The prescription drug Deaner® and the nutrients choline and lecithin increase brain levels of acetylcholine, which also may stimulate sexual activity. Such sexual stimulation is rarely seen in people in their teens or 20s but is a fairly common reaction to these substances after the age of 40. Acetylcholine is also a chemical transmitter that causes your mucous membranes to release moisture, an important part of the physiological preparations for sexual activity.
There has been much confusing dincaiesione in lay publications concerning the use of hormonal-replacement therapy in postmenopausal women. Many people believe that it is very risky to do this. What are the facts? First, estrogen replacement is necessary in order to prevent vulva-vaginal shrinkage and loss of normal sexual function after menopause. Without
adequate estrogenic stimulation, the vagina becomes dry, easily irritated, and often chronically infected. One of the problems in the hormonal replacement therapy commonly used is that only estrogens (the female sex hormones) are given, whereas ovaries of normal premenopausal women also manufacture progestins and about 1 to 2 milligrams per day of testosterone in addition to the estrogens. When estrogens are taken after menopause, progestins and androgens (male sex hormones, such as testosterone) are also needed to avoid excess estrogenic stimulation. In fact, in many cases of breast cancer, androgens are given as therapy; breast cancer and other cancers of sexually responsive female tissues are some-
times stimulated by estrogens.
Ideally, a hormonal-replacement mix of testosterone, progestins, and estrogens might be used as a salve topically in the vagina. This would provide maximum concentration where the hormones are most needed and minimum systemic concentration (such as in breasts, or particularly the ovaries and uterus, which cannot be examined externally). Lipophilic
testosterone esters (preferably testosterone cypionate) combined with lipophilic estradiol esters (preferably estradiol dipropionate) in an absorption base do a good job of maintaining the vaginal mucosa while combatting estrogenic overstimulation of the breasts and ovaries. Testosterone cypionate is used for once-a-month depot injections for androgen replacement in males. The hormone slowly diffuses into
the general systemic circulation over a period of a month or more. Estradiol dipropionate is so immobile that it is rarely used for depot injections; after a year, half of the hormone may still be at the injection site. The use of a topically applied, relatively low mobility testosterone ester ensures that there will be relatively little systemic effects (such as virilization) while, at the same time, there will be a relatively high hormone concentration in the target tissues. The use of topically applied estradiol ester that is much less mobile than the testosterone ester results in very little systemic dosage of estrogen, with those relatively very small systemic effects being counteracted by the relatively higher levels of the more mo-
bile testosterone ester. This particular combination of esters results in a markedly higher estrogen-to-androgen ratio in the target tissues of the vagina to which it is topically applied than elsewhere in the body. This topical combination provides adequate hormone stimulation to maintain a healthy, moist, well- lubricated vaginal mucosa which is not easily irritated by sexual intercourse and is more resistant to chronic infections.
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