If you’re feeling disconnected from intimacy, experiencing vaginal dryness or discomfort, or wondering what happened to your libido, you’re not alone.
Hormone changes during perimenopause and menopause can cause profound shifts in how your body—and brain—respond to arousal, desire, and intimacy. Many women feel frustrated, embarrassed, or even broken.
You are not broken. You’re just out of balance.
And thankfully, there are hormone-based solutions that work. But choosing the right one can feel confusing. Should you try DHEA, vaginal estrogen, or testosterone?
Let’s break down the pros, cons, and ideal uses for each—so you can feel empowered in your choices and supported on your path to reclaiming connection, comfort, and confidence.
DHEA: A Gentle First Line for Libido and Vaginal Health
What it is:
DHEA (dehydroepiandrosterone) is a precursor hormone that your body naturally converts into testosterone and estrogen. It plays a key role in energy, mood, libido, and skin/tissue health.
It can be delivered as:
- Vaginal ovules (like Intrarosa® or compounded options)
- Compounded topical cream for clitoral/outer labia application
- Oral or sublingual capsule to boost systemic levels
✅ Best for:
Women with low libido, vaginal dryness, thinning tissues, or discomfort during intimacy—especially if they’re not ready for testosterone or systemic estrogen.
🧬 Backed by research:
A study in Menopause (2015) found that vaginal DHEA significantly improved sexual satisfaction, moisture, and arousal with minimal systemic side effects (Cameron et al., 2015).
📋 NAMS Recommendation:
The North American Menopause Society lists vaginal DHEA as a first-line therapy for low libido and vaginal atrophy, particularly for women who cannot take estrogen or prefer a more localized approach.
⚠️ Keep in mind:
While effective, some women need systemic hormone support in addition if mood, energy, and libido remain low.
Vaginal Estrogen: Targeted Relief for Dryness, Irritation, and Atrophy
What it is:
Low-dose estradiol or estriol, delivered directly to the vaginal tissue as:
- Cream
- Ring
- Tablet
- Suppository
✅ Best for:
Women with vaginal dryness, itching, burning, or pain with intimacy, often without systemic symptoms.
🧬 Backed by research:
Studies in The Journal of Women’s Health and Obstetrics & Gynecology confirm that local vaginal estrogen therapy restores tissue elasticity, thickness, and moisture—often within 1–2 weeks (North American Menopause Society, 2022).
💡 Bonus:
Vaginal estrogen is not associated with increased breast cancer risk and has minimal systemic absorption, making it a safe choice for many women.
⚠️ Keep in mind:
It doesn’t improve libido on its own—just comfort. If your desire is also missing, DHEA or testosterone might be needed in combination.
Testosterone: The Libido-Boosting Powerhouse (With Some Caveats)
What it is:
Yes, women need testosterone too! It’s essential for:
- Sexual desire and arousal
- Motivation and confidence
- Muscle and bone health
- Mood and focus
Most women who benefit take low-dose, compounded topical testosterone applied to the inner thigh, forearm, or genital area.
✅ Best for:
Women with persistently low libido, difficulty with arousal or orgasm, and symptoms of low testosterone on lab work—especially after trying DHEA without full resolution.
🧬 Backed by research:
A 2019 international consensus endorsed low-dose testosterone therapy as an evidence-based, effective, and safe treatment for postmenopausal women with hypoactive sexual desire disorder (HSDD) (Davis et al., 2019).
⚠️ Why your provider may not prescribe it:
Here’s the catch:
- Testosterone is not FDA-approved for use in women in the U.S.
- Most conventional providers are not trained in how to dose or monitor it for women
- It’s not covered by insurance and must be compounded
- It requires close monitoring to avoid side effects like acne, hair growth, or voice deepening
That’s why functional medicine providers, like those at Antigravity Wellness, offer testosterone only when labs and symptoms align—and with careful follow-up and education.
So… Which One Is Right for You?
Here’s a quick comparison:
| Concern | Best Starting Option |
| Vaginal dryness only | Vaginal estrogen or vaginal DHEA |
| Low libido + dryness | Vaginal DHEA |
| Low libido + low energy | Oral DHEA or testosterone |
| Tried DHEA, still low libido | Testosterone (with monitoring) |
| Hesitant about hormones | Start with DHEA + lifestyle |
Still unsure? That’s okay. Your body deserves a personalized plan, not a one-size-fits-all protocol.
Case Study: Meet “Elena”
Name changed for privacy
Elena, 53, came to Antigravity Wellness feeling discouraged. Her libido had tanked, she felt emotionally disconnected, and intimacy had become uncomfortable. She’d been offered an antidepressant—but intuitively knew something hormonal was going on.
We reviewed her history and ran a full panel. She had:
- Very low DHEA-S and testosterone
- Vaginal atrophy
- Flat cortisol curve
We started her on:
- Vaginal DHEA ovules
- Compounded DHEA + estriol cream externally
- Stress and adrenal support
By week 6, her discomfort was gone. By week 10, her libido had returned—and she felt emotionally connected to her partner again.
At her 3-month check-in, we added a microdose of testosterone to help sustain results—and she’s now thriving in every aspect of life.
“I didn’t realize how much I’d lost until I started getting it back.”
You Deserve to Feel Sensual, Safe, and Strong
If you’re struggling with low libido or vaginal dryness, there are options that work—but they need to be chosen with intention, backed by testing, and customized to your body.
At Antigravity Wellness, we:
- Listen to your story
- Run labs that go beyond the basics
- Offer customized BHRT (bioidentical hormone replacement therapy) including DHEA, estrogen, and testosterone if needed
- Monitor your progress and adjust as your body heals
Ready to Reclaim Your Intimacy and Confidence?
🎁 Start with our FREE 5-Day Hormone Reset Mini-Course
You’ll learn the real reasons behind your symptoms—and get a roadmap to begin restoring balance naturally.
Get it here: https://social.antigravitywellness.com/mini-course-freebie
👩⚕️ Book a Brief Initial Consult with Dr. Nicole Smith
Get personalized guidance, functional lab testing, and a custom BHRT plan tailored to you.
Book a call here: https://l.bttr.to/6lFHL
References:
- Cameron, J. L., et al. (2015). DHEA therapy improves sexual function in menopausal women. Menopause, 22(1), 10–18.
- North American Menopause Society. (2022). Nonhormonal Management of Menopausal Symptoms: 2022 Position Statement.
- Davis, S. R., et al. (2019). Global consensus position statement on the use of testosterone therapy in women. The Journal of Clinical Endocrinology & Metabolism, 104(10), 4660–4666.
Santen, R. J., et al. (2010). Managing urogenital atrophy in women after menopause. Obstetrics & Gynecology, 116(6), 1230–1235.
