Sexual Health & Libido
Sexual health is hormonal health.
Conventional medicine treats low libido as a relationship problem or an inevitable consequence of aging. At Meliora, we treat it as what it usually is: a hormonal signal. We find the root cause and address it clinically.
Low libido is not a character flaw. It is a symptom.
Sexual desire, arousal, and function are regulated by the same hormonal systems that govern energy, mood, sleep, and metabolism. When testosterone falls — in women or in men — libido is often the first thing to go. When estrogen drops in menopause, vaginal tissue changes and intimacy becomes painful. When cortisol is chronically elevated, sex drive is suppressed at the neurological level.
These are physiological facts, not personal failures. And they have clinical solutions.
Dr. Chua's background in Neurology, Integrative Medicine, and Obesity Medicine means she evaluates sexual health through the full lens of hormonal and nervous system function — not just a single hormone panel. The nervous system mediates desire. The endocrine system provides the substrate. Both matter.
What We Treat
What we address.
Low libido and sex drive
One of the most common — and most undertreated — hormonal symptoms. Low libido is not a psychological failing. It is a physiological signal that something in your hormonal milieu is off. We find out what.
Testosterone deficiency (women and men)
Testosterone is not just a male hormone. Women produce and require it for drive, energy, mood, and sexual function. By the time most women are evaluated, their testosterone has been low for years.
Vaginal dryness and painful intimacy
Genitourinary syndrome of menopause — vaginal atrophy, dryness, painful intercourse — is a direct consequence of declining estrogen. Topical and systemic BHRT addresses this at the source.
Andropause and male hormonal decline
Men experience a gradual hormonal decline beginning in their 30s. Fatigue, low motivation, reduced drive, and changes in body composition are often testosterone-related and highly treatable.
Intimacy changes through life stages
Perimenopause, postpartum, post-surgical menopause, and chronic illness all affect sexual health. These changes are real, they are hormonal, and they deserve clinical attention — not dismissal.
Who Benefits
This care is for women and men.
Women with low libido after perimenopause or menopause
Estrogen and testosterone decline together in the menopause transition. Many women report that their interest in sex dropped off a cliff in their late 40s or early 50s — and were told it was normal. It is common. It is not untreatable.
Women already on BHRT who still have low drive
Estradiol and progesterone are essential, but they do not fully address libido. Testosterone is the missing piece for many women on hormone therapy who feel better overall but still notice low drive.
Men experiencing fatigue, low drive, or andropause
Testosterone peaks in the early 20s and declines roughly 1% per year after 30. By the time symptoms are obvious, levels may be significantly below optimal. Lab testing reveals what symptoms alone cannot.
Anyone experiencing hormonal intimacy changes
Postpartum hormonal shifts, thyroid dysfunction, adrenal dysregulation, and chronic stress all suppress sexual health. A thorough hormonal workup looks at the full picture, not just sex hormones in isolation.
Our Approach
Labs first. Treatment second.
We do not prescribe testosterone or hormones blindly. Every recommendation begins with a comprehensive lab evaluation and a clinical picture that tells us what is actually driving your symptoms.
01
Hormonal lab panel
We start with comprehensive labs: total and free testosterone, estradiol, progesterone, DHEA-S, SHBG, and thyroid panel. Symptoms tell us where to look. Labs tell us what we find.
02
Testosterone optimization
For both women and men with documented deficiency, testosterone therapy — pellets or topical creams — is titrated to optimal physiologic levels, not just the low end of the reference range.
03
BHRT for women
Bioidentical estradiol and progesterone address vaginal dryness, painful intercourse, sleep disruption, and mood — all of which directly affect sexual health and intimacy.
04
Ongoing monitoring
We recheck labs to confirm you are in therapeutic range, not just symptomatic range. Dose adjustments are based on objective data and your reported response — both matter.
The Meliora Difference
We optimize, not just replace.
There is a difference between prescribing testosterone and optimizing testosterone. We measure free and total testosterone, sex hormone-binding globulin (SHBG), and the downstream hormones that tell us whether therapy is working — not just whether levels are in the reference range.
For women, this means understanding the interplay between estradiol, progesterone, and testosterone — and how they change across the menstrual cycle, perimenopause, and beyond. For men, it means evaluating the full androgenic picture and managing estradiol conversion appropriately. The goal is not a number. It is restored function.
Common questions.
Do women actually need testosterone?
Yes. Women produce testosterone in the ovaries and adrenal glands throughout life. It supports libido, energy, muscle maintenance, mood, and cognitive sharpness. Levels decline with age and drop significantly after oophorectomy. Testosterone therapy for women is evidence-based and, when properly dosed, safe.
What if my testosterone is "normal" but I still have symptoms?
Standard reference ranges are set to catch frank pathology, not to define optimal function. Many patients with testosterone in the low-normal range are symptomatic. We evaluate free testosterone (the biologically active fraction), SHBG, and your clinical picture together — not a single lab value in isolation.
Is this only for women?
No. We treat men with testosterone deficiency, andropause, and low drive. Testosterone optimization for men — including assessment of LH, FSH, estradiol, and hematocrit — is part of what we do.
Can I address this as part of a broader Meliora care plan?
Sexual health is almost always intertwined with hormonal health, metabolic health, sleep, and stress physiology. At Meliora, we do not evaluate it in a vacuum. Your sexual health concerns are part of your whole-body hormonal picture.
Questions? Send us a message.
We respond within one business day.
You deserve to feel like yourself again.
Sexual health is a clinical matter. It is also a quality-of-life matter. At Meliora, we take both seriously. Book a consultation at our Evanston, Illinois office and let's start with the labs.