Menopause & Hormone Replacement: One Sexologist’s Personal Experience

Betty Dodson's picture
Sat, 02/12/2011 - 17:20
Submitted by Betty Dodson

To my knowledge, there is no one-size-fits-all solution for a woman to remain vaginally active long past menopause without some kind of Hormone Replacement Therapy (HRT). It's unfortunate, but each of us must find our own path through trial and error. First off, menopause varies greatly. What many don't know is that more than half of all women in the USA have little to no uncomfortable symptoms. After all, it's a natural transition we all experience. Others suffer with hot flashes, night sweats, sleeplessness, memory loss, etc., symptoms that will eventually pass. However, medical professionals along with our overzealous pharmaceutical companies have turned menopause into a deficiency that needs to be treated. Early ads for hormone replacement actually promised women a fountain of ever-lasting youth. Buyer beware!

Right after my fiftieth birthday, I began to notice a new kind of body sensation. While going about my work, I'd feel a welling of heat in my pelvic area that would slowly travel up my body ending with light dew on my upper lip. Several times a day, I'd stop what ever I was doing, take a few deep breathes and relax into what I called, "my mini heat orgasms." The internal warmth felt similar to a sexual build-up, followed by the relaxation after an orgasm. I looked forward to these sweet moments that I attributed to the grass I'd scored from Hawaii.

One afternoon I was describing a heat orgasm to my neighbor Priscilla when she began laughing. I was stunned when she said I'd just described a hot flash! Many women had complained so bitterly about hot flashes that I'd been unable to make a connection between what I experienced and the hormonal surges that accompany menopause. Since I was feeling good, I opted to go through the change naturally unlike most of my girlfriends who sought medical advice and ended up on HRT. I decided that marijuana, diet, exercise, meditation and having an abundance of orgasms with my vibrator would be my therapy. At the end of that year, my lovely mini-heat orgasms ended and I actually missed them. Later on I discovered that marijuana had been prescribed by doctors to relieve menopausal symptoms before the US government declared war on this useful plant in 1937. Anyone interested in the history of this remarkable plant, Google "The Great Marijuana Conspiracy."

Around fifty-six, my vagina stopped liking penetration even with plenty of extra lubrication. During a workshop, I felt a new burning sensation when I inserted my Vaginal Barbell to demonstrate the pelvic floor muscle, even using the small end. However, my clitoris still loved to be touched and vibrated, so my self-loving orgasms were delightful. At that time, penis/vagina sex wasn't an issue because I wasn't relating to a male partner. There's a reason they call this transition "men-on-pause." For some women vaginal thinning is a serious problem if they want to continue penetrative sex, but for others it's an opportunity to find new ways to share orgasms. Still others find it's a welcome relief to let go of partnersex because it was never a source of pleasure and orgasms.

At the age of sixty-five, I began to miss vaginal penetration. After my original investigation and careful reading of the information that accompanied the pharmaceutical list of possible HRT side affects, I began looking for alternatives in 1995. While on the West Coast, I saw a young woman gynecologist/endocrinologist who was prescribing "natural hormones" in pill form. She assured me that none of the side affects held true for these plant-based hormones. Technically speaking, using the word "natural" is misleading. Instead of using estrogen derived from pregnant mares' urine, these new hormones were derived from the soybean plant which seemed more body friendly to me. After a few weeks of using this new hormone replacement, within no time, my vagina plumped up and I began lusting for penetration. At first I felt a bit like a male to female transsexual, but I soon settled down into my old familiar heterosexual self enjoying penis/vagina sex while I used my vibrator.

After eight years of taking bio-identical hormones in pill form, I wanted to stop taking hormones orally that had to be processed by my liver. I asked my East Coast Gynecologist if there was a cream that could be inserted directly into my vagina instead. At first she prescribed the pharmaceutical version of plant-based hormones. When I tried the Est. Ring, the low dose was too weak and the high dose caused breast soreness. Besides the ring was a nuisance to use. Then there was a pill that was vaginally inserted with the same problem as the Est. Ring. Finally, I clarified my preference for a small compounding pharmacy because they regulated the dose for individual women. At that point I became an informed consumer who advocated for me.

