Q: I am 23 years old and have a very low sex drive. I think that part of the problem is that I am an insulin dependent diabetic. I suffer from very painful intercourse and try to stay away from it as much as possible. The main problem is that I suffer from vaginal dryness and although there are different lubricants out there none of them are natural. I would greatly appreciate your advice.
A: Low sex drive is very common problem, and you point out one of the most common causes in your question. If sex is uncomfortable, why should you want to do it? Lack of proper lubrication is among the most common problems.
The first question that I would ask is whether enjoy adequate foreplay. Most women do not walk around well-lubricated, and need a good amount of stimulation to lubricate. If that doesn’t produce good lubrication, I would wonder if you are not making a good amount of estrogen. Estrogen is the hormone most responsible for vaginal lubrication. There are sources of vaginal estrogen that are natural. For example, Estrace vaginal cream is derived from sweet potatoes, and the Estring is coated with estrogen from soy and yams. These are topical estrogens, are minimally absorbed, and won’t affect your diabetes situation.
There are also commercially available lubricants that are non-hormonal and just help with lubrication. Many patients seem to like an over the counter product known as Astroglide the best – and it’s really just glycerine.
Now, if intercourse is totally comfortable, and you still don’t feel interested, many gynecologists would suggest testosterone. Although yes, that is the “male hormone,” our ovaries and adrenal glands should be making plenty of it and similar hormones, and it is possible that you are not making a normal amount. These hormones can be measured, and you can easily supplement your own production with some natural testosterone cream. You would get this from a compounding pharmacist, and applied to the labia it is well absorbed and may enhance local responsiveness.
All of these problems should be straightforward – and hopefully you will be all better soon.