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Staying Juicy // Hormones & Perimenopause

Three months ago I started taking testosterone to take control of my sexual health during early stage perimenopause. 💦

I’m a 43 year old cis-woman, and started feeling the complex effects of perimenopause about a year ago. For me, this manifested as super low energy, lack of stamina, and really impacted my ability to do the workouts I want (primarily, weightlifting, which estrogen-based bodies need to ensure strong bones). For others, it might be hot flashes, brain fog/fatigue, weight gain/loss, toothaches, dry eyes, itchy ears/skin, or any number of issues. 

I did a very intense intake session with the illustrious Dr. Irwin Goldstein at San Diego Sexual Medicine. He’s written books about pelvic pain and as helped thousands of people with their sзxual health. My blood was analyzed, I did a very interesting and vulnerable vulvascopy (if you’ve never seen your vulva on a big screen, I do recommend!), and other physical exams. Even at this early age* the doctors were already seeing hormone-related changes in the structure of my vulva, and noticing some early stage vestibulodynia. 

Despite my years of natural healing, naturopathic wellness, and thinking my lifetime of vegetarianism would save me from the ravages of age… well, here I am. I’m taking two types of hormones: one is a topical testosterone that I use daily, at about 1/10 the dose of someone in a testosterone-based body might use. I’m also using a topical testosterone + estradiol cream for my vulva. I had some existential dread and it took me about a week to decide to start taking the hormones… 

But HOLY SHIT! I’m so glad I did. ⭐️

Not only do I have seemingly endless amounts of physical and creative energy, I also have a very happy and 💦🍑… and my sexual desire is off the charts. I didn’t really think there was a problem to begin with, so that’s a super fun bonus. 

I’ve chosen to take the hormones because I want to ensure my own sexual wellness (and a super healthy 🍑 for years to come). I also know how deeply  impactful the loss of testosterone and estrogen can be on our bodies, and it is one of the most important preventative things we can do, both for our mental, physical, and sexual health. So this is very preventative for me; some people wait too long, until there is terrible pain, dryness, or other challenges. 

The symptoms of perimenopause and menopause are often overlooked and dismissed by doctors. For decades we’ve been lied to about women’s pain and issues, and I want to help EVERYONE better understand these changes. Yes, menopause is natural… but we were also supposed to be dead by 40 in earlier generations. So we need support to stay vibrant and sexy until our 90s. I’m certainly gonna try! 

⭐️ IMPORTANT NOTES! I’ll share some resources below, and I’ll share a few facts. But don’t get all mean with me… I’m not saying this is for everyone; I know there is very real medical + financial privilege at play (although I also feel strongly that Medicare for all and Universal Health Care so that we ALL get the care we deserve.⭐️

I’M ALSO NOT A MEDICAL PROFESSIONAL: I cannot answer your individual medical concerns. I can only speak to the research I’ve done and my own experiences with doctors and providers. 

  • Testosterone is the first hormone to decline in our perimenopause years, which can start anytime. Sometimes perimenopause starts as early as 30 and can last a decade or more before moving into full menopause.
  • My testosterone levels were SUPER LOW, like a third of the low baseline needed for like, a functioning human body.
  • The tissues in the vulva are BOTH testosterone and estrogen-dependent , and thus need supplementation for both hormones.
  • The changes that the vulva undergoes during perimenopause can lead to health challenges (like recurring UTIs, pain, dryness, and more) but the tissues will also change and decrease in both size and sensitivity as we age. Hormones are one way to keep your tissues supple and healthy. Yes, what I’m saying is your clitoris will shrink! This used to be called vaginal atrophy and has since been reconsidered as genitourinary syndrome.
  • Because there are so many organ systems that are affected by menopause and hormone declines, it’s easy to dismiss the pain. YOU ARE NOT MAKING IT UP! Trust yourself, trust your body, and find a provider that will listen to you!
  • YOU ARE WORTH this effort to ensure your health, wellness, and VIBRANCY for as long as you want. 
  • Also, get your blood checked as a first line of preventative care. Last year I was super deficient in omega-3 (as a vegetarian, this is quite common) and, like most women, I am deficient in iron. Take a good quality supplement to keep your body, hair, and nails strong. My functional medicine doc recommended iron byglycinate. 

Here are some perimenopause and menopause resources that I love:

  • @drrachelrubin (who trained under Dr. Goldstein)
  • @drmaryclarehaver (freakin brilliant, funny, wise doctor)
  • @drmillhouse for general vaginal and urology information
  • @intimatewellbeing (resources and tools for sexual wellness for midlife women)
  • @isswh (the International Society of the Study of Women’s Health) for deep dive medical information about vaginal/vulva health 
  • @getcliterate for those looking to balance their menstrual cycles naturally during their menstruating years

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