Chronic Diseases And Sexual Dysfunction
When a diagnosis of sexual dysfunction is suspected, a complete and detailed medical history should be obtained to evaluate women for chronic diseases that can adversely affect sexual health. This is especially true in menopause, because as women age they are at an increased risk for acquiring chronic diseases that impact sexual function . Chronic diseases such as hypertension, diabetes, depression, neurological diseases, urinary incontinence, and osteoarthritis commonly impact sexual function . Some reports suggest that cardiovascular disease impacts womenâs sexual desire and arousal through effects on systemic blood flow. The mechanisms by which cardiovascular disease affects sexual arousal is hypothesized to be related to the fact that female genital arousal is achieved when the vascular system increases blood flow and engorges the labia via vasodilation. Vascular disease may reduce vulvovaginal vasodilation and reduce sexual arousal . Reduced physical function in obese women and women with osteoarthritis may also adversely affect sexual activity. Additionally, sexual dysfunction observed in women with diabetes is attributed to reduced energy, altered body image, and suboptimal vaginal engorgement during orgasm .
Aiding Arousal And Orgasm
Both arousal and orgasm depend on a complex array of psychological and physical factors. Issues that reduce libido can also affect arousal and orgasm. In addition, when blood flow to the genitals and pelvis is diminished or nerves are damaged, it can be difficult to achieve either. Identifying and addressing lifestyle factors may increase your sexual response. These are the most common physical factors impeding arousal and orgasm:
Alcohol. Although a glass of wine might enhance your libido, heavy drinking can make it difficult to achieve orgasm.
Health conditions. Diseases that affect blood flow and nerve function, including diabetes, kidney disease, heart disease, and multiple sclerosis, can reduce sexual responsiveness.
Medication. Drugs to lower blood pressure can delay or prevent orgasm. Antidepressants, particularly SSRIs, can also impede orgasm.
Clinical trials have demonstrated that the following may be helpful in stimulating arousal and orgasm:
Zestra. A massage oil that creates a sensation of warmth throughout the genital area, Zestra increased desire, arousal, and satisfaction in 70% of the women enrolled in clinical trials required for FDA approval. It is available over the counter for around $10.
Testosterone Treatment For Low Libido In Women Is Missing
About 30 percent or so of women in the United States report low libido or sex drive, and about 10 percent report being bothered or distressed by it, Brooke Faught, doctor of nursing practice and board-certified women’s healthcare nurse practitioner, who is clinical director of the Womens Institute for Sexual Health in Nashville, Tennessee. Dr. Faught presented on sexual health, libido, and testosterone at the NAMS 2020 conference.
Having a low sex drive isnt automatically a reason for treatment hypoactive sexual desire disorder is when women have a low libido and are bothered or distressed by it. If the patient isnt directly impacted or bothered by it and its not impacting their daily function, its not a true diagnosable condition, says Faught.
Even when they are bothered by a lack of desire, many women put up with it rather than seek treatment they think its a normal part of aging or something they should just deal with, she says.
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Is This Increase In Sex Drive Normal
And among my acquaintanceship, there are quite a few women who are indeed enjoying this symptom during this time in their lives. Lynn from Arlington, VA, for example, is 49, and while she has some traditional symptoms of perimenopause, such as irregular periods and night sweats, shes also experienced an increase in her sex drive for the last few years. Jordan, 43, from San Jose, CA, experienced a decrease in libido a few years ago, but recently, as other perimenopause symptoms have kicked in, shes definitely seen an upsurge in her libido.
Journalist and adventurist Jill Gleeson is 51 and hasnt had a period in about a year she says that since becoming perimenopausal, her sex drive, while always high, has skyrocketed. What Nina has found is that the swings are higher. For example, the week before her period, she says she has no interest in sex at all, but in the days before her period, shes insatiable! This surge in desire lasts for about three days every cycle. Ive always enjoyed sex and had ebb and flow of desire, but this is crazy!
