Category Archives: Hormone Therapy

New treatments restoring sexual pleasure for older women


By Tara Bahrampour

When the FDA approved Viagra in 1998 to treat erectile dysfunction, it changed the sexual landscape for older men, adding decades to their vitality. Meanwhile, older women with sexual problems brought on by aging were left out in the cold with few places to turn besides hormone therapy, which isn’t suitable for many or always recommended as a long-term treatment.

Now, propelled by a growing market of women demanding solutions, new treatments are helping women who suffer from one of the most pervasive age-related sexual problems.

Genitourinary syndrome, brought on by a decrease in sex hormones and a change in vaginal pH after menopause, is characterized by vaginal dryness, shrinking of tissues, itching and burning, which can make intercourse painful. GSM affects up to half of post-menopausal women and can also contribute to bladder and urinary tract infections and incontinence. Yet only 7 percent of post-menopausal women use a prescription treatment for it, according to a recent study.

The new remedies range from pills to inserts to a five-minute laser treatment that some doctors and patients are hailing as a miracle cure.

The lag inaddressing GSM has been due in part to a longstanding reluctance among doctors to see post-menopausal women as sexual beings, said Leah Millheiser, director of the Female Sexual Medicine Program at Stanford University.

“Unfortunately, many clinicians have their own biases and they assume these women are not sexually active, and that couldn’t be farther from the truth, because research shows that women continue to be sexually active throughout their lifetime,” she said.

With today’s increased life expectancy, that can be a long stretch – another 30 or 40 years, for a typical woman who begins menopause in her early 50s. “It’s time for clinicians to understand that they have to bring up sexual function with their patients whether they’re in their 50s or they’re in their 80s or 90s,” Dr. Millheiser said.

By contrast, doctors routinely ask middle-aged men about their sexual function and are quick to offer prescriptions for Viagra, said Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause.

“If every guy, on his 50th birthday, his penis shriveled up and he was told he could never have sex again, he would not be told, ‘That’s just part of aging,’” Dr. Streicher said.

Iona Harding of Princeton, New Jersey, had come to regard GSM, also known as vulvovaginal atrophy, as just that.

For much of their marriage, she and her husband had a “normal, active sex life.” But after menopause sex became so painful that they eventually stopped trying.

“I talked openly about this with my gynecologist every year,” said Mrs. Harding, 66, a human resources consultant. “There was never any discussion of any solution other than using estrogen cream, which wasn’t enough. So we had resigned ourselves to this is how it’s going to be.”

It is perhaps no coincidence that the same generation who first benefited widely from the birth control pill in the 1960s are now demanding fresh solutions to keep enjoying sex.

“The Pill was the first acknowlegement that you can have sex for pleasure and not just for reproduction, so it really is an extension of what we saw with the Pill,” Dr. Streicher said. “These are the women who have the entitlement, who are saying ‘Wait a minute, sex is supposed to be for pleasure and don’t tell me that I don’t get to have pleasure.’”

The push for a “pink Viagra” to increase desire highlighted women’s growing demand for sexual equality. But the drug flibanserin, approved by the FDA in 2015, proved minimally effective.

For years, the array of medical remedies has been limited. Over-the-counter lubricants ease friction but don’t replenish vaginal tissue. Long-acting mosturizers help plump up tissue and increase lubrication, but sometimes not enough. Women are advised to “use it or lose it” – regular intercourse can keep the tissues more elastic – but not if it is too painful.

Systemic hormone therapy that increases the estrogen, progesterone, and testosterone throughout the body can be effective, but if used over many years it carries health risks, and it is not always safe for cancer survivors.

Local estrogen creams, suppositories or rings are safer since the hormone stays in the vaginal area. But they can be messy, and despite recent studies showing such therapy is not associated with cancer, some women are uncomfortable with its long-term use.

In recent years, two prescription drugs have expanded the array of options. Ospemifene, a daily oral tablet approved by the FDA in 2013,activates specific estrogen receptors in the vagina. Side effects include mild hot flashes in a small percentage of women.

