Most physicians treating recurrent UTIs in women are missing half the picture. Estrogen gets some attention. Testosterone almost never does. And yet the female urethra is rich in androgen receptors, depends on testosterone for its resilience and thickness, and becomes significantly more vulnerable to bacterial colonization when those levels decline. This is not experimental medicine. This is physiology that has simply never made it into the standard of care.

Low desire is one of the most common concerns I hear from women, especially during perimenopause and menopause. But low libido is not simply a hormone problem, and it is not a personal failure. Desire is shaped by hormones, stress, nervous system regulation, relationship dynamics, sleep, mental health, and overall wellbeing.

In this article, Dr. Evelin Dacker explores the complex roots of low desire in women and discusses evidence-based options that may help support arousal and sexual connection, including PT-141 (Bremelanotide), Addyi (Flibanserin), cannabis, and a more holistic approach to female sexual health and vitality.