there was very little evidence of that in my own experience. My sex drive and sexual responsiveness were almost the same on HRT as they had been pre-menopause when my periods were regular.

Finally, I noticed an indirect effect of estrogen on sexual feeling and desire. When I started using the estriol cream vaginally, whilst it didn't boost my libido directly or increase the power of my orgasms, the fact that it 'plumped' up the tissues in that area seemed to send signals to the brain which translated into a sexual feeling.

Hi there again
Thanks for your reply. Yes I think you are right about the nuturing feeling going at menopause. As I had my ovaries removed and was previously oestrogen dominant, I found it a huge change and I miss those feelings immensely! I felt quite sad after using testosterone that although I could achieve physical satisfaction, all those powerful "in love" feelings never returned. I suppose that's the end of them now. I have been through quite a few issues about my husband which came more to the fore since meno hit! I suppose, because a huge part of our relationship was always about physical attraction and that waned, it made me think more about other aspects of our relationship which were far from perfect!
All I know now is that i don't want to lose that part of us completely and become like" Darby and Joan", if you know what I mean? I don't know how to live in this marriage without a sexual relationship and I can't give in yet.
Maybe if I was to give the estriol more of a try it might help. I certainly feel more sensation when I do use it.
By the way I tried the progesterone cream and I lasted a week! It made me feel absolutely dreadful !!
janet c

I would think that estrogen's effects on libido are indirect ... like you feel better overall, your mood is brighter, your sex organs are working better, and that can contribute to feeling sexier and craving more physical intimacy. But I do believe testosterone is the true libido-booster.

Hi again Janet

I can identify with not wanting to let go of sexual intimacy. Also with how different things feel with low estrogen compared to previously!

Louann Brizendine's book also says that another hormone, Oxytocin, is instrumental in forming emotional bonds. This is unaffected by menopause so far as I know. Oxytocin is produced by orgasm and also by touching and hugging if I recall. If I remember correctly she cites the example of women who are required to assume the care of grandchildren whose nurturing feelings increase again due to the high degree of physical contact young children require. I hope I'm not misquoting her!

I'm sorry to hear the progesterone cream made you feel so bad. As mentioned, it had some odd effects on me when I first started so the doc advised me to reduce the dose to a pea sized amount and gradually increase it, commenting that I must be sensitive to hormones. She also advised me to stop it for three or four days and then restart in the very early days as when I started using it, one of the effects was to make me feel like I was in early pregnancy! It was quite a while, several months, before all the menopausal symptoms ironed out in my case, although some women seem to feel benefits more immediately. I don't know if the strength of the cream makes a difference as different creams are different strengths. However I know you're very sensitive to hormones because of your reaction to the estriol cream, so things are different for you.

I actually tried the estriol cream again yesterday but then today all I have done is weep as usual .There was no way I could carry on with the progesterone cream! I WAS only using a tiny amount but I got terrible bloating, stomach ache, huge hot flushes and worst of all dreadful dizzy spells. I did not dare tell my acupuncturist what I had been doing but she could tell something was not right. She said I was in a high state of agitation and wht on earth was causing it. For some reason I couldn't bring myself to tell her the truth. After that I carried on with the St Johns Wort and felt generally better but now I have absolutely no libido whatsoever so I don't know what is going on. Stopped SJW at the weekend but cant form a sexual thought in my head.I hope its only temporary!
I have a hospital check up next Wednesday. I wonder if its worth me asking for a different cream? I think all the others are stronger though!
janet c

Oh, you're using estriol ? Not estradiol ? Maybe you should be using estradiol ? Or are you not a candidate for it ?

