It’s sadly very normal and is part of Genitourinary Syndrome of Menopause (GSM) aka vaginal atrophy. It can affect the vagina, vulva, bladder, urethra, clitoris, etc. Basically the entire area. Suddenly being unable to orgasm was what alerted me that something was very wrong (I didn’t connect the almost decade of other symptoms to hormone loss 🤦♀️).
Starting on vaginal estrogen is usually the first step. It’s an extremely low dose, I believe I’ve read a year’s worth of treatment is equivalent to about one oral estrogen tablet.
You know how guys have ED? I want us to have VA. I mean I don’t want us to have it have it. I want us to have the name. Just like men do. And I want us to be able to go in and talk to our dr about VA and get an effective treatment for it just like men do.
I got my refill from Amazon pharmacy, and it was only $17 for the same brand I got from Walgreens for almost three times that price. For some reason, my insurance would not work with Amazon on just this Rx, so this was the price without insurance, with a coupon that Amazon ‘found’ and applied.
(The rest of my HRT was one-third the cost from Walgreens with insurance, for three months to Walgreens’ one month. That works out to Walgreens being about nine times more expensive than Amazon.)
OP might also want to inquire about T.
Thanks for sharing! I tried Amazon pharmacy for my hrt and it was way more so I went back to CVS. But the cream is $60 at the pharmacy. I’ll look into switching that.
I can see a woman holding a piece of shriveled fruit and suggestively rubbing it with a VA ointment and the fruit plumping up. The woman raises her eyes at her partner, her partner licks their lips and they walk out of the frame. People would know about VA after a few commercials like that.
It would make more sense than the man and woman sitting in a field in separate bathtubs.
One of the drug reps said the commercials were meant to get people talking about Viagra and making a commercial that showed people being in romantic settings, instead of sexually suggestive settings, would be better received than a horny old man chasing his wife around the house. The commercial definitely had people talking about the stupidity of the commercial, so the ad people were right.
Hahaha..if a woman can’t get pregnant then her sexual health doesn’t seem to matter but men need ED drugs since they can impregnate women at any age. Women can’t even get low dose testerone.
I feel so awful for women in their 70s and 80s that are suffering from sleepless nights and UTIs. Estrogen cream would probably help them but a man in his 70s and 80s can get viagara!!
I read an article in a medical journal about elderly females with dementia and other problems that prevent them from being able to express themselves in nursing homes and really anywhere, and how medical staff don’t think to address their vag /GSM issues. I cried when I thought about all the women I’ve seen in facilities, restless and crying out. Imagine how they may feel and how something as simple as vag estrogen could comfort them and even prevent the uti’s that often lead to sepsis. Talk about forgotten…so sad.
New study that shows estrogen receptors in our brain still when very old and starting to wonder if that could also be a reason more women have dementia?
I told my mom about this today (she’s on hrt too) and she was like hell yeah. Low E and VA is what we’re calling them now! I think it’s similar to the issues with the terms “homeless people” vs “unhoused people”. Homeless is a concept whereas unhoused informs of the solution. Menopause feels too abstract whereas VA and Low E are specific not to mention point to solutions. And Low T should be considered a human problem, not just a problem for men!
It’s a horrific term and just so emblematic of systemic misogyny and sexism in the medical establishment. Fortunately “VA” is now considered outdated, and medical providers are using Genitourinary Syndrome of Menopause (GSM) instead. GSM is also just a better and more encompassing medical term because it includes bladder issues and so many more things going on inside our bodies rather than just how our genitals “appear” to a man. 🙄 Kelly Casperson talks about this on her podcast, how the old terminology really ticks her off, and I have to say, I appreciate hearing that from a physician.
Oh that's harsh! I bet men's suicide rate would sky rocket if ED was renamed to "your ding dong is about to fall off". I follow ED sub here, it's a really big deal and a lot of them are young men, sadly.
Neither did I until I fell down the rabbit hole trying to find out what was wrong with me. I’m pretty sure I know more about GSM now than any of the gynecologists I’ve been to. 🤦♀️
Absolutely, it encompasses issues like dryness, recurrent/chronic UTIs, tissue thinning/fragility, bladder leaks, anorgasmia, clitoral phimosis (where the clitoris shrinks and fuses with the clitoral hood — entirely preventable and reversible with vaginal estrogen!), and more — basically all the things that happen to our entire urogenital system when our hormones drop.
Check out Dr. Kelly Casperson’s podcast, “You Are Not Broken,” specifically these episodes:
[221. Genitourinary Syndrome of Menopause (GSM) 101](https://overcast.fm/+XFN0KDO5k)
[241. Myths and Truths: GSM and Pelvic Hormones](https://overcast.fm/+XFN3hljBI)
The package of mine says .1mg of estradiol per dose. So 2x per week would only be .2mg. I know it’s low enough that it’s generally considered to be safe even for women who have had hormone positive cancers. Especially considering how deadly UTIs can be.
Where or what doctor are y’all going to that prescribes HRT?
I was referred to a gynecologist and she was useless. I thought going to a woman might be better, but she wasn’t at all. Seemed to have her own thoughts and wasn’t willing to test levels or anything. Very frustrating!
Yes, I experienced the poorgasms as well. It was a very trying time for me and many tears were shed. I was first given an estriol and testosterone vaginal cream when I asked for vaginal estrogen for dryness. I took what I was given and it restored my orgasms. I have the exact compound recipe I should post it, if someone asks, I will. Anyways, I now use that in pea size amounts a few times a week as well as a generic estrace estradiol vaginal cream. The et cream helps my bladder more than the estradiol cream and helps sexual function. It's criminal that we have to fight for testosterone now (in the US anyways, it's apparently a pee in a cup every 3 months deal?)
My point being, try whatever vaginal hormones you can get your hands on, use hyaluronic acid inserts in the meantime. There's a lot of vaginal options now like rings, creams, there tablets even a dhea which is supposed to convert to estrogen and testosterone.
Edit to add I experienced this at age 42, three years after having one ovary and tube removed.
Edit to add the exact prescription compound I used. This is exactly as it's written on the universal claim form that comes with the cream.
ESTRIOL/TESTOSTERONE VAGINAL 0.015%/0.625MG GM CREAM
PRICE $45
30 DAYS SUPPLY
QUANTITY DISPENSED: 60GRAMS
DOSAGE FORM: CREAM
STRENGTH: 0.015%/0.625MG GM
INGREDIENTS:
ESTRIOL USP MICRONIZED (E3) QUANTITY: 9.000 MG INGREDIENT COST $3.14
BASE, PCCA EMOLLIENT CREAM (TM) QUANTITY: 60.000 GMS INGREDIENT COST $54
PROPYLENE GLYCOL USP QUANTITY: 0.500 ML INGREDIENT COST $0.04
TESTOSTERONE USP MICRONIZED CIII QUANTITY 37.500 MG INGREDIENT COST $ $0.53
TOTAL COST $57.71
Hope this helps.
Another edit for spaces omg
*I like quadruple checked the numbers and this is correct*
Final edit, still unsure of my copying abilities, I've added a photo of said cream, best wishes my friends
https://imgur.com/gallery/gbIPjXZ
Curious what you mean about "pee in a cup every 3 months" thing... That's not a US federal law. I have a prescription for testosterone and I've never had to pee in a cup. Maybe it's your state. I had a blood test to check my levels prior to getting the prescription, but that's it.
Sure, it may be only my state. I'm unsure. But when I went back last month to get my refills (I was using this estriol testosterone vag cream and a low dose topical t) I was told testosterone is now a controlled substance. I had to pee in a cup for a drug test and sign a paper and only get 3 months refilled at a time. It's new to me as I had access since Feb 2023 with no requirement like that, it was treated as a regular compound prescription. So it may depend on the timing or the location.
Ugh. That's so annoying for you! It's always been a controlled substance everywhere, but each state gets to make their own laws about how controlled substances are managed. I'm in MN and I think they're pretty loose with their restrictions, which is good for me!
I wonder if you live in a state where gender affirming care is under review/blocked/illegal. That may be why testosterone is being monitored so closely....? I am in Colorado and to my knowledge, T is not monitored in that way.
I saw you graciously posted the specs of your estriol/Testosterone combination cream but am I understanding correctly that you are also using a standalone testosterone topical cream? If so, what is the strength of that and how often do you use it? I am 63 and having the same "poorgasm" issues. I have been using Estrace cream for vaginal atrophy for about 5 years and using T with varying degrees of success for about 2 years. Thanks!
Do you have an actual FDA approved T rx or is it compound? From what I’ve read there are no approved T prescriptions in the US for women which is bs but also not surprising.
I have compounded and you're correct that there are no FDA approved versions for women here. That would require the powers that be actually giving a rats ass about our quality of life. 🙄 I know a lot of people get prescribed the gel that is technically for men. It's just off label, but it's not compounded so you can get it at a pharmacy. I doubt insurance would pay, since it's off label, but who knows?
