In menopause, a woman’s ovaries stop producing the "female" hormones estrogen and progesterone. Levels of the "male" hormone testosterone fall more gradually, so that a woman in her 40s has only about half the testosterone she had in her 20s. These hormonal shifts can add up to a loss of sexual desire, or vaginal dryness that makes sexual intercourse an ordeal. Some women get relief from hormone creams, pills, or other preparations, including the following:

Bioidentical hormones

What they are: Plant-derived hormones with the same molecular structure as the hormones secreted by the body.

What they do: Ease vaginal dryness and boost libido (and relieve other menopausal symptoms).

Prescription required? Yes.

Risks: Long-term use of bioidentical hormones has not been well researched.

Estrogen

What they are: Vaginal creams (Estrace Cream, Premarin Cream), vaginal rings (Estring, Femring), and vaginal tablets (Vagifem) containing estrogen.

What they do: Makes sex more comfortable by building estrogen levels in the vagina to thicken vaginal tissue and increase natural moisture. Prescription required? Yes

Risks: Estrogen may affect breast and uterine health. However, with these preparations, little estrogen should be absorbed into the bloodstream, especially as treatment progresses and vaginal tissue thickens.

Hormone replacement therapy (HRT)

What they are: In women who haven’t had a hysterectomy, estrogen plus progestin in pill form.

What they do: Relieve hot flashes and other menopausal symptoms, including vaginal dryness.

Prescription required? Yes

Risks: The Women’s Health Initiative, a large study funded by the U.S. government, found that long-term use of HRT increased the risk for stroke and other serious illnesses. For complete study results, go to: www.nhlbi.nih.gov/whi/. Most doctors recommend that women who use HRT take the lowest dose for the shortest period of time.

Testosterone

What they are: Creams and gels compounded by a pharmacist; the FDA recently determined that an experimental patch (Intrinsa) made by Procter & Gamble needed further study.

What they do: Increase sexual desire. Prescription required? Yes Risks: Can cause a woman’s voice to deepen and facial hair to grow.

BOTTOM LINE: If you’re considering using hormones, talk to your doctor about the benefits and risks for someone with your health profile.

Carol Weeg is a freelance health, wellness, and medical writer, and yes indeed, is over 40. The newsletter Finding Our Way and now the website focus on issues that are important to women in midlife. A forum is provided where women can share feedback, ideas, advice, and their own experiences. http://www.findingourway.com

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