Midlife sex should be satisfying, not painful, but for too many women, that’s not the case. Dryness, discomfort, and even disappearing labia minora are real symptoms of Genitourinary Syndrome of Menopause (GSM), and Dr. Kelly Casperson says it’s time we stop pretending this is “just aging.”
Dr. Casperson explained how testosterone and vaginal estrogen can dramatically improve GSM symptoms, from painful sex to recurrent UTIs.
“Testosterone helps with every domain of sexual function: desire, arousal, lubrication, orgasm, and distress,” she said. “And vaginal estrogen? Pretty much everyone can take it, even many breast cancer survivors, according to the latest guidelines.”
Here’s the shocking part: studies show less than 4% of women who could benefit from vaginal estrogen are using it.
We also lose one-third of our skin’s collagen in the first five years of menopause. That includes the skin covering the clitoris. Over time, it can even adhere and reduce sensation. Estrogen and testosterone, applied locally, can help restore blood flow, responsiveness, and pleasure.
Dr. Casperson emphasized that “libido is complex” and no hormone can fix a broken relationship or an unhealed trauma. But restoring healthy tissue, sensation, and brain chemistry is a critical step many women haven’t been offered.
“Sex isn’t extra,” she said. “It matters.”
If you’re experiencing painful sex or feeling like your desire has disappeared, this conversation is a must.
To learn more about testosterone, vaginal estrogen, and the real solutions for GSM, listen to this episode of The Tamsen Show Podcast.
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