Prasterone DHEA, a naturally occurring steroid that the FDA approved last year, is a daily vaginal insert that prompts a woman’s body to produce its own estrogen and testosterone. However, it is not clear how safe it is to use longterm.

And then there is fractional carbon dioxide laser therapy, developed in Italy and approved by the FDA in 2014 for use in the U.S. Similar to treatments long performed on the face, it uses lasers to make micro-abrasions in the vaginal wall, which stimulate growth of new blood vessels and collagen.

The treatment is nearly painless and takes about five minutes; it is repeated two more times at 6-week intervals. For many patients, the vaginal tissues almost immediately become thicker, more elastic, and more lubricated.

Mrs. Harding began using it in 2016, and after three treatments with MonaLisa Touch, the fractional CO2 laser device that has been most extensively studied, she and her husband were able to have intercourse for the first time in years.

Cheryl Edwards, 61, a teacher and writer in Pennington, New Jersey, started using estrogen in her early 50s, but sex with her husband was painful and she was plagued by urinary tract infections requiring antibiotics, along with severe dryness.

After her first treatment with MonaLisa Touch a year and a half ago, the difference was stark.

“I couldn’t believe it… and with each treatment it got better,” she said. “It was like I was in my 20s or 30s.”

While studies on MonaLisa Touch have so far been small, doctors who use it range from cautiously optimistic to heartily enthusiastic.

“I’ve been kind of blown away by it,” said Dr. Streicher, who, along with Dr. Millheiser, is participating in a larger study comparing it to topical estrogen. Using MonaLisa Touch alone or in combination with other therapies, she said, “I have not had anyone who’s come in and I’ve not had them able to have sex.”

Cheryl Iglesia, director of Female Pelvic Medicine & Reconstructive Surgery at MedStar Washington Hospital Center in Washington D.C., was more guarded. While she has treated hundreds of women with MonaLisa Touch and is also participating in the larger study, she noted that studies so far have looked only at short-term effects, and less is known about using it for years or decades.

“What we don’t know is is there a point at which the tissue is so thin that the treatment could be damaging it?” she said. “Is there priming needed?”

Dr. Millheiser echoed those concerns, saying she supports trying local vaginal estrogen first.

So far the main drawback seems to be price. An initial round of treatments can cost between $1,500 and $2,700, plus another $500 a year for the recommended annual touch-up. Unlike hormone therapy or Viagra, the treatment is not covered by insurance.

Some women continue to use local estrogen or lubricants to complement the laser. But unlike hormones, which are less effective if begun many years after menopause, the laser seems to do the trick at any age. Dr. Streicher described a patient in her 80s who had been widowed since her 60s and had recently begun seeing a man.

It had been twenty years since she was intimate with a man, Dr. Streicher said. “She came in and said, ‘I want to have sex.’” After combining MonaLisa Touch with dilators to gradually re-enlarge her vagina, the woman reported successful intercourse. “Not everything is reversible after a long time,” Dr. Streicher said. “This is.”

But Dr. Iglesia said she has seen a range of responses, from patients who report vast improvement to others who see little effect.

“I’m confident that in the next few years we will have better guidelines (but) at this point I’m afraid there is more marketing than there is science for us to guide patients,” she said. “Nobody wants sandpaper sex; it hurts. But at the same time, is this going to help?”

The laser therapy can also help younger women who have undergone early menopause due to cancer treatment, including the 250,000 a year diagnosed with breast cancer. Many cannot safely use hormones, and often they feel uncomfortable bringing up sexual concerns with doctors who are trying to save their lives.

“If you’re a 40-year-old and you get cancer, your vagina might look like it’s 70 and feel like it’s 70,” said Maria Sophocles, founding medical director of Women’s Healthcare of Princeton, who treated Mrs. Edwards and Mrs. Harding.

After performing the procedure on cancer survivors, she said, “Tears are rolling down from their eyes because they haven’t had sex in eight years and you’re restoring their femininity to them.”

The procedure also alleviates menopause-related symptoms in other parts of the pelvic floor, including the bladder, urinary tract, and urethra, reducing infections and incontinence.

