IS THERE SEX AFTER MENOPAUSE??

Sandy Greenquist Health Pro
  • Well, the short answer is yes. The long answer has a few conditions and gets a bit more complicated.


    Loss of libido (sex drive) remains a common, usually untreated symptom in postmenopausal women, even though decades of studies universally show that replacement of testosterone has a significant impact on a number of parameters, including desire, frequency, satisfaction, pleasure, fantasy and orgasms.

     

    The first book to come out on the importance of testosterone to women was The Hormone of Desire by Susan Rako. Dr. Rako linked decreasing desire in perimenopause and beyond to the decreasing levels of testosterone in a woman's blood stream. Still, the medical community has been very slow to consider the fact that women actually have significant levels of testosterone in their blood. In fact, the ovaries produce 50% of our testosterone, so as our ovaries age and hormone levels decline our sex drives go right along with them.

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    Testosterone is responsible for more than libido (sex drive). It promotes the development of muscle mass, enhances sense-of-well being and for many women also increases energy level. When we age, all of our hormones..thyroid, estrogen, progesterone, all sex hormone levels...decline. As the production of testosterone slows down, we will notice a flattening of desire, loss of muscle mass, less drive and less energy. Many women use words similar to: " It's like someone flicked the switch off. I just don't think about sex and really don't care."

     

    In general, what happens in the sexual arena with the coming of menopause is everything slows down. It takes longer to become interested; significantly longer to lubricate; longer to reach arousal; and longer to reach orgasm or an inability to reach orgasm at all during this phase. And, don't forget, as you are aging and changing, your partner is too. This can become a very trying time in a partnership especially if you are not being open and honest.

     

    Although using bioidentical testosterone can be very helpful in raising the level of desire, the solution has other components. First is education... educating each other. What feels good... what doesn't? You have to be in this together. Too often, it seems men, in particular, take it personally if their partner is not responsive, or they take no responsibility at all. Neither will work. Partners need to know that what is happening is normal and hormonal. It is not something a woman can wish away.

     

    A second component is time. It's going to take more time. Adequate foreplay is essential if this is going to be a satisfying encounter for both partners. So, make a date. Set time aside. Make it special.

     

    Third is attitude. I've often heard it said that the largest sex organ in the body is the brain. It's at least near the top of the list when it comes to being responsive in sexual intercourse. If you can get your mind engaged, your body will follow.

     

    With all those aspects in place, testosterone is the icing. It is safe and helpful for a majority of women. It has to be made in a compounding pharmacy since, so far, there are no bioidentical (human identical) forms of testosterone available from a pharmaceutical company. Testosterone can be made of soy and yam oils transformed into a powder which is mixed to make a variety of forms available: creams, gels, drops under the tongue, capsules and lozenges. It is important to use appropriately low doses and increase slowly. I usually start at 1-1.5mg and increase by .5 mg at a time as needed.

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    Adverse effects, when testosterone is dosed appropriately, are rare. There is clinical evidence that reports of acne, facial hair and lower voice were associated with higher dosing and are readily reversible with lower doses. Before starting therapy, a cholesterol profile should be obtained since, in rare cases, testosterone has been found to alter the lipid profile. The available safety data indicate that testosterone is contraindicated in postmenopausal women with breast or uterine cancer or who have cardiovascular or liver disease.

     

    The good news is that if you want to maintain an active sex life, there is safe, readily available hormone therapy that can help. If you are using estrogen and therefore have a healthy vagina and progesterone so that you are sleeping better and have more stable moods, and you are still attracted to your partner and want a sexual relationship, a little testosterone might be just the right ticket.

     

Published On: December 19, 2008