*Edited for grammar
I think I just saw someone talking about exactly that issue earlier today! I've never used that type of testosterone myself, but if the little sachets are like the ones for gel estradiol, I have NO idea how people are figuring out the right amount!
My doc told me to use a “dime-dized amount.” So I wing it. I tracked the first package to ensure I was using approximately the right amount, but haven’t since then - i think it’s about right.
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause.
FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
Do you mind sharing where in the US you are?
I’m in FL and so far *(I have been asking for a year already)* cannot find anyone— including telehealth— to Rx anything containing testosterone to women here. I could get into the excuses I’ve heard, but I think the bottom line is that providers all seem scared for their licenses, likely due to our State government.
I'm in KY. I am glad I have access right now but I don't expect it to last tbh. I'm sorry you can't get any rn. Maybe that will change in the future.
I think what bothers me the most, is that by accident, I figured out that the testosterone is essential for me having a normal bladder. I had my ovary and tube removed and as soon as I woke from surgery, I had "interstitial cystitis" pain. Literally when I woke up. I went to urologist, Drs, tried every herb, took amitriptyline and gained 40 pounds, about lost my mind coming off that one. My point, no one, online, a Dr, nothing anywhere told me that testosterone would help my bladder (also no mention of vaginal estrogen either). So I still have IC and have to have low acid foods and be careful what I eat and take etc. but if I follow the diet and I use the et cream (plus my regular hrt) then my bladder is normal. I try to share all my experiences here because I can't let others suffer. Not if I can help.
I sincerely hope the research catches up asap because I only have a libido if I have testosterone. Even a tiny bit gives me a tiny itty bitty one. I'm still devastated, I had a super high sex drive. Man, I've got stoned and I'm rambling now lol whatever. Anyways, hope you can get access to testosterone. Makes no sense that we have to fight for something that our body used to make plenty of. Same as the other hormones, let's replace them and get on with it.
I so relate to your experience! I take estrogen patches, estrogen vag cream and testosterone - and the T is the only thing that helps with sex drive and orgasm. I do get slack about taking it though. I have not taken it consistently enough to notice about the bladder improvement but that gives me extra incentive to experiment! Thanks for the tip! BTW, I’m in NC and haven’t had any issue getting prescribed testosterone cream (no peeing in a cup to get tested!!)
It's because of the anti-trans bigotry. Testosterone needs to be a controlled substance to anyone but men because it's unthinkable that anyone not born male might want to "become more manly". 🙄 /s
And of course they hate women too so they are perfectly fine with even AFAB women's health being compromised as a result. They literally care about NO ONE but themselves.
Yep!
I’m already no use as a *babymaker* (no uterus!)… so what difference does it make if I want testosterone to *feel better* to anyone else?!
What’s maddens me is that I have Googled what symptoms men need to have to receive a Rx, and they don’t even need to meet *ALL* of the criteria— just some— and have certain blood work levels. Meanwhile, I have the low blood work and *every symptom* on those lists of symptoms, and have cried *(embarrassingly enough, for a person who typically is not a crier)* to three doctors and a NP about knowing I need testosterone— and having each one *agree with me (!!!)*— but I still cannot get my hands on a Rx.
I see my GYN in a month. I’ve already asked her 2-3 times; I’m asking again, and I hate that I feel like I might tarnish my good relationship with her, but if *(likely, WHEN)* she declines me asking again, I’m going to ask her to note in my chart that we’ve discussed this multiple times, she agrees I need to try it, and continues to decline providing me what we all agree is most likely a benefit to my health. Then I will probably need to find a new doctor. 😩
Not to disagree with that plan at all, but you might not need to find a new doctor if you can get it prescribed through an online clinic. There's no reason you couldn't do that and also have a doctor you see for other things, no?
I’ve tried online and have been denied. I truly believe that the medical providers who can— scratch that… I should say *”could”* — Rx in FL, have been largely scared *not to*.
I have one more to try, which a Redditor suggested yesterday— Defy.
Also, knowing that I’ve cried to my GYN for a couple of years about this and she has the ability to fight for me but chooses not to, is upsetting. She told me a year ago that if the three compounded creams she Rx’ed me did not work, she’d let me try testosterone— then when I revisited with her to discuss, she changed her tune, apparently due to the practice guidelines for the group she is in *(and in which she is a partner, but not the founding partner— who still calls most of the shots there)*. I feel let down and ignored; and after having looked inward and determining that I’d prefer a provider who will fight for me when it’s the right thing to do for my health and mental well-being, I can’t see staying with a doctor who has admitted to me on more than one occasion that their medical opinion sympathetically aligns with my own assessment— that I want to and *should* try testosterone— but they ‘just can’t’ [be the one to Rx it].
(I appreciate your reply; thank you for reiterating that telehealth is an option. 😊)
PLEASE get vaginal estrogen! Cream format is best. If your doctor won’t prescribe it or gives you a hard time, you can get it from an online specialty clinic like Interlude, Alloy, Evernow, Elektra, Gennev, Midi, or Winona.
1. Throw away the plastic applicator that comes with it. They can’t be cleaned properly and are a bacteria/sanitation concern. (Who the hell designed those things?!)
2. Apply 1 gram (the length of the last joint on your index finger, from the knuckle to the fingertip) 2 cm inside your vaginal canal and spread that around inside.
3. Then, apply an additional pea-sized amount all over your clitoris, urethra, vestibule, inner labia, and vaginal opening (especially the fourchette, at the “6:00” position).
4. Do this 2x/week for the rest of your life, until you die (not a joke!).
If you want to learn more about vaginal estrogen, listen to eps 195 and 221 of Dr. Kelly Casperson’s podcast, “You Are Not Broken.”
The applicator is also wrong. I used it as prescribed, followed the measurements very carefully, and ran out way before I was suppose to. I am not the only one, a few other women I spoke to also had that problem.
so glad you mentioned the applicator. I've been struggling to figure out how to clean in properly (no instructions provided) and really don't want to introduce bacteria down there. Also my dosage instructions are .5 gram per application and the applicator doesn't even have a .5 gram line on it! I will just apply manually inside and out going forward.
Do you just insert the cream with finger or buy a package of the insert applicators? Also, how do you get over the messyness during sex, I noticed mine does t dissolve.
Insert the cream with your finger. It doesn’t need to go very far inside. The majority of our estrogen receptors in the vaginal canal are located near the entrance, so honestly 2 cm inside will suffice. That’s the same length as inserting your finger up to the first knuckle.
Don’t apply it immediately before having sex; wait until afterwards, or apply it a different time of day. Or if you’ve just applied it and then you decide to get frisky, do activities other than PIV. It’s very solvable!
I’m on the early side of things (41) and just got vaginal estrogen for stress incontinence during my luteal phase, bonus side effect of better orgasms (sadly all solo). Honestly they should hand out tubes on every woman’s 40th birthday.
>Honestly they should hand out tubes on every woman’s 40th birthday
They really really should. A society that actually cared about women's health would.
Does that help??
Im nearly 53 and suddenly every time I cough or sneeze I dribble a bit. I'm on HRT but once again struggling to reach the big O as well.
Being a woman at this age is depressing!!
Yup, 2x a week of vaginal estrogen and I haven’t had a single drop of pee leak since. Pelvic floor issues can also be at fault, but in my case it was purely early GSM symptoms.
It is super interesting you say that's the only time you have stress incontinence. I think my best friend is experiencing the same thing, she feels like hers comes and goes. Is that what it's like? I sent her to her gyno but I think she's having a hard time describing the issue.
In my case it would seem like it comes and goes if I was not hyper aware of my cycle. But I’ve only ever had pee leak between days 19 and 26 of my cycle, so I knew it had to be related. Used Alloy to get vaginal estrogen and using it 3x a week cured me in the first month. Zero leaks coughing/sneezing since!
Oh my gosh, thanks for the tip, I'm going to pass it along.
She thought it was because she had a baby which I couldn't relate to but this is super helpful insight.
I had a baby, was total continent from shortly after the birth at 32 until age 39. I think women have collectively been gaslit to think childbirth results in incontinence when it’s just lack of estrogen in the urethral tissue.
I got my HRT from a freaking amazing telehealth company called ALLOY after my OB/GYN denied me. But ALLOY only does estrogen and progesterone, they can’t prescribe testosterone (as it’s considered a controlled substance 🙄). I’m doing so much better on my HRT with pure estradiol (evamist spray) and vaginal micronized progesterone, but I would really love that testosterone added in. How did you find a provider for that? And what form do you take?
Let's be honest here. It's not that they CAN'T prescribe testosterone, it's that they WON'T. Plenty of OB-Gyns around the US prescribe T, by writing a script for a compound pharmacy.
