Question 24 - Loss of Libido And Clitoral Sensitivity
(Posted March 15, 2000)

Dr N

Although I am greatful that I am basically a healthy individual, I am very distressed (and so is my partner) at the fact that my libido has dramatically declined. I had a complete hysterectomy about 12 years ago due to fibroids. I have been given since that time .625 milligram estrogen. Although I feel otherwise healthy and look much younger than my age - I am very concerned. One of the problem is that my clitoris has lost just about any sensitivity. Is there any hope to revert this condition. I used to be hot to trot but it's all gone.

Hopeless

Hi,
It is not unexpected that you are feeling the way that you are. In fact I have had a number of women tell me very similar things over the years and not surprisingly, most of them have had your ovaries removed. In short, you likely require a more appropriate HRT program, including some testosterone. I have addressed this in the area of the web site, Sex and Menopause, and Sex and Libido with HRT.

If you have not read these sections of the web site, it is important to do so as they may provide some insight.

If the an appropriate HRT program is instituted, your chances of regaining your sexuality, including your clitoral sensitivity, are close to 100%. A program of this nature would include testosterone and at least for hypothetical reasons, avoid the oral route. When estrogen is given orally, the level of SHGB, (Sex Hormone Binding Globulin), in the blood becomes elevated. SHGB binds to testosterone, leaving less available to exert its positive affect on sexually involved tissues and libido.

If your physician is unable to do this for you, find another one. Your quality of life is too important to do otherwise.

Let me know what and how you do.

Dr N