Ardella House, a 67-year-old homemaker outside Denver, suffered from incontinence and recurring bladder infections as well as painful sex. After getting the MonaLisa Touch treatment last year, she became a proslyter.

“It was so successful that I started telling all my friends, and sure enough, it was something that was a problem for all of them but they didn’t talk about it either,” she said.

“I always used to think, you reach a certain age and you’re not as into sex as you were in your younger years. But that’s not the case, because if it’s enjoyable, you like to do it just as much as when you were younger.”

Complete Article HERE!


The Thrill Is Gone


Name: Billy
Gender: Male
Age: 46
I have heard it’s normal for sex drive to diminish as you age. I’ll run this by you. I’m a 46 year old male and the last time I was at a strip club with bare boobs bouncing around me, you may as well have rolled a grapefruit across the floor. Actually, I can see more use from the grapefruit. I don’t recall the last time I did it, and jerking off was almost disgusting. My tool has shrank to nothing. I barely touch it and it just dribbles, it doesn’t fire off anymore. I don’t even like to touch it to go piss anymore. I’ve had to shave around it, so I actually find it, to keep from pissing my pants. Is this normal?

No, Billy, this isn’t normal. I think you already know that too, right?

andropauseDo you know anything about andropause? If not, you ought to. Here’s what I suggest. Use this site’s search function in the sidebar. Type in the key word: “andropause” and you will come up with a wealth of information about this issue.

You can also use the CATEGORY pull down menu. Look for the subcategory: Sex and Aging, under the main category: Aging. Everything is alphabetized.

But for the time being, here’s a typical question and response —

Name: Wilson
Gender: male
Age: 58
Location: Lancing MI
I’m a successful entrepreneur, in decent health (I could stand to lose a few pounds.) I have just about everything a man could want in life, but I’m miserable. I have no energy and I feel like I’m sleepwalking through my life. I have no sex drive at all; my wife thinks I’m having an affair…I wish. Even Viagra doesn’t do the trick anymore. Is this just old age, or what?

Old age, at 58? Middle age, perhaps! Regardless what we call it, you sound like you’re in the throws of andropause — male menopause — ya know, the change of life!

Never heard of such a thing? You’re not alone. It’s only been recently has the medical industry has begun to pay attention to the impact changing hormonal levels has on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!andropause-1

Every man will experience a decrease testosterone, the “male” hormone, as he ages. This decline is gradual, often spanning ten to fifteen years on average. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.

There is no doubt that a man’s sexual response changes with advancing age and the decrease of testosterone. Sexual urges diminish, erections are harder to come by, they’re not as rigid, there’s less jizz shot with less oomph. And our refractory period (or interval) between erections is more pronounced too.

While most all of us have heard of a mid-life crisis, and it’s tragic consequences — red convertible sports cars, comb-overs, and the trophy wife or lover — fewer have heard of andropause. A mid-life crisis is essentially a psycho-social adjustment to aging — bored at work, bored at home, bored with the wife or partner — that sort of thing. Andropause, although it may coincide with a mid-life crisis, is not the same thing. Andropause is a distinct physiological phenomenon that is in many ways akin to female menopause.

Unlike women, men can continue to father children after andropause, but like I said, the production of testosterone diminishes gradually after age 40. I suppose you know that testosterone is the hormone that stimulates sexual development in the male infant, bone and muscle growth in adult males, and is responsible for our sexual drive. But did you know that by the age of 55, the amount of testosterone secreted into our bloodstream is significantly lower than at 45. And by age 80, most male hormone levels have decreased to pre-puberty levels.

Men, are you over 50? Are you feeling weak, lethargic, depressed, and irritable? Do you have mood swings, hot flashes, insomnia, and decreased libido, like our buddy Wilson, here? Then you too may be andropausal. You need to get some lead back in your pencil!

mutateAll kidding aside, andropausal men might want to consider Testosterone Replacement Therapy (TRT). Ask your physician about this. Just know that some medical professionals resist testosterone therapy, mistakenly linking Testosterone Replacement Therapy with prostate cancer. Even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. However, before starting a testosterone regiment, insist on a complete physical, including blood work and a rectal examine. Mmmm, rectal exams!