This explanation of increased libido coming with a drop in fertility and a lessened fear of pregnancy makes sense: after all, the largest sexual organ in the body is the brain.
How Can I Improve Intimacy With My Partner
During menopause, if your sex drive has dropped but you don’t think you need counseling, you should still take time for intimacy. You can still show your partner love and affection without having sex. Enjoy your time together: take walks, eat dinner by candlelight, or give each other back rubs.
To improve your physical intimacy, try these tips:
- Consider experimenting with erotic videos or books, masturbation, and changes to sexual routines.
- Use distraction techniques to boost relaxation and ease anxiety. These can include erotic or non-erotic fantasies, exercises with sex, and music, videos, or television.
- Have fun with foreplay, such as sensual massage or oral sex. These activities can make you feel more comfortable and improve communication between you and your partner.
- Minimize any pain you might have by using sexual positions that allow you to control the depth of penetration. You may also want to take a warm bath before sex to help you relax, and use vaginal lubricants to help ease pain caused by friction.
- Tell your partner what’s comfortable and what’s not.
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Itisdefinitely True That Sex After Menopause Can Be Painful At Least For Some Time
The most prominent change I hear about from my patients is that sometimes sex can become painful after menopause, board-certified ob/gyn Antonio Pizarro, M.D., tells SELF. Most of the time, this is related to a loss of estrogen. That can cause what’s known as vaginal atrophy or genitourinary syndrome of menopause, in which the vaginal tissue becomes thinner and more delicate, Dr. Pizarro explains. Issues like pain, vaginal dryness, and urinary problems can crop up as a result of vaginal atrophy. Around half of postmenopausal people experience these symptoms, according to the Mayo Clinic.
Doctors mainly treat vaginal atrophy with some form of estrogen supplementation, but there can be drawbacks. Pizarro notes that theres a small risk the amped up estrogen can contribute to uterine cancer unless a woman pairs it with the synthetic hormone progestin. But combining the two may then increase a woman’s risk of breast cancer, according to The American Cancer Society, which has a comprehensive breakdown of the benefits and drawbacks of using hormones to deal with menopause symptoms.
With All That Said You Can Still Have A Great Sex Life In Menopause
Pizarro and Brown-James both agree on this point. In fact, Dr. Pizarro says meno post-menopausal people have very active sex lives even without taking estrogen. Whats more, sexual satisfaction might increase once someones been through menopause.
There are a few reasons that might happen. The worry of being pregnant is no longer there, says Brown-James. Also, some people experience an increase in their sexual awareness of their bodies. Many women have not been taught to explore their bodies and have internalized ideas that the vulva or vagina are dirty or for someone elses pleasure, not theirs, she explains. A lot of times, if the knowledge that none of that is true hasnt taken root before, it gets dispelled at this point, and women realize their bodies are really for themselves. Bonus: That may also lead to more intense orgasms, says Brown-James.
Hormones And Sex Drive
Sexual desire often wanes with age. Around the late 40s and 50s, many women begin to experience a reduced sex drive. While physical symptoms of menopause can undermine sex drive, hormonal changes also play a role. During menopause, the body stops producing estrogen. Testosterone levels also decrease in women around midlife.
During menopause, the hormones that regulate sex drive, reproduction, mood and more begin to ebb, and these declining levels can negatively impact sexual function and desire. Hormones act as messengers in the body to control a vast array of functions. Three hormones are believed to affect female sexuality to some degree:
- Estrogen: The main female hormone regulates the menstrual cycle, female sex organ development and the lining of the uterus. During perimenopause, estrogen levels begin to drop dramatically. Menopause occurs when estrogen levels are too low for the uterine lining to thicken.
- Testosterone: Women have natural testosterone levels. This hormone is produced by the ovaries to help make estrogen. Testosterone declines naturally with age, especially after menopause. Some studies have suggested higher testosterone levels are associated with greater sexual behavior and desire in women.
- Progesterone: This female hormone supports pregnancy and controls the menstrual cycle along with estrogen. As with estrogen, progesterone levels decline during menopause. It’s believed changing progesterone levels impact female sexual behavior.
