Ovaries. You can’t always live with them—I know I couldn’t—but when they’re gone, there are things we miss.
I surely don't miss the troublesome little egg sacs. The havoc they played with my system when they were there made my life miserable, to say the least. The new freedoms I have without them are well worth the maintenance work of not having them.
But if, like me, you’re a CWO—a Chick Without Ovaries—then you, too, may be discovering what life without hormones means to your sex life. (We do need to get better about communicating this stuff up front, don't you think? But, I digress...)
It took just a few months without a regular supply of estrogen and testosterone for me to begin to notice what’s different. See if this list means anything to you:
- Initiating sex less often
- Responding to sexual offers less enthusiastically
- Loss of sensation—clitoral and labial tissues and nipples just kind of numbing
- Clitoral shrinkage—okay, where did I leave my clitoris...?
- Pain—dry, dry, dry and tissue-thin vaginal tissues. Thinking about using Chap-stik in a very off-label way...
- Itch—random vaginal infections, not normal...
Your mileage may vary, but these are very common symptoms for women who undergo bilateral ooophorectomy. They can be symptoms any woman in menopause experiences, too, but with surgical removal of the ovaries, the cessation of hormone production is immediate and almost complete (the one advantage of being a little chubby
—our fat actually does produce hormones).
The loss of estrogen will bring many changes to the vulvo-vaginal tissues. The loss of testosterone, also produced by the ovaries, will bring a drop in our sexual drive and the intensity of our orgasms. What can a CWO do? Of course, hormone replacement therapy is an option for some. But for some of us, systemic hormone replacement is not on our list of options. What's an ovary-free, bad-hormone-replacement candidate to do?
Here’s what I’ve found to be helpful so far:
Vaginal estrogen—I use Vagifem tablets. They come in very low doses and are not absorbed systemically enough to be a worry for my clotting condition or for estrogen-fed cancers. What they do is immediately reverse the problem of thinning vaginal tissues. No more tearing. The dryness is much improved. For this you need a prescription from your doc.
Vaginal moisturizer—I use these products, particularly during romantic getaways or weekends or times when I know I’m going to be especially active. It’s funny, how all my life I never thought of my vagina being “comfortable.” But losing estrogen changed that.
Labial moisturizer—There isn’t really a product called a labial moisturizer that I know of, but I like my silicone lubricant for this. The silicone means it stays around for awhile. A dab of this after showering helps keep labia, vestibule, and everything up to the mons comfy and happy and friction-free. You can try your favorite lubricant for this.
Dilators—We giggled about it with Meryl Streep and her friends in “It’s Complicated,” but the rumor turns out to be true... It is possible for your vagina to close up if you haven't been using it. No kidding. Tissues unsupported by estrogen grow thin and dry, friction causes them to crack and bleed and fissure, the walls scar-ify and grow together. It happens. Undoing it is possible, but uncomfortable. Dilators help keep your vagina in working order.
Calendar—The best tool I've got. Make appointments with your partner and/or yourself. Orgasms beget orgasms, and you can’t trust your libido to make the time for sex for you. Scheduling it may not seem romantic, but it’s way, way, way better than nothing.
Well, that's my maintenance plan so far. And it works. It really does. But what works for you? Calling all CWOs… what changes have you noticed? And what's your maintenance plan? We’d love to hear from you…
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.