Testosterone is available in many forms — oral, injectable, trans-dermal and by way of implants. The oral form is not recommended because of the high risk of liver damage. But injections, patches, pellets, creams and gels might be just the answer. I encourage you to be informed about TRT before you approach your doctor, because the best medicine is practiced collaboratively — by you and your doctor.

Good luck


Too pooped to pop


Name: Djon
Gender: Male
Age: 54
I’m a 54-year-old man, who 3 years ago managed to finally come out and live the life I so desperately longed for all my life. My question — is there a biological clock in men like the issues women have to deal with in menopause. During the last years of my marriage there was no sex life other than with myself. Now I’m living a fantastic life, with a great man who I love very much. I know there is more to life than sex but now that I’m finally able to express myself physically with a man my ability to perform is just not working.

I’ve tried Viagra and such years ago. They used to work in maintaining an erection, it was just by myself, but I always had fun. The headache’s and discomforts from the meds bring up the question — do I really want to take this?

But now the med’s don’t even help, and as for my libido it suffers with my lack of ability. I’ve been tested for testosterone levels and they say I’m right where I should be at for my age. I’ve seen two doctors about the issue and when they find out my partner’s sex they don’t want to deal with it and seem to just pass it off as an age thing.

I’m in fairly decent good shape, I exercise 3 – 4 days a week at the gym, can you send me any advice on a path to take.

A little frustrated: Djon

A little frustrated? Holy cow, darlin’, you sound a lot frustrated. I don’t blame ya. You finally find what’s been missing throughout your whole life only to discover that your plumbing is now givin’ out on you. Ain’t that a bitch! And before I continue I want to tell you and all the other alternative lifestyle people in my audience, don’t settle for a sex-negative physician no matter what. Dion, find yourself a sex-positive doctor that will look beyond your choice of partner and give you the respect you deserve! Damn, I hate shit like that.

andropause2258You raise an interesting question about the aging process when you ask if men experience something similar to menopause in women. The short answer is — yeah, you betcha! In fact, it even has a name; andropause.  I’ve written and spoken extensively about this very subject. Here’s what I want you to do. Look for the CATEGORIES section in the sidebar, look for the category — AGING. There you will find everything I’ve written and said about Andropause, and Sex and Aging.

You’ll find a whole lot more information there than I can put together for you in this posting. However, I can offer you an overview. It’s only been recently that the medical industry has started to pay attention to the impact changing hormonal levels have on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!

Every man will experience a decrease testosterone, the “male” hormone, as he ages. This decline is gradual, often spanning ten to fifteen years on average. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.

And listen, when a physician says that your testosterone level falls within an acceptable range, he/she isn’t telling you much. Let’s just say you had an elevated level of testosterone all your life, till now. Let’s say that you now register on the lower end of “acceptable”. That would mean that you’ve had a significant loss in testosterone. But your doctor wouldn’t know that, because he has no baseline for your normal testosterone level to begin with.andropause

There is no doubt that a man’s sexual response changes with advancing age and the decrease of testosterone. Sexual urges diminish, erections are harder to come by, they’re not as rigid, there’s less jizz shot with less oomph. And our refractory period (or interval) between erections is more pronounced too.

Andropausal men might want to consider Testosterone Replacement Therapy (TRT). Just know that most medical professionals, like yours, Dion, resist testosterone therapy. Some mistakenly link Testosterone Replacement Therapy with prostate cancer. Even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. I encourage you to be fully informed about TRT before you approach your doctor, your new sex positive doctor, because the best medicine is practiced collaboratively — by you and your doctor.

Finally, getting the lead back in your pencil, so to speak, may simply be an issue of taking more time with arousal play. Don’t expect to go from zero to 60 in a matter of seconds like you once did. Also, use a cockring.  But most of all, fuckin’ relax, why don’t cha already. Your anxiety is short-circuiting your wood, my friend. And only you can stop that.

Good luck


SEX WISDOM With Toni Newman — Podcast #299 — 09/21/11


Hello sex fans! Welcome back.

