During Covid, Carlin brought together a group of Bodysex women for a weekly Erotic  Recess on Zoom. Joining sex-positive women from around the world to experience pleasure together was a lifeline during that time of uncertainty. I could always count on the women in our virtual circle.

Since the start of the pandemic, my previously reliable orgasm became less certain. My body gradually responded less with my “old faithful” techniques. It took me much longer to get there. I noticed the same during partner sex too. Penetration wasn’t as pleasurable. Then I began to experience a bit of incontinence and urinary urgency. I excused it as stress and anxiety about the pandemic. Maybe I was just tired. Something wasn’t right, but I could not put my finger on what was wrong.

It got to the point where I could only achieve just a small orgasm when I cranked up the vibrator and used a lot of tension in my pelvic floor. It took much longer than usual to achieve only a quick peak of pleasure. Something was clearly wrong. I’m a Bodysex woman. I coach women. But applying all that I knew still wasn’t working for me.

Finally, I put together a possible reason for the change.

In January before the pandemic, I consulted with a new hormone doctor. She was the acclaimed “expert” in my area on HRT. I wanted to make sure that my treatment was optimal, especially since I had no ovaries due to a total hysterectomy in my early 40’s. My new prescription was BIJUVA, a bioidentical combination of oral estradiol and progesterone. This replaced my previous prescription of compounded bioidentical Bi-Est, progesterone, and testosterone in a sublingual tablet. She cautioned me about the use of compounded hormones, told me that I didn’t need testosterone, and only agreed to include progesterone because I have sleep apnea.

It took a few months on the new HRT before the gradual changes in my body became apparent. When I lost the ease of orgasm, I finally made the connection. I went back to my previous HRT doctor, and sheepishly shared that I had gone to a different doctor.

“Dr. X sold out to big pharma!” he exclaimed, upset that I didn’t get the right treatment. “She used to prescribe compounded like I do.”

My original doctor got me back on track with my previous sublingual prescription, plus gave me an Estriol cream that brought my vaginal tissues back in shape. In a couple of months, my orgasms were back to normal, penetration was more comfortable, and incontinence improved.

I learned that the delivery of hormone therapy can make a difference. Hormones in the sublingual tablet are absorbed directly through the skin into the blood stream and are delivered to the body more quickly. Hormones in tablet form go through the digestive tract before entering the blood stream. For me, transdermal delivery through the skin works better.

I also learned that I need Estriol in addition to Estradiol as part of my therapy. Estriol is a weaker form of estrogen. It supports tissues and can help with incontinence. From my experience, I think it made a difference in my orgasm too.

Almost two years ago, I added an estradiol patch to my compounded sublingual tablet. My body now feels optimal. I sleep through the night like I did when I was young. My orgasms are fantastic and easy to access. I noticed that penetration feels more pleasurable too.

As I’ve aged, my body has changed. Just like I need medication for my thyroid and blood pressure, I need HRT to keep my body feeling at my best. The key for me is to pay attention and believe my body. Then I need to advocate for myself by finding a knowledgeable doctor who listens and believes me.

Finding effective hormone replacement is different for everyone. Some do better with a patch, some do better with a pill. Some do best with a combination of different hormones, some don’t need HRT at all. If I could find what I needed with traditional pharmaceuticals, I’d be fine with it. Until traditional medicine catches up, I’ll trust how my body responds to know what works best for me.

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