I'm currently using an estrogen cream combined from the soybean plant. It's similar to what my body once produced and therefore I believe it's more easily assimilated. Best of all it's applied as a cream with an applicator inside my vagina once or twice a week before I go to bed. As yet, there have been no long term studies on plant-based hormones, but my gut feeling is that they are safer than the synthetic ones.

You need a doctor's prescription but go to a compounding pharmacy to avoid getting over-charged (When I went to fill my perscription at my local CVS, they wanted to charge $300 for the same tube of cream I buy for $30 from The Women's International Pharmacy):

The Women's International Pharmacy in Madison WI. You can email them through their site or call them at 800-279-5708.

My instincts have often served me well. I was always suspicious of the HRT promoted by the big pharmaceutical companies that keep an eye on the bottom line of profit. The dramatic drop in breast cancers starting in 2003 paralleled a sharp drop in HRT usage following the 2002 release of a widely reported government study questioning the safety of HRT. Since that time, other approaches to addressing menopausal symtoms have become available that focuss more on herbal remedies and vitimins. Several of my friends have said they have reservations about the hormones made from the soybean plant and they prefer to stay with those offered by the pharmaceutical companies. We are free to make our individual choices.

Today the latest scientific research is aimed at a pill for women that would create sexual desire. There is no pill, cream or gel on the market that I would recommend regardless of their claims. Viagra brings increased blood flow to the genitals but it doesn't necessarily enhance a woman's sexual interest. If I relied on my sex drive for all of my orgasms, they would be few and far between. After vibrating my clitoris for a few moments, sexual desire always appears. The electric vibrator is to women what Viagra is to men.

It's unfortunate that so many women see the change of life as a marker for the onset of old age which cause some to become depressed. I prefer what anthropologist Margaret Meade said when she spoke about the many women who experienced what she called "Postmenopausal Zest." I too felt a renewed vigor and embraced what was to become a phase of personal power in my creativity and career. My hope is that half of our government's leadership will be made up of postmenopausal women. Meanwhile, sharing our experiences with menopause along with more details of our sexlives with each other is one of our best hopes for supporting women's sexual pleasure and health. Our sexuality is present throughout all of life's transitions that begins in utero, and continues with infants, toddlers, children, teens, adults and elders. Let's bless all of our happy life-affirming orgasms.

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you are my hero Betty!

Wed, 02/16/2011 - 01:11
Marcy (not verified)

What a beautiful essay, I hope I get more zest as I get older! I'm mid-30 and have been avoiding the pill since I was 18 and it seemed to make me 'PMSy'. Now I have more inspiration, information and an excellent example on how to avoid HRT when I get to menopause. I've always used marijuana for cramps and now I can look forward to using it for menopause as well. 


Tue, 02/22/2011 - 20:14
Scribbler (not verified)

Excellent words here, 'life affirming orgasms'  a fit wrap up.
At 56 I am long  past menopause, a hysterectomy at 23 was empetus for being introduced to peri-menopause at 35 and declared totally 'post menopausal' at 47 - -  nobody told my libido that my uterus was missing.  When the symptoms began I gave serious debate to the hormones and held off for most of the time, then caved and tried two times with HRT - it was horrible for me.   Night sweats were nightmarish, hot flashes were strange, but otherwise everything kept working. So I muddled along and kept on going.    It wasn't easy. There is no single answer for all of us, but the bottom line I think is that I decided I wasn't ready to give up on sex.     I like the term 'post menopausal zest' - I see gobs of it floating around with some of my friends and all I want to do is latch on and catch some for myself. I like being this age and I like sex, a lot.  There are days when penetration needs to be held off, or it's just not so great - in short  the timing is good!

Thank you.

