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And for those women with a healthy libido, while they have desire, they may still struggle with actual arousal or an arousal strong enough to reach orgasm. “The female sexual-response cycle generally starts at desire, which is psychological. Desire leads to arousal, which is physiological, and arousal leads to orgasm,” says Wheeler. Just as arousal presents itself as an erection for men, the Mascots miami heat huddle 2023 shirt besides I will buy this same is true for women; it’s just more difficult to see and feel an erection in the clitoris. Oral Viagra (known generically as sildenafil), which has been approved for use in men since 1998, is a vasodilator that increases blood flow to the penis leading to an erection. “There is data showing that Viagra can increase blood flow to the genitalia in women, which can increase sensitivity and arousal,” says Millheiser, adding that it has been prescribed for years off-label, not for low libido but for the treatment of genital-arousal disorder or orgasmic disorder. It’s a solution for women that has been hiding in plain sight, says Molenaar. “The only reason it hasn’t been available for women is that nobody cared or prioritized our sexual pleasure,” she says.What Alloy Health has started offering its customers is a topical version of sildenafil, which it has branded as Oh-mazing Cream. Containing a percentage that is a fraction of the dose men take, the topical sildenafil, says Molenaar, functions the same way but, unlike its oral predecessor, has no contraindications. Apply 15 to 30 minutes before a sexual experience solo or with a partner, and its effects will kick in. While sildenafil handles arousal, Alloy encourages customers to first use vaginal estrogen to address common issues like dryness and irritation that happen when the vaginal walls naturally weaken. “Once you have re-estrogenized the vagina, sildenafil is a great tool to improve sexual pleasure,” says Fulenwider. Vella’s signature Pleasure Serum works similarly but with cannabinoids and liposomes. “It facilitates increased blood flow and clitoral engorgement, which, even for women who do not have any problems with reaching climax, can mean a stronger and longer lasting orgasm and an easier and quicker time toward multiple orgasms,” says Wheeler. If your barrier to intercourse has to do with dryness, Millheiser recommends personal lubricants (silicone or oil-based versions as they last longer) to reduce friction or nonhormonal vaginal moisturizers (used consistently two to three times a week) to increase moisture content. When lower libido is related to menopausal hormone shifts, she sometimes turns to off-label testosterone therapy. Sexual mindfulness, or what Millheiser calls “beforeplay,” is something she discusses with all her patients. “Many women during and after the menopause transition experience a decline in spontaneous desire and tend to rely more on responsive desire, meaning they need something to get them in the mood,” she explains. Beforeplay is a way of building arousal (whether it be by masturbating or watching or reading something stimulating) before your partner is even in the room. There are still only a few medications approved by the FDA for female sexual dysfunction (Addyi, Vyleesi, vaginal estrogen therapy, Intrarosa), and, Millheiser adds, there are none approved for low libido, the most common sexual disorder in postmenopausal women.



While there have been advancements and there is more discussion about female sexual health, not to mention havens for treatment like New York’s Vspot, there is still a ways to go. Right now, we are witnessing, says Wheeler, a soft launch of women’s sexual pleasure. “There is still an enormous amount of work to be done, including medical research and public education, but it’s finally regarded as a true subset of women’s sexual health and, in turn, our overall health,” says Wheeler. As it should be because sexual health is, adds Fulenwider, about quality of life. Besides a wider cultural reckoning and reeducation about female sexual pleasure—“It’s still very challenging to say the Mascots miami heat huddle 2023 shirt besides I will buy this word vagina on TV during daytime hours without getting censored,” says Millheiser—the medical establishment needs to be brought up to speed as well. “Education around female sexual disorders is not a requirement in medical school and residency curricula, and as a result clinicians are not being trained on these common conditions,” says Millheiser. “When a clinician does not know how to address or treat a medical disorder, they usually will not ask their patients about it.” Oftentimes, experts agree, when women find a solution for their issues of libido or arousal that works, it can be transformative. Says Fulenwider: “Once you have a nice experience, you’re going to want to do it again more.”


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