By Louise Sloan
February 29, 2016

The sexual pain that menopause can cause in some women hit Lillian Arleque especially hard because her sex life had been in disarray for some time. After the birth of her first child in 1975, Arleque stopped being interested in sex. "Everything was fine, I had a baby, and the switch went off," she recalls.

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 Arleque—even though it was often an embarrassing topic for her to bring up.

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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."

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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.

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Her groove is back

The treatment seemed to do the trick. "If I didn't have the hormones, I'd be in chronic pain," she says. Arleque is also happy to report that her sexual pleasure has returned, completely intact. "I'm definitely 100% happier. We're best friends," she says of her husband, "but you want to have that intimacy. There's a lightheartedness that comes with intimacy."

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Now Arleque, coauthor of When Sex Isn't Good, counsels women to be persistent, and to seek the help of a specialist if they are not getting the help they need. "There's a core belief: I deserve to have good health, I deserve to have a good relationship. It's self-esteem."

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