Medicines may be used in treating certain conditions that contribute to sexual problems.
For women who have pain in the area around the opening of the vagina (vulvodynia), putting on lidocaine gel shortly before sex may be helpful. Talk to your doctor about how to use the gel safely.
Estrogen for postmenopausal women
If you only have vaginal dryness and irritation (and not other symptoms such as hot flashes), you can use a limited amount of estrogen in a cream, tablet, or ring in the vagina. The daily estrogen makes your vaginal lining thicker. Many women find that using a cream or tablet twice a week is enough. This may increase vaginal tone and lubrication, which will decrease vulvar dryness, irritation, and shrinkage (atrophy).
If you also have other menopausal symptoms that affect physical and mental well-being, talk to your doctor about taking daily estrogen. Estrogen can increase the blood flow in the vagina and reduce hot flashes and other symptoms of menopause.
Estrogen therapy or estrogen-progestin therapy can be oral (pills), vaginal, or transdermal (with a patch). In a small number of women, hormone therapy can cause heart disease, breast cancer, ovarian cancer, dangerous blood clots, stroke, and dementia. Talk to your doctor about whether this therapy is right for you.
This hormone may play a part in a woman's sex drive and satisfaction. Your ovaries make testosterone throughout your life. Women have the most testosterone in early adulthood. Testosterone levels drop by half between the early 20s and the early 40s.
A woman who has had surgery to remove her uterus (hysterectomy) and ovaries (oophorectomy) will suddenly be in menopause. She will have an immediate drop in both estrogen and testosterone. She may then have a problem with sexual desire. If so, her doctor may suggest hormone therapy.
Ospemifene (Osphena) is used to reduce vaginal changes that can make sex painful.
Sildenafil (Viagra), which is used to treat erectile dysfunction in men, is being studied for use in women who have arousal problems but has not been shown to work.3