DIMINISHED and LOW SEX DRIVE

Testosterone is the hormone of sexual desire. Perimenopausal and menopausal women often experience a decreased desire for sex caused by an imbalance in the hormones: estrogen, progesterone, and testosterone. Surgical menopause (i.e., removal of uterus and ovaries) causes immediate decline in testosterone by 50% as well as an 80% fall in estradiol. The decline in libido continues steadily from approximately 30% of 30-year-old women to 50% of 50-year-old women. Women who are having normal periods in their 40's and 50's may still be 50% low in testosterone levels compared to 30-year-old women. Testosterone levels are reduced by more than 40% with estrogen replacement. This is because, normally after menopause, the pituitary gland in our brain continues to secrete a hormone (LH) that stimulates the ovary to continue producing androgens. (Libido actually improves for some women after 50.) Adding replacement estrogen, however, keeps the pituitary from producing the androgen-stimulating hormones. Symptoms in addition to decreased or low libido and sex drive and decreased intensity of orgasm may include loss of energy and sense of well being, and affect as many as 50% of menopausal women.

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