Holy cow, I’m giddy with excitement, because I have an extraordinary program in store for you today. I am honored to be welcoming my first transgendered guest to the show. Just to be clear, it’s not like I haven’t reached out to other transgendered people in the past; I have. It just that I was never was able to seal the deal.

So when I contacted Toni Newman, the author of the groundbreaking: I Rise – The Transformation of Toni Newman, I kind of expected the same kind of noncommittal response I got from the other prospective guests. I was so pleasantly surprised to find that not only was Toni willing to come speak with us, she has an inspirational story of survival and triumph over the most amazing odds to tell.

But wait; that’s not all! This show is a twofer, don’t cha know. My guest, our conversation and the themes discussed in this podcast easily fall into both the SEX WISDOM series and the Sex EDGE-U-cation series.

Toni is, of course, among the movers and shakers in the field of human sexuality; who are making news and helping us take a fresh look at our sexual selves. But she’s also a former sex worker who honestly and forthrightly speaks about her life on the streets and as a tranny dominatrix. Hold on to your hats, sex fans, you’ll not find a more startling and revealing interview anywhere on the net.

Toni and I discuss:

  • Being the first African-American transgendered person to write a memoir;
  • The unique perspective of transgendered people or color;
  • Transgender/transsexual;
  • Gender and genitalia;
  • Being shunned by other sexual minorities;
  • Transgender and sexual orientation;
  • Her life before her transition;
  • The difficulties she faced in her transition;
  • The phenomenal expense of a transition;
  • Being a sex worker.

Toni invites you to visit her on her site HERE!  She’s on Facebook HERE! And enjoy her twitter feed HERE!

(Click on the book art below to buy Toni’s book.)


Check out The Lick-A-Dee-Split Connection. That’s Dr Dick’s toll free podcast voicemail HOTLINE. Don’t worry people; no one will personally answer the phone. Your message goes directly to voicemail.

Got a question or a comment? Wanna rant or rave? Or maybe you’d just like to talk dirty for a minute or two. Why not get it off your chest! Give Dr Dick a call at (866) 422-5680.


Look for all my podcasts on iTunes. You’ll find me in the podcast section, obviously. Just search for Dr Dick Sex Advice. And don’t forget to subscribe. I wouldn’t want you to miss even one episode.

Today’s Podcast is bought to you by: DR DICK’S — HOW TO VIDEO LIBRARY.



Sex Advice With An Edge — Podcast #47 — 01/21/08


Hey sex fans,

I have a nice load of provocative questions from the sexually worrisome. And I respond with an equal number of astounding, amiable and oh so informative responses! Hey, it’s what I do.

  • Amy’s vibrator don’t work no how!
  • Dan is dating a woman with a blockage. But what kind of blockage?
  • Jon’s meds eliminates his spooge output. Pity that!
  • LD’s partner died, but he wants to get back in the swing of things.


  • The Big Tease; How to Strip for Someone Special


Check out The Lick-A-Dee-Split Connection. That’s dr dick’s toll free podcast voicemail. Don’t worry people; no one will personally answer the phone. Your message goes directly to voicemail.

Got a question? No time to write? Give dr dick a call at (866) 422-5680. Again, the TOLL FREE voicemail number is (866) 422-5680. DON’T BE SHY, LET IT FLY !

Look for my podcasts on iTunes. You’ll fine me in the health section under the subheading — Sexuality. Or just search for Dr Dick Sex Advice With An Edge. And don’t forget to subscribe. I don’t want you to miss even one episode.

Say, would you like to become a sponsor for one or more of my weekly sex advice podcasts? As you know, I plug a product or service at the beginning and end of each show. Each podcast has its own posting on my site along with the name of the podcast sponsor and a banner for the product or service.

The beauty part about this unique opportunity is that once a sponsor’s ad is included in a particular podcast that sponsor is embedded there forever.

Your sponsorship also underscores your social conscience. Your marketing dollars will not only got to promote your product, but you will be doing so while helping to disseminate badly needed sex education and sexual enrichment messages. Simply put, ya just can’t get a better bang for your advertising buck!

For further information, contact me at:

Today’s podcast is once again bought to you by: Eden Fantasys — for all your adult toys!