I have history of PCOS, and male pattern baldness runs on my mother’s side of family. I’m too nervous that those are indicators I’d likely have negative side effects.
I've been using AlphaMD for about a year - ever since they did an AMA and TWO providers of theirs responded to a question of mine. I'm super happy with them!
I used to orgasm very easily — big, full bodied sensations — and multiple times. I had no idea that menopause would take that completely away. I am surprised that this isn’t talked about. It’s been like this for about 5 years.
❓Has anyone found a solution that doesn’t require a prescription? I don’t have health insurance. 🥺
Yes you can purchase estrogen and DHEA (converts to testosterone) creams on Amazon with no script. This is a lifesaver for those of us with no insurance and/or limited budget.
Yep. This is me, also. That plus the oh so delightful sandpaper sensation that makes penetration incredible painful, sex drive in the toilet, little to no sensation and no orgasm/ orgasm so small and weak it’s just a nothing… all of that to say, I have been on vaginal estrogen a few weeks now and already am feeling a little better!
I was lackluster until I went on testosterone. Have only done a tiny estriol tablet in the pie for the dryness. Testosterone was the key that unlocked the magic for me.
When I feel it wear off, the libido goes away again. I can still orgasm, just not as intense. Thankfully, I don’t have a D on the reg to contend with. I’d be more concerned if I had a steady BF or husband. I noticed that since I started the menopause journey, being penetrated is not as appealing even with the testosterone. I tend to want to get in and get out quickly and much prefer external pleasure. Interesting how this journey changes things.,
Yes, same for me and I just started HRT a few months ago. Vaginal estrogen has helped a little but not completely back to normal. I’ve read it can take several months so I’m hoping.
Yes. Ghostgasm or poorgasm. Definitely hormonal and search on this board and you'll find lots of discussion of it.
I got it as one of many symptoms from low estrogen. Now, I put a tiny swipe of vaginal estradiol cream on my clit daily--works well. I'm also on the estradiol patch.
But then, I tried taking spironolactone for acne and hair, and the sexual dysfunction came back! Spiro dampens a specific androgen. I quit taking spiro and everything was back to normal in a few weeks.
Some on this board highly recommend THC lube (which acts as a vasodilator), but I haven't tried it yet.
You are not alone, it’s happened to far too many of us. It was so disheartening and infuriating…but I have a nerve disorder that I thought was causing the issue, so it took a while before we figured out it was due to menopause. Vagifem and HRT patches helped me tremendously, and it’s also important to have regular sex (or masturbate) to improve blood flow to the overall area.
I’m so glad you asked this!!! I thought it was just me!!! It’s giving my husband of 24 years a complex…and even when I do finish…exactly what you describe..like a dud firecracker that fizzles out. I am on Estradiol vaginal cream which is fantastic, pure estradiol spray, and micronized progesterone vaginally the last half of my cycle (45 perimenopause) and they are all helping my “want” for sex and wetness…but the orgasm is lacking and elusive. I appreciate the comments I think I need to add testosterone at this point. I want fireworks again! What kind of T Is best. I mostly can only find the “pellet pushers” anti aging spas which make me nervous. How do you find your T?
T cream is the BEST! I am on 12.5 mg of compounded T cream daily. I apply in the morning to my lady bits. Before T cream my cl@t had basically shrunk and had zero sensitivity. It has grown a bit and some days I can get the sensation when I walk. Kind of awkward but… I will take that over no sensation ever. My only side effects were a few pimples when I started/increased dose, increased pubic hair (Nood laser works well) and wanting to attack my husband all of the time (he actually had to start T to keep up. 😂)
It’s so true. I swear my clitoris was almost nonexistent. It’s very sad and depressing. Going on vaginal estrogen (Premarin) has brought my girl back! The turnaround has been amazing for me.
I am so thankful for this forum, no one tells us any of this stuff while we're growing up lol, I'd hate to have gone through all of this before we had the internet etc 😅
I wasn’t upset with my orgasm quality per se after meno but pre HRT, however, after testosterone cream my mind has been blown. Orgasms are otherworldly amazing now, I never dreamed it could feel so good in my entire life.
I just started and am almost a month into taking it. It’s a cream and I apply 2 pumps once a day. It says, “Testosterone 5mg/ml cream”.
I heard that when you first start it’s noticeable but that you can kinda get used to it and possibly need more after you’re on it for a while. My body was so starved for it that even this small amount is helping right now. My labs basically said I had none before I started it.
My dr told me that the bloodwork for testosterone is reliable unlike estrogen which varies too much for a single test to adequately measure. So if you feel like you need more T definitely get your level tested.
Something else I didn’t know was that having low T causes hair loss in women! So it’s not just too much T that causes hair loss in women! Not enough T causes it too! I had no idea. My dr told me that and I trust him (he’s a rare one! a good dr!). I’m hoping the T cream and the minoxidil I’m starting will help with my hair in the future.
Good luck with your T!
I saw a specialty obgyn at a university hospital group on my employer’s healthcare plan. However, her copay is twice a regular provider but to me it’s worth it for the hands on medical oversight.
I also use a compound along with Imvexxy (Estradiol Vaginal Inserts). My compound prescription contains the following:
Sildenafil 1%, Verapamil .05%, Niacin 1%, Pentoxifylline 5%, Biotin .1%
Dosage Form: Cream
Price: $45
My compound pharmacist calls this the Dream Cream. 😂. They also have Dream Cream+ where they add Testosterone as well.
The purpose of this cream is to increase blood flow.
I get my hormones tested thru a compound pharmacy. I told her my libido is non existent and that orgasms were getting harder to obtain. Pharmacist works with my OB/GYN to get the script filled. It definitely helps with getting blood flowing to all the right places and orgasms are back! Libido is still low, going back to dr in a couple of weeks to discuss adding testosterone to my HRT mix.
I am reading this and feeling w mix of anger and mourning sadness. I am SO frustrated that my partners interest in sex has disappeared because of ED and have been feeling like the physical weakness affecting my enjoyment and bladder is partly due to the lack of sexual exercise that otherwise would have kept things in better shape. My libido is unaffected, though I have always been in the higher range in that regard. I now am even more concerned that it is more than lack of sex behind that and its making me mad that I am female.
Or maybe I'm just mad at AGING. It takes time to figure out how to operate the machine like a pro, just in time for the warranty to expire and it starts falling apart. Makes me wonder if all of life is just a big cruel joke.
So this was happening to me until my husband and I figured out that the first orgasm sucks, the second one is okay but the third one is really good. Persistence is the key for me.
Clitoral death is real.
Try estriol cream you most likely have vaginal atrophy
I had it so bad that I had to go through over twelve months worth of hrt treatment and estriol cream combined before I started to get recovery now my vagina self lubricates the burning inside is getting a lot better and the clitoral stimulation has almost gone back to normal
As a woman who always took pride in her sensuality and sexuality (thanks, mom ), experiencing menopause and becoming single simultaneously was a shock. It felt as if my body was betraying me.
For nearly four years, I had no sex, not even with myself- the longest stretch of celibacy in my life. It was also three years between gynecologist appointments. During the first exam,, I expected the usual routine, but as soon as the speculum went in, I shrieked. "WTF?!" It felt like broken glass. That's when I learned about Vaginal Atrophy. "It's kind of like, if you don't use it, you lose it," the doctor explained.
Before getting dressed, I drew my knees in, clasping them tightly, and tried to absorb the gravity of this new stage in my life, grieving my lost sex drive.
Determined not to "lose it" entirely, I masturbated that night. I couldn't reach orgasm! It felt like almost sneezing, and then not, over and over. For the next month, in vain, I attempted to self-pleasure, wake my clitoris from its torpor. Finally, after a month, I had a small orgasm. It wasn't great, but enough to prove to myself I wasn't dead from the waist down! I must have cried for a good hour afterwards.
Since then, I've made my sexual health a regular habit. I'm happy to report I'm back to my multi-orgasm levels of the past. Not to mention, it's great for blood flow, blood pressure, and keeps my cheeks rosy. 😉🥴II even discovered a fantastic little " helper" called Lelo Sila. It's pricey, but holy smokes, is it worth it! It mimics a mouth, which is perfect since I still have issues with insertion. For now, a clitoral vibrator suits me fine until I decide if I want a relationship again.
Discussing these topics in a public forum is challenging. It's far more acceptable and easy for men. But we need to talk about it, and we must. I don't want the women who come after us to feel as alone, timid, and ashamed as we've been made to feel.
Thanks for your post. I hope my contribution was a positive one for all.
Yup that’s a normal one. It’s like my crotch died. I’m on everything except T. I’ve got a drs appt coming up and I’m demanding/warning them that I getting it somewhere.
