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Low Libido after several years of surgical menopause Low Libido after several years of surgical menopause

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Unread 08-25-2009, 07:52 PM
Low Libido after several years of surgical menopause

Question is this- can libido change several years post hysterectomy?
I am four years post surgical menopause for endo.ca. and I noticed that my libido for the past year has been low to non-existent. I waited before being concerned, because I wanted to rule out other factors such as relationship (stable 3.5 yrs.), environment, etc., but weighing out all the other variables led me to the same conclusion- something is drastically wrong. Particularly since other forms of sexual pleasure (i.e. masturbation, erotic massage) were not of interest to me either. Finally chose to speak w/dr., but couldn't get in to see my regular one. So, chose to go to a dr. in her practice. The appt. was somewhat discouraging- she said that after several years, it's unlikely that I would have such a drastic change- that I would have had low libido right after surgery. From what I've read, that may not be true, but I had to specifically request to get testosterone. (I started w/ 2% gel today). I am on .5 mg. Estradial, and have been somewhat stable for the past year and 1/2, but the change in libido has been drastic and extremely disappointing. She did take blood, but gave me no indication of follow-up on results. What should I be aware of with blood test? Also, don't know how long I should continue w/testosterone gel or what the long term effects are. This dr. actually said that if it were her, she would not even go w/HRT (I won't be going back to someone w/such a lack of understanding). Having had cancer, I feel very fortunate that I was able to survive without having chemo or radiation. However, losing my ovaries and ability to have children was a pretty major thing- now my sex drive? If I can, I'd like to hang on to it as long as possible. I welcome your support and suggestions.
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Unread 08-25-2009, 07:57 PM
Re: Low Libido after several years of surgical menopause

I was not able to restore libido with patches alone, BUT.... with Femring or other forms of systemic vaginal estrogen, it has returned. It was gone/missing for almost a year, now has returned. I use Estrace tablet (portion thereof) vaginally. The testosterone did not do it for me, the vaginal estrogen did.

Hope you find a more sympathetic doctor and get the relief you need soon.
I would request copies of all bloodwork hormone testing so you can see where things are at, and perhaps note how you're feeling and on which meds, on the results page for future reference.
Unread 08-26-2009, 09:35 PM
Re: Low Libido after several years of surgical menopause

Calypso: are you still using the patches or only femring and estrace? How long have you been using the femring? What dose and is it more consistent then the patches? Thanks.
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Unread 08-27-2009, 06:45 AM
Re: Low Libido after several years of surgical menopause


I am only using Estrace tablets vaginally at this time. I quit the patches twice. Never got relief from them, despite upping dose from 0.0375 to above 0.1mg. I loved Femring 0.1mg but it didn't last more than 3-4 weeks for me before low estrogen symptoms returned. I found Femring to be more evenly dosed than the patches. I think it wore off early for me because I'm on a lot of thyroid meds and the estrogen and thyroid meds compete for binding sites.

I noticed a surge in libido with Femring within a week. I just don't get relief without the estrogen being delivered vaginally. So now I use pieces of Estrace generic tablet vaginally for all my estrogen needs. Have been doing it for almost 6 weeks now. (see thread: can you use estrace tablet vaginally - for more info).
Unread 08-27-2009, 05:40 PM
Re: Low Libido after several years of surgical menopause

I also had surgical menopause -almost 4 years ago and my libido pretty much disappeared after a year although it was great just after surgery.
I definitely needed testosterone. Apart from bringing back libido it increased my energy levels and gave me back my zest for life. I don't need to use it very often now as my levels are up.
I don't use systemic estrogen but I do use an estradiol oil vaginally which really switches on libido for me. I would suggest you ask for some kind of local estrogen such as estriol to target the area specifically.

uk lady
Unread 08-27-2009, 06:54 PM
Re: Low Libido after several years of surgical menopause

Yeah, I'm in the same spot with libido....it's been 4 years for me, too, since my LAVH. Last time I saw my doctor she said to increase my frequency of testosterone cream use; I was using it twice a week, and she upped it to 4. Well, it did help my libido...but also caused a dramatic hair loss! Great. So my choice is to be bald or have a normal libido...wonderful. I dropped back the testosterone immediately to previous levels--and my libido went right back to zero.
Unread 09-03-2009, 08:01 AM
Re: Low Libido after several years of surgical menopause

I'm 1 year out from surgery, been using Vagifem for estrogen since surgery, but, with absolutely no sex drive at all, in fact very little passion for anything. However, I did'nt realize just how dispassionate I was until 2 weeks ago when I started with testosterone cream. Within a week, my life is back! Sex drive is not 100%, but infinitely better!!!!
Unread 09-03-2009, 11:05 AM
Re: Low Libido after several years of surgical menopause

Originally Posted by Calypso
I just don't get relief without the estrogen being delivered vaginally.
Technically, Femring doesn't deliver estradiol vaginally. It delivers estradiol acetate vaginally, and estradiol acetate isn't usable for symptom relief. However, when the estradiol acetate enters the bloodstream, it encounters the enzyme esterase, which converts it to estradiol. The estradiol is then delivered to the vagina via the bloodstream, just as with other methods.

(((beav))) I'm so sorry you had such an unsupportive doctor and hope you find a new one who will work with you to restore your libido. I would, though, call your old doctor's office and request a hard copy of the blood test results so you can see exactly which test(s) were run and what the results are.

Ideally, they would have tested your serum levels of free and total testosterone, plus checked your lipids (cholesterol) and liver function. The free testosterone number is the one that's most predictive of libido. Lipids and liver function can be adversely affected by testosterone use (though the effect would be greater with oral testosterone than with gels/creams), so those things should be followed up on after you've been on the testosterone a while to make sure you're doing OK there.

It can take several weeks to see an effect of testosterone on libido, so try to be patient and stick with it a while. Don't be tempted to up the dosage to hurry things along... that's where you can get into trouble, when you build up too high a level of testosterone. If you start feeling an increase in energy level and sense of well-being, you are on the right track. If you start developing acne and oily skin and hair, you know to ease off on the testosterone a bit. Cystic acne means you're definitely getting too much.

I hope this helps... and best of luck finding the right doctor for your needs.


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