Hormone Therapies You Should Know | Ep 23

Hormone Therapies You Should Know

Ep 23 of The Libido Lounge

Dr. Diane: Welcome to the Libido Lounge, where we focus on all things love, lust, and libido. We believe that fabulous sex is just as important to your health as exercise and good food.

Hey everybody, welcome back to another episode of the Lounge. In this episode, we’re talking about all things hormones.

Hormones and Low Libido: What’s the Connection?

Dr. Diane: One of the most common responses I get when people find out I’m the Libido Doc is, “Oh, so you do hormones?” And yes, I do! But I want to be clear—low libido and sex drive aren’t just about hormones.

Hormones are only one piece of the puzzle. Low libido can also relate to the cardiovascular system, neurological system, emotions, safety, relationships, confidence, body image, dopamine, motivation, and even cultural messages we’ve received about sex.

Understanding Estrogen: It’s More Than One Hormone

Dr. Diane: Let’s talk about estrogen. We actually have three types:

• E1 (estrone) – most predominant after menopause
• E2 (estradiol) – most potent and predominant before menopause
• E3 (estriol) – weakest, but still important

If you’re premenopausal and your doctor runs a total estrogen level that looks “normal,” it may still be misleading. For example, if your total estrogen is dominated by E2 but you’re low in E1 and E3, your estrogen effect may be too strong. That can cause mood swings, PMS, acne, irritability, and a lower sex drive.

The Truth About Testosterone for Women

Dr. Diane: Testosterone isn’t just for men. It plays a major role in libido, weight management, muscle development, and confidence.

Most conventional doctors only test total testosterone—but we really need to test free testosterone, the kind your body can actually use.

There are also two main types of testosterone:

• DHT (dihydrotestosterone) – the potent form
• Regular testosterone – the weaker form

If your body makes mostly the weaker kind, you may not feel the benefits of testosterone even if your labs look “normal.” On the flip side, too much DHT can cause unwanted hair growth or hair loss.

Why Urinary Hormone Testing Matters

Dr. Diane: If you want to get a full picture of your hormones, I highly recommend urinary hormone testing. This type of test looks at:

• All types of estrogen
• Both forms of testosterone
• Progesterone
• DHEA

Let’s not forget about DHEA—the precursor to estrogen and testosterone. It declines with age and plays a huge role in how good we feel. Topical DHEA (especially on the vulva) can help with vaginal dryness, pelvic pain, and bring blood flow to erectile tissue. I’ve seen it help women regain their libido.

You can find urinary hormone tests in my store—available direct-to-consumer if your provider doesn’t offer them.

Hormone Replacement Therapy (HRT): What You Need to Know

Dr. Diane: Let’s shift gears and talk about HRT—and why it’s so important, especially during perimenopause and menopause.

Research shows there is a critical window to start estrogen therapy. When we begin HRT early—right as hormone levels start to drop—it helps with:

• Cognitive function
• Cardiovascular health
• Memory and focus

Estrogen increases blood flow to areas of the brain like the prefrontal cortex and hippocampus. But if we wait too long (5–10 years after menopause), the benefits drop significantly.

You can still get benefits later—like improved libido and bone strength—but it’s ideal to start sooner rather than later.

Addressing the Fear: The Truth About the Women’s Health Initiative Study

Dr. Diane: I want to revisit something I’ve mentioned before—the Women’s Health Initiative (WHI). It was a massive study started in the 1990s to evaluate the safety of hormone therapy.

There were some problems:

1. Many participants were 15+ years post-menopause—not an ideal time to start hormones.
2. The study didn’t exclude for conditions like obesity or diabetes, which can skew heart health outcomes.
3. Most importantly, the data was misrepresented.

Here’s what happened:

• Let’s say 4 out of 1,000 women in the non-hormone group developed breast cancer.
• In the hormone group, 5 out of 1,000 did.

That’s a 1 in 1,000 difference, or an absolute risk increase of less than 1%.

But headlines reported a 20% increase—which is a relative risk. That scared a lot of people and caused a major backlash against HRT.

What the Science Really Tells Us

Dr. Diane: When you dig into the science, the real story is that bioidentical hormones—especially when started early—have powerful benefits for your:

• Brain
• Heart
• Skin
• Libido
• Mood
• Motivation
• Confidence

I’m not giving you medical advice here—just education. My job is to help you understand the facts, so you can make the best decision for you.

Wrapping Up: You Deserve a Healthy, Sexy Midlife

Dr. Diane: I’m in my mid-40s, and this is personal for me. I’m passionate about helping women enter midlife feeling confident, sexy, strong, and full of wisdom.

If you’re navigating perimenopause or menopause, I want you to know:
Hormones can be a game-changer.
Education is power. When you understand the science, the risks, and the benefits, you can make informed decisions that support your libido and your life.

Please reach out with questions—this is a controversial topic, and I’m here to help you navigate it.

Thank you for joining me on this episode of The Libido Lounge.
Stay classy, stay sexy, and stay a little badassy.

You can find me on YouTube, on Instagram, and check out our Modern Libido Club for so much more!