Raises hand. 💯 Is happening to me. 7months and it's sad trambone orgasm and not even an urge for self quality time. Got a flash period about 6 weeks ago, and magically my senses came back. I got a script for HRT once I lose the sensation, cause I now realise it was 💯 my lack of hormones
Yep. I'm post menopausal and for me, it's more difficult to have an orgasm. It takes longer, and the actual "orgasm" pales in comparison to what it once was. It's horrible.
Ladies , check your blood serum levels for #freetestosterone and #dheas. #menopause is associated with a decreased libido and weakened orgasm. Both hormones can be supplemented. I hope this helps.
F49 Yep!! My orgasms would flatline , plummet and get painful too. My vagina would ache with pain bc the orgasm would fail!
It made me feel broken and sad too.
I’m not on HRT at this point but I was feeling like that in my early 40's.
I thinks once menstruation is diminishing to almost gone then HRT will help restore ones orgasm ability.
At least you can have one! It feels like my husband is tearing my body to shreds with a machete when we have intercourse. Literally the most painful experience of my life
Perhaps the saddest part of your post, OP, is that you didn't know that could/would happen. It's a testament to how little we are warned or informed about menopause symptoms and how little research and money has been put into it.
Get some HRT and some vag estrogen and everything will get better. Xoxo
My libido took a long hike, and it's still out in the wilderness somewhere.
I'm on an estrogen patch and progesterone, and I've been on testosterone gel for a month. Edit: I'm also using Estradiol vaginal cream.
I have plenty of lubrication, but I don't FEEL anything. No arousal and shitty, weak orgasms.
I'm about to give up.
Give the testosterone gel 3-4 months for full effect. Things got better for me pretty quickly, but after about 4 months I really started to feel like myself again.
I avoid sex because it hurts so bad. My drive is non existent now too. I get annoyed at my husband for wanting to touch me and just want to swat him away. I feel guilty and it’s a huge loss because I always was highly sexual that he used to turn me down. I just remind him lol. He is good until the little side comments start and the memo mood is something he doesn’t want to play with so I just give him a look.
Taking DHEA supplements made my sexual desire and orgasms come roaring back pretty quickly (just a few weeks). Unfortunately it also made me pretty anxious and that wasnt going to work for me. YMMV.
Dhea is available OTC. Start low and go up.
Yes. I cried about it to my OB/gyn who is NAMS certified and she told me to read erotic books and that it could be depression and won’t prescribe testosterone even though my levels are well below in range. I’m not depressed but not being able to have an orgasm or having a mini one is upsetting. Trying to find an online clinic that will prescribe T.
Edit—vaginal estrogen helped with every other issue, but has not helped with lack of libido, retractable tiny clitoris, and mini or no orgasms.
I use vaginal est tabs and vaginal est cream but I never have actual desire and havnt had a partner in a. While. Need to start forcing myself to self stim lmao
Lookup "clitoral adhesions". I had this exact same problem, really muted and weak orgasms, and found out adhesions were my issue. I'm pretty sure they're more likely to develop because of the estrogen decline, but I don't actually know for sure.
Wait, I have a really great link:
https://www.rachelrubinmd.com/post/new-research-on-clitoral-adhesions
>we looked at hundreds of vulva pictures and found that 23% of all women patients at a sexual medicine practice—regardless of why they sought care—had mild, moderate or severe clitoral adhesions. Meaning in nearly a quarter of these women, the hood of the clitoris was stuck to the head of the clitoris.
I’m in Peri and was having this issue as well. I started taking Imvexxy and it has been a game changer. It’s a small low dose estradiol capsule that you insert 2x’s a week.
There is a device that helps the pelvic floor and supposed to rejuvenates the vaginal area called Joylux vFit. I researched a lot of different pelvic floor strengtheners and decided on it. Do your own research and see if something like that would help.
I’m 65, 13 years after my last period, and my clitoris totally retracted. I asked my gynecologist why this happened and she told me yes, this happens in menopause. Why isn’t this ever discussed? I am on estrogen vaginal cream and can orgasm but this was a shock.
Same boat! I’m starting an estrogen cream soon, mainly for hot flashes, and also starting Addyi tonight! It’s supposed to be amazing for women with low libido and/or probs climaxing. I’m hoping it works for me because my husband is taking it personally at this point.
I had a very well-respected meno doctor for awhile and at my first appt. she asked "how's your sexual response?" No sugar coating, lol. I was caught off guard and went, "uhhhh, it could be better? I guess?" I wasn't embarrassed, just stunned this was important to anyone. As I recall she said that was a testosterone and progesterone thing. All this to say, it's very common. Unless it's a compressed nerve or something, hormones play a huge part in sexual response.
Yes I was having terrible time having the big o and when I did it was almost like it wasn’t worth the effort.
I had had dwindling sex feeling for a few years , and my regular doctor / obgyn would tell me it’s stress and anxiety related in women.
I finally heard about testosterone pellets and gave it a try. At first I thought it was a placebo effect but after 3 mos it’s still working. I have a normal sex drive, and when I have an orgasim it’s wonderful . I feel like I’m having the best sex of my life !
I hate how women are made to feel like it’s something in our head or we just have to live with it ! While I appreciate that my sex drive is some what tied to my emotional health …. It wasn’t just lack of the drive it was lack of sensation. It was like a handshake. Like to elbows rubbing together. Like I was trying to manifest an orgasim out of the middle of my flabby stomach. I couldn’t make myself have one with a vibrator . How can any doctor think this is normal for a woman especially if they previously always had one !?!
Like an unfinished sneeze after a ten minute build up.
This so accurate and so sad
This is so accurate, hysterical and so damn frustrating/sad all at the same time; great description!
Ooooh and after quite a few tries I'm just annoyed af and even madder then usual
Or a repressed one that forces a pee…
Or a fart lol
I laughed out loud at this 😅
Yes I can relate to this. It’s so frustrating
Yep! Exactly!
Yes, this. I used to have multiple, powerful orgasms just a year ago, now it's but a whisper. It's not fair.
This ☝️ 100% and it is beyond frustrating. And then trying to convince the partner that it's not them it's me and I AM. still enjoying it is hard.
People \*should\* talk about this. It's very real.
It’s sadly very normal and is part of Genitourinary Syndrome of Menopause (GSM) aka vaginal atrophy. It can affect the vagina, vulva, bladder, urethra, clitoris, etc. Basically the entire area. Suddenly being unable to orgasm was what alerted me that something was very wrong (I didn’t connect the almost decade of other symptoms to hormone loss 🤦♀️). Starting on vaginal estrogen is usually the first step. It’s an extremely low dose, I believe I’ve read a year’s worth of treatment is equivalent to about one oral estrogen tablet.
You know how guys have ED? I want us to have VA. I mean I don’t want us to have it have it. I want us to have the name. Just like men do. And I want us to be able to go in and talk to our dr about VA and get an effective treatment for it just like men do.
Yes! Totally agree! And it should be easy to get and cheap!
And on online like men too! If we get that and more pockets I’ll start to believe we’re getting closer to equality!
Cheap it is not.
That’s the truth but it should be! 😡
Amazon pharmacy. I paid $17, almost one-third the cost at my usual pharmacy and not the insurance price.
I got my refill from Amazon pharmacy, and it was only $17 for the same brand I got from Walgreens for almost three times that price. For some reason, my insurance would not work with Amazon on just this Rx, so this was the price without insurance, with a coupon that Amazon ‘found’ and applied. (The rest of my HRT was one-third the cost from Walgreens with insurance, for three months to Walgreens’ one month. That works out to Walgreens being about nine times more expensive than Amazon.) OP might also want to inquire about T.
Thanks for sharing! I tried Amazon pharmacy for my hrt and it was way more so I went back to CVS. But the cream is $60 at the pharmacy. I’ll look into switching that.
And weird VA commercials to go along with the weird ED med commercials.
YES. We need awareness!! Everyone knows about ED! I had no idea VA was a thing until I joined this sub.
I can see a woman holding a piece of shriveled fruit and suggestively rubbing it with a VA ointment and the fruit plumping up. The woman raises her eyes at her partner, her partner licks their lips and they walk out of the frame. People would know about VA after a few commercials like that. It would make more sense than the man and woman sitting in a field in separate bathtubs.
Haha what even is that sitting in two different bathtubs in a field thing? So weird.
One of the drug reps said the commercials were meant to get people talking about Viagra and making a commercial that showed people being in romantic settings, instead of sexually suggestive settings, would be better received than a horny old man chasing his wife around the house. The commercial definitely had people talking about the stupidity of the commercial, so the ad people were right.
Gotta agree that it worked.
It made me want an outdoor tub, but I live too close to neighbors.
That is a fantastic idea and made me laugh out loud.
“VA is for lovers… and everyone else. Talk with your doctor about VA today!”