Well estriol is supposed to be the gentlest one and the safest -as I had cancer. However I dont think there would be a problem with the doc prescribing estradiol now as I am almost 3 years on. I just think that if estriol makes me tearful and depressed after one small application then what would estradiol do? Is that the one in Vagifem? I was using that when I was diagnosed with endo cancer-the surgeon has since told me that it may well have been that-that caused my cancer. I remember having bad palpitations and other side effects although it did stop the hot flushes. Bear in mind that I was already estrogen dominant so maybe that is why it affected me so badly.Can estradiol be supplied as a cream? I would not be allowed Vagifem because that would mean inserting hormone right into the vagina-too risky.
I am so tired of fighting to get my body and emotions sorted out. I did message Pete a few times and he advised me to try Biest-which is nearly all estriol so I can't see the point of that. Any advice is appreciated.
janet c

I think estradiol is available in a cream, and I believe I read that it's even better at being absorbed through the skin than progesterone is. You would probably have to use progesterone with it. Maybe Biest would be better, maybe the little bit of estradiol would knock out your unpleasant symptoms, or at least tone them down ?

Have you used Biest or estradiol anyway? I live in the UK and I don't think Biest is available here.

Hi Janet C, I relate to your experience with estriol and progesterone as the same thing happens to me. I also tried biest and it made me weepy, anxious and nervous and I also started with the internal trembling when I was on it.

Have you tried Macca root powder? It is supposed to help with libido and lubrication. I did try it for a very brief time and it gave me feel brighter and gave me more energy and get up and go, but I found it also made me a bit jittery which I didn't want because of the internal trembling. This could also be dose related.
It may be worth a try in your case.

Rehma

Hi Rhema
I have just been reading some of your old posts and you do sound like another sensitive soul where taking hormones is concerned! I do not tolerate anything very well either including herbal stuff so I dont fancy that Macca !
I completely messed myself up with all the things I have been trying. Actually, I had not used testosterone for 3 months and my libido was still good. The trouble was that due to external factors I got very depressed and tearful so I decided to use a little testosterone as it helps me feel less emotional. At the same time, I started using St Johns Wort and I began to feel better really quickly. Then the progesterone cream that I had sent for when I was feeling depressed arrived so I started using that as well.I know for sure that it was the progesterone cream that made me feel ill and I stopped that after a week. I took a few days for the horrid side effects to wear off. Then I noticed that my libido had disappeared. I have sensation but i cant "join the dots" in my head. So then I thought maybe the St Johns Wort was to blame so I stopped that. This was all about 2 weeks ago.My libido has still not come back and now I am wondering what was the culprit?
I am one messed up woman at present!
I tell you something-I don't think HRT of any sort will be good for me. Actually my worst symptoms of surgical menopause are gone but I want to continue to have a satisfying sex life. I am not sure if it will be possible without something. I would love to know if there is anyone out there who had their ovaries removed and whose sexual feelings returned on their own without any HRT .
janet c

Hi Janet,

I had one ovary removed 4 years ago and even though the other worked, my cycles started to become erratic a few months after the surgery and I hit the peri stage harder then. My libido went south around that time even with one ovary and it has never returned. After two years of just not doing anything I started with some herbs but nothing helped. I started bhrt 3 months ago after blood tests showed my testosterone free was -0.2. I started on 5mg of testosterone but it didn't seem to help and so I ended up taking just one dose from time to to time at 2.5mg. As of today I still don't feel much of a libido boost. I guess if I could get around to making the time maybe I would set things in motion, but with the aches and pains I have every day I just haven't had any energy to get it going.

Wanted to share that even with one ovary I have had no libido for almost 4 years.

Hi corky
Thanks for your post. Since my last post things have settled down a bit. I really think it was using the progesterone cream that messed me up so once that got out of my system I started to get back on track. I have been trying to use the estriol cream again and I do find it definitely brings the feelings alive in that area if you know what I mean? I too use testosterone from time to time. After my surgery I went physically numb and thought my sex life was over. Although I wasn't allowed estrogen, my doctor gave me testosterone and it brought back all the bodily sensations. I was able again to have orgasms-very strong ones, even without estrogen but the emotional side was absent. I have come to the conclusion that we ladies do need a little estrogen for the loving feelings. I have found sex to be much more like it used to be with a little estriol but it does, as I said, make me weepy. I had my 6 months check today and all is well! The doctor has advised me to try to keep going with the estriol as my body should begin to tolerate it with regular use. I suggest you keep trying with the testosterone and dont wait until you necessarily feel "in the mood". It does not turn you into a teenager and you have to make a bit of an effort to get started. You might find yourself pleasantly surprised when you do!
janet c