Arleque, now 62 and a motivational speaker based in Andover, Mass., sought help for her sex drive problem from 10 different doctors over the years. "I wouldn't stop asking," says Arlequeeven though it was often an embarrassing topic for her to bring up.
She made do. "Fortunately I'm married to a wonderful man who was very understanding," says Arleque. "We managed in our 30s and 40s by using lubricants, and we didn't have sex as often as my husband would have wanted."
But in her 50s, during the hormonal changes of menopause, sex began to hurt. That progressed to "vulval burning, 24/7, like I was on fire. I didn't want to move; it was torture."
Finally, a diagnosis
Arleque had her hormones tested, and it turned out she had a severe androgen insufficiency, plus some tissue changes from having too little hormones for so many years.
As treatment, Arleque and her doctor considered hormone replacement therapy (HRT). But her mother had had breast cancer, so she was genetically at risk herself, and she knew HRT would further increase her likelihood of breast cancer. So Arleque started taking small amounts of carefully prescribed bioidentical hormones, which can be monitored through periodic blood tests unlike other forms of HRT.