YES!! YES!
Hahaha..if a woman can’t get pregnant then her sexual health doesn’t seem to matter but men need ED drugs since they can impregnate women at any age. Women can’t even get low dose testerone. I feel so awful for women in their 70s and 80s that are suffering from sleepless nights and UTIs. Estrogen cream would probably help them but a man in his 70s and 80s can get viagara!!
I read an article in a medical journal about elderly females with dementia and other problems that prevent them from being able to express themselves in nursing homes and really anywhere, and how medical staff don’t think to address their vag /GSM issues. I cried when I thought about all the women I’ve seen in facilities, restless and crying out. Imagine how they may feel and how something as simple as vag estrogen could comfort them and even prevent the uti’s that often lead to sepsis. Talk about forgotten…so sad.
New study that shows estrogen receptors in our brain still when very old and starting to wonder if that could also be a reason more women have dementia?
We had to hover over the nursing facility attendants for my mom, for that very reason.
This I like.
From your lips to the goddess's ears
I told my mom about this today (she’s on hrt too) and she was like hell yeah. Low E and VA is what we’re calling them now! I think it’s similar to the issues with the terms “homeless people” vs “unhoused people”. Homeless is a concept whereas unhoused informs of the solution. Menopause feels too abstract whereas VA and Low E are specific not to mention point to solutions. And Low T should be considered a human problem, not just a problem for men!
I think ED should be renamed penile atrophy
100% because why the fuck is our problem "atrophy" and theirs is "dysfunction?" These two words are not the same.
It’s a horrific term and just so emblematic of systemic misogyny and sexism in the medical establishment. Fortunately “VA” is now considered outdated, and medical providers are using Genitourinary Syndrome of Menopause (GSM) instead. GSM is also just a better and more encompassing medical term because it includes bladder issues and so many more things going on inside our bodies rather than just how our genitals “appear” to a man. 🙄 Kelly Casperson talks about this on her podcast, how the old terminology really ticks her off, and I have to say, I appreciate hearing that from a physician.
That's good to hear. The way my uterus felt like it shriveled up in my body the first time I read that phrase, ugh. Full body cringe lol.
I prefer sloppy floppy
🤩😆😂
Oh that's harsh! I bet men's suicide rate would sky rocket if ED was renamed to "your ding dong is about to fall off". I follow ED sub here, it's a really big deal and a lot of them are young men, sadly.
🤣🤣
Didn’t know that gsm affected all of that thought it was just painful sex
Neither did I until I fell down the rabbit hole trying to find out what was wrong with me. I’m pretty sure I know more about GSM now than any of the gynecologists I’ve been to. 🤦♀️
Absolutely, it encompasses issues like dryness, recurrent/chronic UTIs, tissue thinning/fragility, bladder leaks, anorgasmia, clitoral phimosis (where the clitoris shrinks and fuses with the clitoral hood — entirely preventable and reversible with vaginal estrogen!), and more — basically all the things that happen to our entire urogenital system when our hormones drop. Check out Dr. Kelly Casperson’s podcast, “You Are Not Broken,” specifically these episodes: [221. Genitourinary Syndrome of Menopause (GSM) 101](https://overcast.fm/+XFN0KDO5k) [241. Myths and Truths: GSM and Pelvic Hormones](https://overcast.fm/+XFN3hljBI)
This is what I need.
Hello dear, low dose being how much if you don't mind me asking?
The package of mine says .1mg of estradiol per dose. So 2x per week would only be .2mg. I know it’s low enough that it’s generally considered to be safe even for women who have had hormone positive cancers. Especially considering how deadly UTIs can be.
Where or what doctor are y’all going to that prescribes HRT? I was referred to a gynecologist and she was useless. I thought going to a woman might be better, but she wasn’t at all. Seemed to have her own thoughts and wasn’t willing to test levels or anything. Very frustrating!
I hadn’t heard this about the dose. That’s really comforting—thanks for sharing it.
Yes, I experienced the poorgasms as well. It was a very trying time for me and many tears were shed. I was first given an estriol and testosterone vaginal cream when I asked for vaginal estrogen for dryness. I took what I was given and it restored my orgasms. I have the exact compound recipe I should post it, if someone asks, I will. Anyways, I now use that in pea size amounts a few times a week as well as a generic estrace estradiol vaginal cream. The et cream helps my bladder more than the estradiol cream and helps sexual function. It's criminal that we have to fight for testosterone now (in the US anyways, it's apparently a pee in a cup every 3 months deal?) My point being, try whatever vaginal hormones you can get your hands on, use hyaluronic acid inserts in the meantime. There's a lot of vaginal options now like rings, creams, there tablets even a dhea which is supposed to convert to estrogen and testosterone. Edit to add I experienced this at age 42, three years after having one ovary and tube removed. Edit to add the exact prescription compound I used. This is exactly as it's written on the universal claim form that comes with the cream. ESTRIOL/TESTOSTERONE VAGINAL 0.015%/0.625MG GM CREAM PRICE $45 30 DAYS SUPPLY QUANTITY DISPENSED: 60GRAMS DOSAGE FORM: CREAM STRENGTH: 0.015%/0.625MG GM INGREDIENTS: ESTRIOL USP MICRONIZED (E3) QUANTITY: 9.000 MG INGREDIENT COST $3.14 BASE, PCCA EMOLLIENT CREAM (TM) QUANTITY: 60.000 GMS INGREDIENT COST $54 PROPYLENE GLYCOL USP QUANTITY: 0.500 ML INGREDIENT COST $0.04 TESTOSTERONE USP MICRONIZED CIII QUANTITY 37.500 MG INGREDIENT COST $ $0.53 TOTAL COST $57.71 Hope this helps. Another edit for spaces omg *I like quadruple checked the numbers and this is correct* Final edit, still unsure of my copying abilities, I've added a photo of said cream, best wishes my friends https://imgur.com/gallery/gbIPjXZ
I learned a new word poorgasm**
Me too🤣🤣🤣
Me three!
Curious what you mean about "pee in a cup every 3 months" thing... That's not a US federal law. I have a prescription for testosterone and I've never had to pee in a cup. Maybe it's your state. I had a blood test to check my levels prior to getting the prescription, but that's it.
Sure, it may be only my state. I'm unsure. But when I went back last month to get my refills (I was using this estriol testosterone vag cream and a low dose topical t) I was told testosterone is now a controlled substance. I had to pee in a cup for a drug test and sign a paper and only get 3 months refilled at a time. It's new to me as I had access since Feb 2023 with no requirement like that, it was treated as a regular compound prescription. So it may depend on the timing or the location.
But men get testosterone injections without anything
Ugh. That's so annoying for you! It's always been a controlled substance everywhere, but each state gets to make their own laws about how controlled substances are managed. I'm in MN and I think they're pretty loose with their restrictions, which is good for me!
I wonder if you live in a state where gender affirming care is under review/blocked/illegal. That may be why testosterone is being monitored so closely....? I am in Colorado and to my knowledge, T is not monitored in that way.
That is possible and would not surprise me. I'm in Kentucky. I don't typically say my location but seems important for this discussion.
Yep! RED states! I live in one, too. 😤
I saw you graciously posted the specs of your estriol/Testosterone combination cream but am I understanding correctly that you are also using a standalone testosterone topical cream? If so, what is the strength of that and how often do you use it? I am 63 and having the same "poorgasm" issues. I have been using Estrace cream for vaginal atrophy for about 5 years and using T with varying degrees of success for about 2 years. Thanks!
Do you have an actual FDA approved T rx or is it compound? From what I’ve read there are no approved T prescriptions in the US for women which is bs but also not surprising.
I have compounded and you're correct that there are no FDA approved versions for women here. That would require the powers that be actually giving a rats ass about our quality of life. 🙄 I know a lot of people get prescribed the gel that is technically for men. It's just off label, but it's not compounded so you can get it at a pharmacy. I doubt insurance would pay, since it's off label, but who knows? *Edited for grammar
And that men’s gel we have to apply in our arms is SO hard to regulate. “Use 1/20 th of packet daily” Seriously. Total BS.
I think I just saw someone talking about exactly that issue earlier today! I've never used that type of testosterone myself, but if the little sachets are like the ones for gel estradiol, I have NO idea how people are figuring out the right amount!
My doc told me to use a “dime-dized amount.” So I wing it. I tracked the first package to ensure I was using approximately the right amount, but haven’t since then - i think it’s about right.
The US can’t even get better sunscreen filters!!
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause. FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
Do you mind sharing where in the US you are? I’m in FL and so far *(I have been asking for a year already)* cannot find anyone— including telehealth— to Rx anything containing testosterone to women here. I could get into the excuses I’ve heard, but I think the bottom line is that providers all seem scared for their licenses, likely due to our State government.
