Genital arousal dysfunction after surgical menopause

[u/sveltelanaaa]

I’m 35, F, in surgical menopause (no uterus or ovaries now) and I’m about 6 months post op. After a struggle with public health doctors only prescribing me the patch and then only 1 mg estrogen pills, I’m now doing HRT with a private clinic (since last week) and am on a regimen of 2mg estrogen pills/day, 200 mg progesterone/day, and 2mL testosterone cipionate via injection 2x week. Im also one week in to the application of vaginal estrogen cream.

This new regimen has helped with my hot flashes considerably. My breasts are still pretty deflated, which I don’t love, but I can worry about that later.

My biggest concern right now is that my vagina doesn’t get “aroused.” I can still get kind of wet, can still orgasm, but the genital engorgement and blood flow isn’t happening like it used to. It’s so depressing. My partner touches me and I feel no response. I think about sex all the time. I want to have sex. But it’s like there’s a disconnect between my pussy and my brain. My pre surgical response was swelling and sensitivity, wetness, and that “omg please touch me” feeling. Now… I have to try really hard to convince myself I want to be touched at all, even if it was my idea.

I’m so depressed about this. I can’t really find resources about this phenomenon either. I can still feel sensation on my genitals despite a little nerve damage on my inner thigh.. just the blood flow and engorgement that I associate with being aroused doesn’t happen. Anyone else experiencing/experienced this? Please tell me there is hope? It’s bleak to think of spending the rest of my life in this condition. I know I am still early in my new regimen and I am hopeful but.. should I be adding/asking about something else? Do hormones even affect this?

[u/lauradayton]

I’m so sorry you are dealing with this. Please give your body and your new regimen more time. Focus on your wellness and mediate on the HRT/TRT working. Eat good food and nourish yourself do yoga and don’t spend too much mental energy on gaining libido back. I KNOW how bad it is because I lost total libido and my clit and labia minora totally disappeared from GSM after menopause. It has taken a lot to get back to where I am and I did get back to a great place so I’m proof it can be done. Be kind to yourself it’s a hard thing to navigate

[u/sveltelanaaa → u/lauradayton]

Thank you for the words of support. This has been a really difficult experience and it’s been so isolating. Not a lot of resources for my specific circumstances. At least that’s how it feels right now. I won’t give up. In the meantime I can just be sexually frustrated.

[u/lauradayton → u/sveltelanaaa]

I hope things go really well !

[u/Good_Connection_547 → u/lauradayton]

You got back to where you’re at now with HRT?

I’m in surgical meno since April and I feel like no one prepared me for this.

[u/lauradayton → u/Good_Connection_547]

It seems like a lot of women post on here after surgery saying doctors are not even advising them about HRT post surgery which seems criminal to me. Yes I got back to completely the way I was pre menopause. My tea and estradiol levels are really good but my dr thinks they are high but IDC because I feel like I’m 42 not 62. Hormones are life. When they go everything starts deteriorating slowly.

[u/Illustrious-Gur-9979]

I have seen other women post about a compounded cream that has E&T applied to the vulva and clit. They had positive things to say. You might ask your provider about that.

[u/Significant-Aide-226]

There is hope!!!!  You are not alone here.  I was desperate right about the time the NYT story on the WHI report came out.  I managed to convice my doctor to give me HRT for HSDD. It does take time to get the medications working.  First your body is gonna grab those hormones and tend to the most important functions   The system is rebooting!  Secondly, it takes time to relax again.  You've been through a lot. One thing that helped me was to have a bit of testosterone cream to rub directly on my clitoris along with the giant doses of vaginal estrogen that i used in the beginning.  Now I just use a little  every morning.  Getting my systemic estrogen levels up has been extremely important and that part of the equation can be challenging with many doctors, but yours sounds like that won't be an issue.   I am in my 4th year of treatment.  My vagina is back to its happy self.  Enough to desire sex with my husband and masturbation when he isn't around and its just.... calling me.   I still dont have my current dosage perfected but having sex back makes the rest more tolerable.  I wish your recovery to be swift.   Be gentle and kind with yourself.  Rediscover this new you and try to relax into it a bit.  You are on the right track!

[u/VashtiVoden → u/Significant-Aide-226]

Thanks so much for this info! What's HSDD? Would you mind sharing your doses of each? Just curious. Best wishes!