How To Have The Best Sex Of Your Life During Menopause
Ladies, we deserve to have the best sex of our lives — now! Even better, it’s completely doable . During our menopausal years, our sex lives have so much from which they can benefit: a strong sense of self, deep relationships, and bodies we actually know how to use!
For women, sex is like a fine wine. It gets better with age! Research published in the American Journal of Medicine shows that women’s sexual satisfaction actually tends to increase with age — even despite the hormonal throes of menopause.
Why? “As we age, most of us become more aware of what we need in the bedroom and how to get there. We feel more deserving of sexual pleasure and are more willing to ask for what we want from our partners,” says Hilda Hutcherson, M.D. Clinical Professor of Obstetrics and Gynecology at Columbia University Medical Center and author of Pleasure: A Woman’s Guide to Getting the Sex You Want, Need and Deserve. “In our 50s we are more likely to focus on our pleasure than in our 20s, when we tend to focus almost exclusively on his experience.”
So if your current sex isn’t the best you’ve ever had, it’s time to do something about it. After all, you do have hormonal changes to contend with.
A silent symptom of menopause, vaginal dryness occurs in up to one-half of postmenopausal women, while about one-third of postmenopausal women suffer from pain during sex, according to a 2009 review by Susan Wysocki, WHNP, FAANP, president at iWoman’s Health.
Take Responsibility for Your Own Orgasm
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How Can I Protect Myself From Stds
Take some basic steps to help protect yourself from STDs:
- Not having sex is the only sure way to prevent STDs.
- Use a latex condom every time you have sex.
- Limit your number of sexual partners. The more partners you have, the more likely you are to catch an STD.
- Practice monogamy. This means having sex with only one person. That person must also have sex with only you to lower your risk.
- Choose your sex partners with care. Don’t have sex with someone who you suspect might have an STD.
- Get checked for STDs. Don’t risk giving the infection to someone else.
- Ask a potential sex partner to be checked for STDs. Symptoms of STDs may not be visible or even cause any symptoms for your partner.
- If you have more than one sex partner, always use a condom.
- Don’t use alcohol or drugs before you have sex. You may be less likely to practice safe sex if you’re drunk or high.
- Know the symptoms of STDs.
Sex May Become Painful
There are consequences to the estrogen drop that occurs at the time of menopause, namely less lubrication. And that desertlike dryness can make sex uncomfortable or even painful.
Changes to the vaginal tissue can also interfere with your ability to become lubricated, says Dr. Streicher, whos also the host of the forthcoming podcast Inside Information With Dr. Streicher. Thats where a good lubricant comes in. She recommends silicone-based lubes, because water-based lubes can actually be drying to vaginal tissue.
If lubricants arent enough to counter the dryness, you may want to use a vaginal moisturizer two or three times per week, which can help make sex more comfortable. Beyond that, talk to your doctor about other treatments, including vaginal estrogen, which is available in creams, rings, pills, and capsules.
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Myth: Menopause Ends Sexual Pleasure
The facts: Menopause does bring certain changes that can negatively impact the physical aspect of sex, including:
- Loss of natural vaginal lubrication due to decreased estrogen production, which can make sexual intercourse painful
- Vaginal atrophy due to declining estrogen production, which may cause discomfort during sexual intercourse as well as urinary incontinence, vaginal infections, and other troublesome conditions
Fortunately, many effective treatments exist that can help restore your vaginal health, improve arousal, and increase your sexual pleasure.
We may recommend:
- A vaginal lubricant to ease dryness and discomfort during sexual intercourse
- Estrogen applied to the vaginal area via cream, suppositories, or a vaginal ring, to help repair and rebuild tissue
- Hormone replacement therapy to treat various symptoms associated with menopause, including the physical changes in your vaginal area
Interestingly, once weve eliminated your physical discomfort, regular vaginal sexual activity may help as well, since it increases blood flow to your vagina, keeps your vaginal muscles toned, and helps maintain vaginal elasticity.
