Estrogen and Sexual Function

When estrogen levels decline, both men and women may experience reduced libido which can ultimately affect their self-confidence as well as quality of life. In women, estrogen deficiency can cause changes to the structures and pH of the vagina, which in turn leads to vaginal health issues such as vaginal dryness, inflammation of vaginal tissues, irritation, and painful sexual intercourse (dyspareunia). In men, low estrogen levels can cause erectile dysfunction and reduced sexual desire. Studies show that undergoing ERT can help treat a wide array of sexual health issues associated with age-related decline in estrogen levels:
1. In castrated men, elevations in estrogen help maintain some sexual function and do not appear to be harmful. [89]
2. In male rats, estrogen is considered essential for normal intromission and ejaculatory function. [90]
3. In postmenopausal women with dyspareunia due to vaginal dryness, ERT restores vaginal cells, pH, lubrication, and blood flow, which in turn improves sexual function. [91-95]
4. In pre-menopausal women with estrogen deficiency on hemodialysis, transdermal estradiol treatment is associated with restoration of regular menses and a marked improvement in their sexual function. [96]
5. In postmenopausal women with decreased libido, ERT improves female sexual functioning by acting on the central nervous system to increase sexual desire. [97-101]
6. In women who had hysterectomy, ERT is associated with significant improvements in lubrication, orgasm, sexual satisfaction, and general well-being. [102-110]
7. In postmenopausal women, ERT is associated with higher frequency of sexual activity and improvements in various sexual parameters such as satisfaction, interest, enjoyment, desire, thoughts and fantasies, arousal, responsiveness, and pleasure. [111-113]