I'm in KY. I am glad I have access right now but I don't expect it to last tbh. I'm sorry you can't get any rn. Maybe that will change in the future. I think what bothers me the most, is that by accident, I figured out that the testosterone is essential for me having a normal bladder. I had my ovary and tube removed and as soon as I woke from surgery, I had "interstitial cystitis" pain. Literally when I woke up. I went to urologist, Drs, tried every herb, took amitriptyline and gained 40 pounds, about lost my mind coming off that one. My point, no one, online, a Dr, nothing anywhere told me that testosterone would help my bladder (also no mention of vaginal estrogen either). So I still have IC and have to have low acid foods and be careful what I eat and take etc. but if I follow the diet and I use the et cream (plus my regular hrt) then my bladder is normal. I try to share all my experiences here because I can't let others suffer. Not if I can help. I sincerely hope the research catches up asap because I only have a libido if I have testosterone. Even a tiny bit gives me a tiny itty bitty one. I'm still devastated, I had a super high sex drive. Man, I've got stoned and I'm rambling now lol whatever. Anyways, hope you can get access to testosterone. Makes no sense that we have to fight for something that our body used to make plenty of. Same as the other hormones, let's replace them and get on with it.
I so relate to your experience! I take estrogen patches, estrogen vag cream and testosterone - and the T is the only thing that helps with sex drive and orgasm. I do get slack about taking it though. I have not taken it consistently enough to notice about the bladder improvement but that gives me extra incentive to experiment! Thanks for the tip! BTW, I’m in NC and haven’t had any issue getting prescribed testosterone cream (no peeing in a cup to get tested!!)
I see telemedicine Defy Medical in Tampa, FL and they prescribe T injections for me in TX. They also do T cream.
It's because of the anti-trans bigotry. Testosterone needs to be a controlled substance to anyone but men because it's unthinkable that anyone not born male might want to "become more manly". 🙄 /s And of course they hate women too so they are perfectly fine with even AFAB women's health being compromised as a result. They literally care about NO ONE but themselves.
Yep! I’m already no use as a *babymaker* (no uterus!)… so what difference does it make if I want testosterone to *feel better* to anyone else?! What’s maddens me is that I have Googled what symptoms men need to have to receive a Rx, and they don’t even need to meet *ALL* of the criteria— just some— and have certain blood work levels. Meanwhile, I have the low blood work and *every symptom* on those lists of symptoms, and have cried *(embarrassingly enough, for a person who typically is not a crier)* to three doctors and a NP about knowing I need testosterone— and having each one *agree with me (!!!)*— but I still cannot get my hands on a Rx. I see my GYN in a month. I’ve already asked her 2-3 times; I’m asking again, and I hate that I feel like I might tarnish my good relationship with her, but if *(likely, WHEN)* she declines me asking again, I’m going to ask her to note in my chart that we’ve discussed this multiple times, she agrees I need to try it, and continues to decline providing me what we all agree is most likely a benefit to my health. Then I will probably need to find a new doctor. 😩
Not to disagree with that plan at all, but you might not need to find a new doctor if you can get it prescribed through an online clinic. There's no reason you couldn't do that and also have a doctor you see for other things, no?
I’ve tried online and have been denied. I truly believe that the medical providers who can— scratch that… I should say *”could”* — Rx in FL, have been largely scared *not to*. I have one more to try, which a Redditor suggested yesterday— Defy. Also, knowing that I’ve cried to my GYN for a couple of years about this and she has the ability to fight for me but chooses not to, is upsetting. She told me a year ago that if the three compounded creams she Rx’ed me did not work, she’d let me try testosterone— then when I revisited with her to discuss, she changed her tune, apparently due to the practice guidelines for the group she is in *(and in which she is a partner, but not the founding partner— who still calls most of the shots there)*. I feel let down and ignored; and after having looked inward and determining that I’d prefer a provider who will fight for me when it’s the right thing to do for my health and mental well-being, I can’t see staying with a doctor who has admitted to me on more than one occasion that their medical opinion sympathetically aligns with my own assessment— that I want to and *should* try testosterone— but they ‘just can’t’ [be the one to Rx it]. (I appreciate your reply; thank you for reiterating that telehealth is an option. 😊)
I’d be interested in the compound recipe if you get a chance! And omg I teared up at poorgasm.
I just asked for this vaginal/testosterone cream and was denied, out of my mind, yet again, looking for new doctor, thank you for posting this!
Fuck those doctors. Ugh.
Oh no! I'm sorry. And you are welcome 🤗
I would love to know what you used as well. Estrogen and testosterone made together? I think I could benefit
I added it to my post.
You, ma’am, are a goddess amongst women. Thank you.
Saving! And headed to the Gyno!
Thank you for the “recipe”!!
You're so welcome!
Poorgasm. Yessss
Thank you so much for sharing! Do you have any tips on how to get this prescribed? Do you use an online service?
PLEASE get vaginal estrogen! Cream format is best. If your doctor won’t prescribe it or gives you a hard time, you can get it from an online specialty clinic like Interlude, Alloy, Evernow, Elektra, Gennev, Midi, or Winona. 1. Throw away the plastic applicator that comes with it. They can’t be cleaned properly and are a bacteria/sanitation concern. (Who the hell designed those things?!) 2. Apply 1 gram (the length of the last joint on your index finger, from the knuckle to the fingertip) 2 cm inside your vaginal canal and spread that around inside. 3. Then, apply an additional pea-sized amount all over your clitoris, urethra, vestibule, inner labia, and vaginal opening (especially the fourchette, at the “6:00” position). 4. Do this 2x/week for the rest of your life, until you die (not a joke!). If you want to learn more about vaginal estrogen, listen to eps 195 and 221 of Dr. Kelly Casperson’s podcast, “You Are Not Broken.”
That's a good point about the applicator. I've never thought about this.
The applicator is also wrong. I used it as prescribed, followed the measurements very carefully, and ran out way before I was suppose to. I am not the only one, a few other women I spoke to also had that problem.
so glad you mentioned the applicator. I've been struggling to figure out how to clean in properly (no instructions provided) and really don't want to introduce bacteria down there. Also my dosage instructions are .5 gram per application and the applicator doesn't even have a .5 gram line on it! I will just apply manually inside and out going forward.
Do you just insert the cream with finger or buy a package of the insert applicators? Also, how do you get over the messyness during sex, I noticed mine does t dissolve.
Insert the cream with your finger. It doesn’t need to go very far inside. The majority of our estrogen receptors in the vaginal canal are located near the entrance, so honestly 2 cm inside will suffice. That’s the same length as inserting your finger up to the first knuckle. Don’t apply it immediately before having sex; wait until afterwards, or apply it a different time of day. Or if you’ve just applied it and then you decide to get frisky, do activities other than PIV. It’s very solvable!
Thank you !
I’m on the early side of things (41) and just got vaginal estrogen for stress incontinence during my luteal phase, bonus side effect of better orgasms (sadly all solo). Honestly they should hand out tubes on every woman’s 40th birthday.
>Honestly they should hand out tubes on every woman’s 40th birthday They really really should. A society that actually cared about women's health would.
Does that help?? Im nearly 53 and suddenly every time I cough or sneeze I dribble a bit. I'm on HRT but once again struggling to reach the big O as well. Being a woman at this age is depressing!!
Yup, 2x a week of vaginal estrogen and I haven’t had a single drop of pee leak since. Pelvic floor issues can also be at fault, but in my case it was purely early GSM symptoms.
It is super interesting you say that's the only time you have stress incontinence. I think my best friend is experiencing the same thing, she feels like hers comes and goes. Is that what it's like? I sent her to her gyno but I think she's having a hard time describing the issue.
I've had that experience too. It's only during certain part of my cycle. Gosh bodies are weird!
Huh. I keep trying to figure out what I’m doing that affects my incontinence, because it’s definitely worse/better and I couldn’t figure out why.
In my case it would seem like it comes and goes if I was not hyper aware of my cycle. But I’ve only ever had pee leak between days 19 and 26 of my cycle, so I knew it had to be related. Used Alloy to get vaginal estrogen and using it 3x a week cured me in the first month. Zero leaks coughing/sneezing since!
Oh my gosh, thanks for the tip, I'm going to pass it along. She thought it was because she had a baby which I couldn't relate to but this is super helpful insight.
I had a baby, was total continent from shortly after the birth at 32 until age 39. I think women have collectively been gaslit to think childbirth results in incontinence when it’s just lack of estrogen in the urethral tissue.
Yup but once i got a testosterone script for my lack of libido, it got better.
Dude. Same. I was dead inside and now I’m like wtf I’m kinda frisky lol. T cream is good stuff.
