Menopause, Libido, and Childbirth: Deep Dive on Women's Sexual Health, with Dr. Mary Jane Minkin | Ep. 609
Aug 16, 2023
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Dr. Mary Jane Minkin, OBGYN and clinical professor at Yale School of Medicine, discusses women's libido issues, medical conditions affecting sexual drive, the effects of relationships on libido, the lack of discussion about sexual health, medical options to increase women's libido, the impact of various medications on libido, the effect of antidepressants on women's sexual desire, how age and birth control affect libido, causes of pain during sex, challenges related to orgasm, HPV vaccine, sexual health after vaginal births, the benefits of kegel exercises, menopause symptoms and treatments, and overcoming pain during sex.
Women experiencing pain during sex should consult a medical provider to explore potential underlying causes and treatment options.
Vaginal dryness can be addressed with moisturizers and lubricants, and there is no shame in using these products.
Decreased libido in women can be treated with medications like Flabanserin or Addyi, and testosterone supplementation for post-menopausal women has shown benefits.
Seeking professional help from medical providers or specialists can assist in addressing sexual dysfunction and improving sexual health.
Treatment options for menopause-related issues include vaginal moisturizers, hormone replacement therapy, and open communication with healthcare providers for personalized care.
Deep dives
Options for Pain during Sex
For women experiencing pain during sex, there are various potential causes and treatment options available. It is important to consult a medical provider to discuss the symptoms and explore potential underlying issues. Conditions such as endometriosis or vestibular vulvitis can cause pain during penetration and can be addressed with appropriate medical intervention. A thorough examination and discussion with a healthcare professional can help determine the most suitable treatment approach.
Understanding Vaginal Dryness and Lubrication
Vaginal dryness can be addressed through the use of moisturizers and lubricants. Moisturizers can be used regularly to provide ongoing moisture to the vaginal area, especially for those experiencing discomfort from dryness without engaging in sexual activity. Lubricants, on the other hand, are applied during sexual activity to reduce friction and increase comfort. It is important to choose the right product, starting with a small amount first to ensure compatibility and reduce the risk of irritation. Many women use both moisturizers and lubricants, and there is no shame or harm in using these products to enhance comfort and pleasure.
Exploring Options for Increased Libido
For women experiencing a decrease in libido, there are various options available. Pre-menopausal women may consider medications such as Flabanserin or Addyi, which are FDA-approved to increase desire. Another option is testosterone supplementation, which has been shown to help post-menopausal women with low libido. It is important to consult a medical provider who is knowledgeable in the area of menopause and sexual health to discuss the best possible treatment approach based on individual needs and preferences.
Seeking Professional Help for Sexual Dysfunction
For individuals experiencing sexual dysfunction, such as pain during sex or decreased libido, it is important to seek professional help. A medical provider or specialist, such as a sex therapist or couples therapist, can provide guidance and support in understanding and addressing the issue. Open and honest communication with a trusted healthcare professional can help determine the best course of action and explore potential medical interventions or therapeutic approaches to improve sexual health and overall well-being.
Benefits of Vaginal Moisturizers and Hormone Replacement Therapy
Using vaginal moisturizers and hormone replacement therapy can effectively address dryness and discomfort associated with menopause. Moisturizers can be inserted into the vagina and used a few times a week. Hormone replacement therapy, such as vaginal estrogen, can also be beneficial, especially for women in a low estrogen state. It is important to consult with a healthcare provider to determine the best options for individual needs and to ensure safe usage.
Options for Treating Vaginal Dryness and Incontinence
There are various options available for treating vaginal dryness and urinary incontinence. These include moisturizers, such as gels, suppositories, and inserts, which provide lubrication and help alleviate dryness. Additionally, some women may benefit from the use of vaginal estrogen products, either as creams, rings, or tablets. It is crucial to consult with a healthcare provider to determine the most suitable treatment approach.
Considerations for Sexual Health and Menopause
Maintaining sexual health during menopause involves addressing issues like vaginal dryness, diminished libido, and difficulty achieving orgasm. Treatment options include the use of moisturizers, stimulating topical creams, and sex toys. Additionally, communicating with healthcare providers about potential hormonal imbalances and exploring alternative medications, when applicable, can help manage symptoms. Open dialogue with providers ensures personalized care and consideration of individual circumstances.
The role of estrogen and progesterone in regulating the uterus lining
Estrogen stimulates the growth of the uterus lining, while progesterone regulates and cleans it. Progesterone can be used to regulate the menstrual cycle and control excessive bleeding. Low-dose birth control pills containing both estrogen and progesterone can be beneficial in managing irregular periods and menopausal symptoms like hot flashes and sleep disturbances. The duration of taking birth control pills depends on individual factors, such as smoking habits. Hormone replacement therapy (HRT) with estrogen and progesterone can also be considered, with the duration depending on individual needs and health risk assessment.
Managing menopausal symptoms and considerations for HRT
Various options can help manage menopausal symptoms in women who cannot or prefer not to take estrogen. These include SSRI antidepressants, herbal products, GABA-PENTIN, and a new medication called VOCES. Women who have a history of breast cancer and experience menopausal symptoms can explore non-hormonal alternatives. However, for women going through early menopause, taking estrogen therapy is crucial due to the increased risk of certain health conditions. There is ongoing research on the impact of estrogen therapy on dementia and heart disease prevention, but current recommendations are not definitive. It is important to consult a knowledgeable menopause practitioner to explore the appropriate options and personalize treatment plans.
Megyn Kelly brings listeners and viewers a deep dive on women's sexual health, with Dr. Mary Jane Minkin, OBGYN and clinical professor at Yale School of Medicine, and expert on the issue. They discuss women's libido issues, the difference between desire and arousal, how medical conditions could affect sexual drive, how relationships could affect a woman's libido, why women don't talk about their sexual health enough, the medical options to increase women's libido, how testosterone works for women, how various medications could decrease libido in women and men, the effect of antidepressants on women’s sexual desire, how age affects libido, how the birth control pill can affect women's libido, causes of pain during sex, challenges related to orgasm, HPV vaccine, sexual health after vaginal births, the benefits of kegel exercises and "pelvic floor physical therapy," when to know when you are in menopause and notable treatments for symptoms, the “erratic period” and how to regulate it, and more.
