Sex Drive & Menopause

Women come to me for health advice from all walks of life and in every stage of life’s progression. Over the years it became apparent to me that; every woman needs a plan for good health that is individually crafted for them alone.

The part of my practice that specializes on woman’s sexual health, from 40 years old to post-menopause, has made me keenly aware of this on a profound level. Sexuality and the need to maintain sexual vibrancy are as deeply individualistic as it gets. From young adulthood to post menopause the one constant element in a woman’s body is continual change and that particular kind of change, is driven by hormones. Hormones regulate sexuality on a grand and unifying scale and therein lies the complexity of coming up with an effective plan for aging gracefully and staying sexually active. The mix of hormones that compels these sexual changes varies woman by woman and also over time.

Sometime between 40 and 50 years old women begin to experience symptoms of pre-menopause or menopause itself. These symptoms assert themselves differently and therefore affect each woman differently. Some of these symptoms will be strongly felt by some women but not so much by others, some may not have them at all. Hot flashes and insomnia for example are common but not universal and not all women will experience them in a similar way. All women pass through the stages of menopause but each one does so by herself and the experience will be unique to her.

Treating the affects of the three stages of menopause; pre-menopause, menopause and post-menopause therefore depends on what the symptoms are and when in a woman’s progression through menopause they will need treatment and what type of treatment is best for them. Early symptoms can be treated with non-prescription medications and treatments. Some of these are herbal and are useful for hot flashes and insomnia. Other treatments are targeted on the issues that arise in relation to sex such as vaginal dryness or painful sex and these come in the form of lubricants and moisturizers. Treating sexual discomfort early and paying close attention to the symptoms as they begin to assert themselves is sex-positive advice that I give for a reason. As sex becomes less pleasurable, desire for it arises less often. Therefore to retain a healthy sex drive it is vital to retain the ability to experience sexual pleasure. As we all know, any diminishment in the sex department may lead to relationship, emotional and even psychological problems a little ways down the road.

For many women mild treatments are very effective early on and become less so as time goes by. Milder treatments, non-prescription medications, moisturizers and creams may need to give way to another range of safe, effective treatments such as prescription creams, patches or pills. These treatments include non-hormonal treatments called SSRI’s, bio-identicals, synthetics and other types you may have heard or read about. There are also hormone replacement therapies and the choice of which to use depends on a woman’s preference and what proves to work most effectively over time. At the moment we know that both types work well and are safe but which one is the best and best at what exactly is still not definitively known. Having a wide range of treatments and medications is a very positive attribute as it allows for trying different approaches until we find the best one for each woman.

As menopause progresses, milder treatments that worked well before may not work so well now. This becomes evident, as some women will experience increasing difficulty having sex. Sexual activity and desire for sex now become an important factor in determining the next stage of effective treatment for each woman.

Both the need and desire for sex varies widely from woman to woman. Some women prefer to have sexual activity regardless of menopause; some women prefer to have less sexual activity or none at all. This becomes an important question when it comes to treating vaginal dryness, loss of sexual desire and sexual functioning. If sexual activity is not so frequent, short-term treatments such as lubricants may be effective. For women who are sexually active more frequently, there is a new safe and effective treatment that restores vaginal tissue to that of a thirty-year-old woman. The treatment uses a laser of the kind used in facial rejuvenation. Older tissue is zapped by the laser, which excites new tissue to grow. The result is moister, softer skin along the walls of the vagina like that found in younger women. In the city where this laser treatment was first introduced it became a favorite Christmas gift from husbands and boyfriends to their wives and girlfriends. Called “The Mona Lisa Touch” it is an effective, safe and painless treatment for sexual discomfort due to menopause.

As a clinical physician in practice for over twenty years, I have spoken to many thousands of women and have examined many thousands of women’s bodies in every stage of their lives. What I have learned is that they are highly individualistic and what works for one woman may not be effective for another. Sexual health is a good example of this. Every woman goes through menopause but menopause is different for every woman. Why? Every woman is unique; deeply, fundamentally, hormonally, emotionally and on every other level, unique. In the early stages of menopause a woman may benefit from herbals and mild treatments for mild symptoms. As levels of estrogen continue to decline then cease, more severe symptoms may assert themselves over time. Treating the right symptoms at the right time with the right approach lies at the heart of effectively helping women through the changes of menopause.

The North American Menopause Society (NAMS) publishes a list of qualified menopause physician specialists and it may also be helpful to ask your regular doctor for a referral for a menopause specialist he or she may recommend.

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