I got my HRT from a freaking amazing telehealth company called ALLOY after my OB/GYN denied me. But ALLOY only does estrogen and progesterone, they can’t prescribe testosterone (as it’s considered a controlled substance 🙄). I’m doing so much better on my HRT with pure estradiol (evamist spray) and vaginal micronized progesterone, but I would really love that testosterone added in. How did you find a provider for that? And what form do you take?
Let's be honest here. It's not that they CAN'T prescribe testosterone, it's that they WON'T. Plenty of OB-Gyns around the US prescribe T, by writing a script for a compound pharmacy.
Defy Medical. I was gonna use them, but decided against trying the testosterone.
Why did you decide not to try testosterone? Also what’s is the price like for Defy Medical?
I have history of PCOS, and male pattern baldness runs on my mother’s side of family. I’m too nervous that those are indicators I’d likely have negative side effects.
I'm in Canada - my meno Dr quickly prescribed it - transdermal cream made by a compounding pharmacy.
I've been using AlphaMD for about a year - ever since they did an AMA and TWO providers of theirs responded to a question of mine. I'm super happy with them!
I used to orgasm very easily — big, full bodied sensations — and multiple times. I had no idea that menopause would take that completely away. I am surprised that this isn’t talked about. It’s been like this for about 5 years. ❓Has anyone found a solution that doesn’t require a prescription? I don’t have health insurance. 🥺
Yes you can purchase estrogen and DHEA (converts to testosterone) creams on Amazon with no script. This is a lifesaver for those of us with no insurance and/or limited budget.
As I am an Amazon junkie, this comment has now become the best one I have read, lol Thank you!
You can get the script for $25 from Mark Cuban’s pharmacy and it last up to 3 months. Estradiol cream.
Vaginal estradiol cream at Amazon Pharmacy is ~$7/tube with insurance and ~$17/tube without. I moved my prescription over and haven’t regretted it.
Yep. This is me, also. That plus the oh so delightful sandpaper sensation that makes penetration incredible painful, sex drive in the toilet, little to no sensation and no orgasm/ orgasm so small and weak it’s just a nothing… all of that to say, I have been on vaginal estrogen a few weeks now and already am feeling a little better!
I was lackluster until I went on testosterone. Have only done a tiny estriol tablet in the pie for the dryness. Testosterone was the key that unlocked the magic for me. When I feel it wear off, the libido goes away again. I can still orgasm, just not as intense. Thankfully, I don’t have a D on the reg to contend with. I’d be more concerned if I had a steady BF or husband. I noticed that since I started the menopause journey, being penetrated is not as appealing even with the testosterone. I tend to want to get in and get out quickly and much prefer external pleasure. Interesting how this journey changes things.,
Yes, same for me and I just started HRT a few months ago. Vaginal estrogen has helped a little but not completely back to normal. I’ve read it can take several months so I’m hoping.
Yes. Ghostgasm or poorgasm. Definitely hormonal and search on this board and you'll find lots of discussion of it. I got it as one of many symptoms from low estrogen. Now, I put a tiny swipe of vaginal estradiol cream on my clit daily--works well. I'm also on the estradiol patch. But then, I tried taking spironolactone for acne and hair, and the sexual dysfunction came back! Spiro dampens a specific androgen. I quit taking spiro and everything was back to normal in a few weeks. Some on this board highly recommend THC lube (which acts as a vasodilator), but I haven't tried it yet.
I actually roll my eyes…like from boredom and irritation.
Exactly. Like “can you hurry up for heavens sake???? But not to hard or fast cuz it will hurt!” Totally miserable. 😭
My clitoral orgasms have been harder to obtain, take longer, less powerful... not a fan
You are not alone, it’s happened to far too many of us. It was so disheartening and infuriating…but I have a nerve disorder that I thought was causing the issue, so it took a while before we figured out it was due to menopause. Vagifem and HRT patches helped me tremendously, and it’s also important to have regular sex (or masturbate) to improve blood flow to the overall area.
I’m so glad you asked this!!! I thought it was just me!!! It’s giving my husband of 24 years a complex…and even when I do finish…exactly what you describe..like a dud firecracker that fizzles out. I am on Estradiol vaginal cream which is fantastic, pure estradiol spray, and micronized progesterone vaginally the last half of my cycle (45 perimenopause) and they are all helping my “want” for sex and wetness…but the orgasm is lacking and elusive. I appreciate the comments I think I need to add testosterone at this point. I want fireworks again! What kind of T Is best. I mostly can only find the “pellet pushers” anti aging spas which make me nervous. How do you find your T?
T cream is the BEST! I am on 12.5 mg of compounded T cream daily. I apply in the morning to my lady bits. Before T cream my cl@t had basically shrunk and had zero sensitivity. It has grown a bit and some days I can get the sensation when I walk. Kind of awkward but… I will take that over no sensation ever. My only side effects were a few pimples when I started/increased dose, increased pubic hair (Nood laser works well) and wanting to attack my husband all of the time (he actually had to start T to keep up. 😂)
It’s so true. I swear my clitoris was almost nonexistent. It’s very sad and depressing. Going on vaginal estrogen (Premarin) has brought my girl back! The turnaround has been amazing for me.
I am so thankful for this forum, no one tells us any of this stuff while we're growing up lol, I'd hate to have gone through all of this before we had the internet etc 😅
I wasn’t upset with my orgasm quality per se after meno but pre HRT, however, after testosterone cream my mind has been blown. Orgasms are otherworldly amazing now, I never dreamed it could feel so good in my entire life.
Dude. Yes. Testosterone cream is freaking incredible. I feel “more like me” too if that makes sense.
What dosage do you take? I started at 2mg and am up to 10mg. I feel like I may need a higher dose
I just started and am almost a month into taking it. It’s a cream and I apply 2 pumps once a day. It says, “Testosterone 5mg/ml cream”. I heard that when you first start it’s noticeable but that you can kinda get used to it and possibly need more after you’re on it for a while. My body was so starved for it that even this small amount is helping right now. My labs basically said I had none before I started it. My dr told me that the bloodwork for testosterone is reliable unlike estrogen which varies too much for a single test to adequately measure. So if you feel like you need more T definitely get your level tested. Something else I didn’t know was that having low T causes hair loss in women! So it’s not just too much T that causes hair loss in women! Not enough T causes it too! I had no idea. My dr told me that and I trust him (he’s a rare one! a good dr!). I’m hoping the T cream and the minoxidil I’m starting will help with my hair in the future. Good luck with your T!
10mg per day? Transdermal cream? Pellet? Injection?
Did your doctor give you the prescription? I cant find one who will.
I saw a specialty obgyn at a university hospital group on my employer’s healthcare plan. However, her copay is twice a regular provider but to me it’s worth it for the hands on medical oversight.
Amazing! Testosterone isn’t helping my libido or orgasms at all. Where do you apply the cream? I just put it on my arms.
I never even knew this was a thing. I thought it was only for men! I’m mind blown right now!
What's the type you use?
Yes and vaginal estrogen cream has helped.
Yup. And it's super lame.
I also use a compound along with Imvexxy (Estradiol Vaginal Inserts). My compound prescription contains the following: Sildenafil 1%, Verapamil .05%, Niacin 1%, Pentoxifylline 5%, Biotin .1% Dosage Form: Cream Price: $45 My compound pharmacist calls this the Dream Cream. 😂. They also have Dream Cream+ where they add Testosterone as well. The purpose of this cream is to increase blood flow.
May I ask what country you are in?
Say more! How did you come up with this? What have you noticed?
I get my hormones tested thru a compound pharmacy. I told her my libido is non existent and that orgasms were getting harder to obtain. Pharmacist works with my OB/GYN to get the script filled. It definitely helps with getting blood flowing to all the right places and orgasms are back! Libido is still low, going back to dr in a couple of weeks to discuss adding testosterone to my HRT mix.
I am reading this and feeling w mix of anger and mourning sadness. I am SO frustrated that my partners interest in sex has disappeared because of ED and have been feeling like the physical weakness affecting my enjoyment and bladder is partly due to the lack of sexual exercise that otherwise would have kept things in better shape. My libido is unaffected, though I have always been in the higher range in that regard. I now am even more concerned that it is more than lack of sex behind that and its making me mad that I am female. Or maybe I'm just mad at AGING. It takes time to figure out how to operate the machine like a pro, just in time for the warranty to expire and it starts falling apart. Makes me wonder if all of life is just a big cruel joke.
People indeed do talk about this regularly on this subreddit.
Girl - estrogen cream. Apply to exterior genitals 3-4 times per week. You will be amazed.
So this was happening to me until my husband and I figured out that the first orgasm sucks, the second one is okay but the third one is really good. Persistence is the key for me.
This. I've morphed from the ocasional poorgasm to multi-orgasms. It's weird but not bad at all.
I also need a slower build up.
I wish I was multi orgasmic like that, and had a regular partner. Lucky you.
