Dr. Lauren Streicher

We don't know.

But that's not getting the same local application.

So we know, we know that those neurotransmitters are critically important in terms of not only arousal, but in sending messages down to the pelvis.

It's kind of, you know, that's the brain, like everything else, is in charge of what's happening all over your body.

We also know, and I know you've talked about this, Mary Claire, again and again and again, that we have estrogen receptors and testosterone receptors throughout our brain.

What do they do?

They prime the pump.

They make those neurotransmitters work better and they enhance the release of those neurotransmitters.

So if you have something that's going to get in the way of that, you are going to lose the benefit of the brain talking to your pelvis.

What's going to get in the way of that?

Well, we've already talked about.

If you don't have estrogen, not only are you going to have problems in terms of what's happening right down at the level of your vulva, vagina, and clitoris, but you're also going to have some problems in terms of the function of your neurotransmitters.

They're not going to be primed as much, which is also why when people take systemic estrogen, even if they're not putting it

directly on their clitoris, for a lot of women, in addition to getting rid of their menopause symptoms, that can, in some cases, also enhance sexual function.

So there's that.

We've already talked about the SSRIs and the impact that they have.

When we talk about how else can we enhance the function of these neurotransmitters, well, there are two libido drugs that are FDA approved.

One is flibanserin, the other is bremelanotide, and these are

FDA approved for use in young women, of course, but we do have data in older women.

And it's important to keep in mind that while we don't think of those drugs as being orgasm drugs, they really are because they are working on those transmitters, specifically dopamine.