Sexuality and ageing

Fri, 05/27/2011 - 17:18

A wonderful article! Thank you! I am a fifty year old woman who loves partner sex and masturbation. They are quite different forms of expressing my sexuality and both are mainstays of my life. Sex is such a vital part of our lives and I think of my sexuality as something that goes naturally through so many stages. We really need more articles like this that celebrate the sexual vitality of older women. 

Estrogen cream affects on clit?

Thu, 09/22/2011 - 11:25
ann000 (not verified)

Hi! I tried using Esctrace estrogen replacement cream recently, but then noticed that about the same time my clit has decreased in size and sensitivity. I don't know if this is cause->effect or just coincidence. I did read on several sites that clit shrinkage is a result of testosterone decrease and that estrogen cream can skew the testosterone:estrogen balance. (For background, I'm 49, have been noticing age-related vaginal changes for ~1 year, and have been on an SSRI for 5+ years though have found my interest/responsivity towards sex tanks worse when I'm depressed than on the SSRI.) Does anyone have experience with clit shrinkage coininciding with estrogen use?

Natural aging

Thu, 11/17/2011 - 02:29
Pam (not verified)

I, too, had heard horror stories about Hot flashes, Mood Swings etc. I started menopause in my late 30's. The first sign I had was no period. I thought maybe I was reacting to level of stress I was under. I went to  my dr. After examining me he ordered a blood test. Later he informed me I wasn't in menopause and gave me some pills to take to start my  period. It came but was so  light it was just a pale pink. I  had 2 light periods after that and then it quit again. By then I was noticing "warm flashes" being restless and had become a very light  sleeper. Sure seemed to be the start of menopause. Because manifestations were so  minor I didn't take anything. I still enjoy sex and to some extent I seem to enjoy it more. I wonder if regular masturbation has anything to do with the ease of my transition and  my continued sexual enjoyment?

Sotto Pelle is the answer

Sun, 09/02/2012 - 13:21
Carol H. (not verified)

Post-menopausal women need not only estrogen but testosterone also -- and (if they still have a uterus) progesterone. And Sotto Pelle is the most carefree, safe, and accurate way to go. Based on blood tests, precisely formulated tiny pellets (one for estradiol, one for testosterone) are inserted under the skin of the buttocks and released directly into the bloodstream when and as YOUR body needs it. I started last spring and it's given me my life back: ability to lose weight, energy, libido (incredible), and more. Men also need HRT (testosterone) after they go through andropause ~ age 50. Check it out:


Mon, 09/17/2012 - 10:48

I had surgical menopause at 42 and took synthetic estrogen for years. When I tried to stop, I became very anxious UNTIL I finally had a decent practitioner who realized I was glaringly hypothyroid (she also pointed out that estrogen cream rubbed into my arms or legs was far safer than oral estrogen). Once I was on desiccated thyroid, I no longer needed any form of estrogen. I am 58 years old and have absolutely no trouble lubricating quite generously. If you show hypothyroid symptoms, which doctors don't recognize no matter how bad they may be, it is worth finding a practitioner to help you. If I had been treated earlier, I would not have ended up with PID and the consequent early menopause.

This is such a breath of

Tue, 05/05/2015 - 23:06
giselle (not verified)

This is such a breath of fresh air to get some positive advice. All the other websites I've been reading are so full of doom and gloom. Thank you so much, Betty, for sharing your experiences in such a positive way! It makes me feel better about my early menopausal transition.

bio identical hormone pellets

Thu, 06/11/2015 - 11:15
Teri (not verified)

Sotto Pelle recently was sold to BioTe. I can personally relate to this post. At age 50 penetration became painful. As a Nurse Practitioner I knew the symptoms of vaginal atrophy. I started using some vaginal estrace which helped the thining and the pain and recently became a BioTe certified provider. Using the testosterene and estrogen pellets have been life changing. 50 is way too young to be having vaginal pain. I am a lesbian and dont' relate to a male partner but one doesn't have to be herto to enjoy penetration. 
If you are suffereing from low libido or vaginal thinning, painful penetration --esp if none of these things were problems before. I highly recommend checking out the BioTe website and looking for a practitioner in your area.