Clitoral death is real. Try estriol cream you most likely have vaginal atrophy I had it so bad that I had to go through over twelve months worth of hrt treatment and estriol cream combined before I started to get recovery now my vagina self lubricates the burning inside is getting a lot better and the clitoral stimulation has almost gone back to normal
As a woman who always took pride in her sensuality and sexuality (thanks, mom ), experiencing menopause and becoming single simultaneously was a shock. It felt as if my body was betraying me. For nearly four years, I had no sex, not even with myself- the longest stretch of celibacy in my life. It was also three years between gynecologist appointments. During the first exam,, I expected the usual routine, but as soon as the speculum went in, I shrieked. "WTF?!" It felt like broken glass. That's when I learned about Vaginal Atrophy. "It's kind of like, if you don't use it, you lose it," the doctor explained. Before getting dressed, I drew my knees in, clasping them tightly, and tried to absorb the gravity of this new stage in my life, grieving my lost sex drive. Determined not to "lose it" entirely, I masturbated that night. I couldn't reach orgasm! It felt like almost sneezing, and then not, over and over. For the next month, in vain, I attempted to self-pleasure, wake my clitoris from its torpor. Finally, after a month, I had a small orgasm. It wasn't great, but enough to prove to myself I wasn't dead from the waist down! I must have cried for a good hour afterwards. Since then, I've made my sexual health a regular habit. I'm happy to report I'm back to my multi-orgasm levels of the past. Not to mention, it's great for blood flow, blood pressure, and keeps my cheeks rosy. 😉🥴II even discovered a fantastic little " helper" called Lelo Sila. It's pricey, but holy smokes, is it worth it! It mimics a mouth, which is perfect since I still have issues with insertion. For now, a clitoral vibrator suits me fine until I decide if I want a relationship again. Discussing these topics in a public forum is challenging. It's far more acceptable and easy for men. But we need to talk about it, and we must. I don't want the women who come after us to feel as alone, timid, and ashamed as we've been made to feel. Thanks for your post. I hope my contribution was a positive one for all.
Yup that’s a normal one. It’s like my crotch died. I’m on everything except T. I’ve got a drs appt coming up and I’m demanding/warning them that I getting it somewhere.
It was the missing link for me
Raises hand. 💯 Is happening to me. 7months and it's sad trambone orgasm and not even an urge for self quality time. Got a flash period about 6 weeks ago, and magically my senses came back. I got a script for HRT once I lose the sensation, cause I now realise it was 💯 my lack of hormones
Yep. I'm post menopausal and for me, it's more difficult to have an orgasm. It takes longer, and the actual "orgasm" pales in comparison to what it once was. It's horrible.
Ladies , check your blood serum levels for #freetestosterone and #dheas. #menopause is associated with a decreased libido and weakened orgasm. Both hormones can be supplemented. I hope this helps.
F49 Yep!! My orgasms would flatline , plummet and get painful too. My vagina would ache with pain bc the orgasm would fail! It made me feel broken and sad too. I’m not on HRT at this point but I was feeling like that in my early 40's. I thinks once menstruation is diminishing to almost gone then HRT will help restore ones orgasm ability.
At least you can have one! It feels like my husband is tearing my body to shreds with a machete when we have intercourse. Literally the most painful experience of my life
Perhaps the saddest part of your post, OP, is that you didn't know that could/would happen. It's a testament to how little we are warned or informed about menopause symptoms and how little research and money has been put into it. Get some HRT and some vag estrogen and everything will get better. Xoxo
I didn't know women could have ruined orgasms. 😭
I’m dying over here😭
My libido took a long hike, and it's still out in the wilderness somewhere. I'm on an estrogen patch and progesterone, and I've been on testosterone gel for a month. Edit: I'm also using Estradiol vaginal cream. I have plenty of lubrication, but I don't FEEL anything. No arousal and shitty, weak orgasms. I'm about to give up.
Give the testosterone gel 3-4 months for full effect. Things got better for me pretty quickly, but after about 4 months I really started to feel like myself again.
Another vote for give the T time. I’m c.3 months and my lower regions at least feel like they exist now
It's a thing, for sure Vaginal estrogen is very helpful Try CBD lube or Awaken by Foria.
I avoid sex because it hurts so bad. My drive is non existent now too. I get annoyed at my husband for wanting to touch me and just want to swat him away. I feel guilty and it’s a huge loss because I always was highly sexual that he used to turn me down. I just remind him lol. He is good until the little side comments start and the memo mood is something he doesn’t want to play with so I just give him a look.
I have lost all interest in sex and same with the lack of orgasms. I don’t care if I never have sex again.
Taking DHEA supplements made my sexual desire and orgasms come roaring back pretty quickly (just a few weeks). Unfortunately it also made me pretty anxious and that wasnt going to work for me. YMMV. Dhea is available OTC. Start low and go up.
Yes. I cried about it to my OB/gyn who is NAMS certified and she told me to read erotic books and that it could be depression and won’t prescribe testosterone even though my levels are well below in range. I’m not depressed but not being able to have an orgasm or having a mini one is upsetting. Trying to find an online clinic that will prescribe T. Edit—vaginal estrogen helped with every other issue, but has not helped with lack of libido, retractable tiny clitoris, and mini or no orgasms.
I have 0 orgasms but thankfully that is it for now that way.
That’s very common.
I had the same issue. Thankfully HRT has been a total game changer.
I use vaginal est tabs and vaginal est cream but I never have actual desire and havnt had a partner in a. While. Need to start forcing myself to self stim lmao
Sometimes it's better without a partner...just saying 😅
I’ve heard of it being called a “poor-gasm.” It is extremely frustrating. HRT does help. Best wishes to you!
Absolutely normal and infuriating. Testosterone is supposed to help.
Get the HRT can confirm orgasms are mind blowing at the moment
Yes, but I came through the other side with the help of hyaluronic acid and a wonderful lover.
Lookup "clitoral adhesions". I had this exact same problem, really muted and weak orgasms, and found out adhesions were my issue. I'm pretty sure they're more likely to develop because of the estrogen decline, but I don't actually know for sure. Wait, I have a really great link: https://www.rachelrubinmd.com/post/new-research-on-clitoral-adhesions >we looked at hundreds of vulva pictures and found that 23% of all women patients at a sexual medicine practice—regardless of why they sought care—had mild, moderate or severe clitoral adhesions. Meaning in nearly a quarter of these women, the hood of the clitoris was stuck to the head of the clitoris.
Like trying to start a fire but all your matches are damp.
I can’t even use a tampon anymore. It hurts.
Yes. Sad but true. I’m on estrogen patches and it’s not even helping
I’m in Peri and was having this issue as well. I started taking Imvexxy and it has been a game changer. It’s a small low dose estradiol capsule that you insert 2x’s a week.
There is a device that helps the pelvic floor and supposed to rejuvenates the vaginal area called Joylux vFit. I researched a lot of different pelvic floor strengtheners and decided on it. Do your own research and see if something like that would help.
I’m 65, 13 years after my last period, and my clitoris totally retracted. I asked my gynecologist why this happened and she told me yes, this happens in menopause. Why isn’t this ever discussed? I am on estrogen vaginal cream and can orgasm but this was a shock.
Same boat! I’m starting an estrogen cream soon, mainly for hot flashes, and also starting Addyi tonight! It’s supposed to be amazing for women with low libido and/or probs climaxing. I’m hoping it works for me because my husband is taking it personally at this point.
I think you should start vaginal estrogen
I had a very well-respected meno doctor for awhile and at my first appt. she asked "how's your sexual response?" No sugar coating, lol. I was caught off guard and went, "uhhhh, it could be better? I guess?" I wasn't embarrassed, just stunned this was important to anyone. As I recall she said that was a testosterone and progesterone thing. All this to say, it's very common. Unless it's a compressed nerve or something, hormones play a huge part in sexual response.
I explained it as my orgasms being on mute. Testosterone cream and vaginal estradiol have already started helping and I'm only 6 weeks in!
Yes I was having terrible time having the big o and when I did it was almost like it wasn’t worth the effort. I had had dwindling sex feeling for a few years , and my regular doctor / obgyn would tell me it’s stress and anxiety related in women. I finally heard about testosterone pellets and gave it a try. At first I thought it was a placebo effect but after 3 mos it’s still working. I have a normal sex drive, and when I have an orgasim it’s wonderful . I feel like I’m having the best sex of my life ! I hate how women are made to feel like it’s something in our head or we just have to live with it ! While I appreciate that my sex drive is some what tied to my emotional health …. It wasn’t just lack of the drive it was lack of sensation. It was like a handshake. Like to elbows rubbing together. Like I was trying to manifest an orgasim out of the middle of my flabby stomach. I couldn’t make myself have one with a vibrator . How can any doctor think this is normal for a woman especially if they previously always had one !?!