What Happened to My Sex Drive?!

Last week, I gave you a snippet of Part I of my interview, The Secret of a Happy Menopause, with gynecologist Dr. Karen Westermoe. Today I want to share the highlights of the second part of our interview, What Happened to My Sex Drive?! Enjoy more great information and advice Karen has to share.

Karen, welcome back and I just want to thank you again for all that you do to ease the pain and suffering that your midlife patients come to you with.

Thank you, