Promising Treatments for Women’s Intimate Health: What Every Woman Should Know About Hormones and Menopause

By Dr. Charles Mok — Author of Testosterone: Strong Enough For A Man, But Made For A Woman

Let’s talk about something that doesn’t get nearly enough attention in women’s health: hormone replacement therapy (HRT). You’ve probably heard people talk about estrogen and progesterone, but here’s what most don’t realize—testosterone is a key player in healthy aging for women, too.

Why Hormones Matter More Than You Think

When menopause hits and your ovaries slow down, your body starts to change in ways that go far beyond hot flashes. You’re more likely to gain weight, your bones get thinner, your brain ages faster, and you’re at greater risk for cardiovascular disease and even wrinkles. It’s a lot. But here’s the kicker: a big part of that decline is because you’re losing testosterone, not just estrogen and progesterone.

Key Takeaway:
Restoring your hormones—especially testosterone—can help regenerate your body. We do this with hormone pellets (think tiny implants under the skin) that release testosterone and estrogen. Most of our patients come in every three months for their hormone pellet, and the results are quite dramatic: better mood, increased energy, glowing skin, healthier hair, and, yes, you look and feel better overall.

But there’s one topic a lot of providers (and patients) shy away from: sexual health.

Let’s Be Real:
Sex, libido, and the ability to have an orgasm matter at every age. Menopause can bring dryness, decreased sensation, and less frequent orgasms. But you don’t have to just accept it—there are real solutions.

Dr. Charles Mok

Sexual Health Solutions: What’s New and What Works

Over the last 20 years, treatments for sexual health in women have evolved rapidly. Here’s what’s actually working right now:

1. Vaginal Rejuvenation with IntimaLase
   This is a laser device (made by Fotona) that’s inserted into the vagina—think of it like a medical-grade wand. The laser stimulates tissue regeneration, improving vaginal moisture, increasing friction (which means more sensation), and even helping with urinary incontinence. Basically, it makes the tissue younger. We offer this in our Livonia and Shelby offices.
2. Topical Hormone Creams
   • Estriol Cream:
     Estriol is a gentle, non-stimulating form of estrogen that boosts moisture and sensation without stimulating the uterine lining. If regular HRT isn’t fixing your dryness, estriol cream can be a game-changer.
   • Testosterone Gel:
     Usually, a 0.1–0.2% gel is applied to the external genitalia. It increases sensitivity and can make orgasms easier to achieve.
3. Scream Cream
   Yes, that’s the real name. Scream Cream is a compounded topical medication that improves blood flow and sensation, often allowing women to orgasm faster or more frequently. If you used to have multiple orgasms and now can’t, or if you struggle with orgasm at all, this can help. Some formulations include ingredients like theophylline, aminophylline, or even a form of Cialis (tadalafil).
4. Sublingual Tablets
   Combination tablets (like Cialis + oxytocin or VigRX + oxytocin) can be taken under the tongue before sex. They’re inexpensive, fast-acting (effects can last from an hour up to 20 hours), and make orgasms easier and more frequent.
5. The O-Shot (Platelet-Rich Plasma)
   The O-shot is an injection of platelet-rich plasma (PRP) or platelet-rich fibrin (PRF) directly into the clitoris. It boosts blood flow and sensation, improving the ability to have a clitoral orgasm. We don’t use the trademarked O-shot, but the effect is the same. The procedure can be a little uncomfortable (we use numbing cream first), and results can last up to a year.
6. The G-Shot
   This shot targets the G-spot (just inside the vagina, behind the urethra) using a filler like hyaluronic acid (think Juvederm or Revanesse). We inject three syringes into the G-spot area, thickening the tissue and increasing sensitivity—making vaginal orgasms more achievable. While it’s more consistent for women who’ve had vaginal orgasms before, some patients who have never experienced them have seen results.
7. Clitox (Botox for the Clitoris)
   This might sound wild, but injecting 50 units of a neurotoxin (like Xeomin) into the clitoris can actually help. The mechanism isn’t fully understood, but it seems to dial down the “nervous system noise” that can block orgasm (like performance anxiety). Results typically last about six months.

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The Big Picture: Why All Women Should Consider HRT

I feel strongly that every woman going through menopause should at least consider hormone replacement. For years, it was standard practice, but a misunderstood study in the early 2000s led to widespread abandonment of HRT. Now, we know that was a mistake. Women have been left with a lower quality of life and even shorter lifespans because of it.

Step 1: Restore your hormones.
Step 2: Address the specific issues—vaginal or clitoral orgasm, dryness, laxity, incontinence.

There are solutions for all of it, and the right treatment can lead to a better quality of life, stronger relationships, and a whole new level of confidence.

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Quick Reference: Treatment Options

• Vaginal Rejuvenation: Fotona IntimaLase (or other laser devices)
• Estriol Cream: For vaginal dryness (3% is typical, non-stimulating to the uterus)
• Testosterone Gel: For sensitivity, applied to the clitoris and labia before sex
• Sublingual Pills: Cialis + oxytocin, VigRX + oxytocin—cheap, fast-acting
• Scream Cream: Compounded by your pharmacy, boosts blood flow and sensation
• Clitox: Botox/Xeomin injection for clitoral orgasm issues
• O-Shot/PRF: Platelet-rich plasma/fibrin injected into the clitoris
• G-Shot: Filler injected into the G-spot for vaginal orgasm

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If you’re struggling with any aspect of sexual health or menopause symptoms, don’t hesitate to talk to your provider. There’s a lot more out there than most people realize, and you deserve to feel your best—inside and out.