Relationships Menopause And Sex Drive
Menopause in marriage is one of the reminders that we are in the closing stages in our journey through life.
Scientifically speaking, menopause means the woman is no longer physically capable of fulfilling their biological purpose of bearing a child. Hormones play a part, but the anxiety and depression associated with menopause run around this notion.
Nobody wants to die, but its even worse to spend the precious sunset years doing nothing.
Spending time with your long-time partner, intimate time included, is a good way to spend the rest of your days. Do the things youve always wanted to do when you were young, but wasnt able to for one reason or another.
Its not the end of the world, at least not for menopausal women and their partners. Its never too late to live healthily and be happy about it. It can save your relationship and your life.
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Gsm And Sex After Menopause
Genitourinary syndrome of menopause is a collective name that refers to the urinary tract and vaginal problems women experience when they are going through menopause or are postmenopausal. GSM symptoms can include pain during sex, bladder control issues, the urgency to urinate and a lack of lubrication. Researchers recently examined the prevalence of GSM and how it affects the ability of women to enjoy sex.
Dr. Amanda Clark and a team of researchers surveyed over 1,500 women over the age of 55 between March and October 2015. Most of the women were white and 48 percent reported no sexual activity in the six months leading up to the study. The results of the study were presented at the North American Menopause Society annual meeting.
Within two weeks of a visit to a gynecologist or primary care doctor, the researchers approached the women after selecting them as participants using digital health records. The survey asked women about their history of urinary, sexual and vulvovaginal symptoms. The questionnaire was compiled for the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire with questions the researchers specifically designed.
Rediscover What Libido Means To You
In my office, women talk of changes in their sexual lives. Our conversation often surrounds what to do and what is available for treatment. Often it requires opening up the can of worms to discuss what libido is and what drives it.
Libido is a complex aspect of sexuality. Many people are uncomfortable discussing it. And many times, it isnt until menopause happens that we try to find the time to peel back the layers and figure out what libido really means for us individually.
Finding new ways to transform arousal and moments of excitement such as pelvic physical therapy or laser vaginal rejuvenation also restore intimacy in relationships. The incorporation of lifestyle changes, technology, and medications can together help maintain the results of arousal with vaginal lubrication and vaginal tissue changes.
Sex therapists are also extremely effective in helping foster a new sense of intimacy with partners. Their tips may include:
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When To See A Doctor
A woman should speak to her doctor whenever perimenopause or menopause is having a significant impact on her day-to-day activities, including sexual activity.
Sometimes, a doctor can recommend changes in health habits as well as discuss whether prescription medications may help relieve the symptoms, including a low libido.
Speaking with a doctor can also rule out any other underlying medical conditions that may cause a reduced libido. These conditions include urinary tract infections, uterine prolapse, endometriosis, or pelvic floor dysfunction.
Your Aging Sex Drive: Whats Normal After Menopause
Famously, when a reporter told feminist icon Gloria Steinem in 1974 that she didnt look her age, Steinem responded, This is what 40 looks like weve been lying for so long, who would know? At that time, she believed growing older was a penalty for women. Whether or not she still sees age as a handicap unique to women, one thing is certain: She believes in a dwindling libido, which she herself admits to experiencing. Yet she considers it not so much a problem, as too many women do, but an overall advantage. The brain cells that used to be obsessed are now free for all kinds of great things, she recently told The New York Times.
For many women this perspective may come as a welcome surprise. Too often womens sexual feelings are criticized or even pathologized, with women held to standards few can meet or wish to meet. The articles written about the sexual lives of older women either focus on the rare, insatiable cougars, or they retread advice appropriate for a woman in her twenties. Meanwhile, many post-menopausal women, who are dealing with vaginal dryness or painful intercourse or a simple lack of motivation, may be left wondering, Is my experience normal? Other aging veterans of the sexual revolution may be sick-to-death of the constant temperature-taking when it comes to sex. At what age does self-acceptance come must comparisons to other women continue into old age?
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