I am 51 years old and have completed menopause. I have not had sexual relations for more than 20 years. However, a new man has entered my life and although he is patient and very generous, I find I cannot become physically excited. I have checked with my physician, and we seem to agree that this lack of interest may be hormonal. However, we differ on how balance may be achieved. I have heard of a 2% testosterone ointment that is said to work wonders. Apparently this cream must be prescribed by a physician and may be made by any compounding pharmacist. My physician knows nothing about this. Have you any information about this cream?

--EG

Recent findings in large-scale research studies suggest that HRT may increase a woman's risk of breast cancer, heart disease and stroke. In addition, when estrogen is prescribed alone, it may increase the risk of ovarian cancer. Consult a physician before starting any medication regimen.

It is true that decreased sex drive (libido) often goes hand in hand with all the other symptoms of menopause. Sometimes the loss of desire is real, but other times it is due to physical discomfort during intercourse, which can be a result of decreased lubrication or narrowing of the vagina.

You didn't mention whether you were on hormone replacement therapy (HRT). In addition to its significant benefits on bone health, estrogen also improves vaginal dryness and makes the vaginal tissues more pliable. If you are not on HRT, talk to your gynecologist about its pros and cons.

If you are already on HRT, the addition of testosterone may be beneficial. I have actually been prescribing an oral estrogen-testosterone preparation (Estratest) for years and many patients do report an increase in their sex drives. The 2 percent testosterone ointment (testosterone propionate), which is rubbed into the external genitalia, is just another way of delivering the hormone.

One very important thing to mention -- testosterone has been shown effective in postmenopausal women. This information cannot then be applied to premenopausal women, and testosterone certainly should not be used in any woman who might become pregnant.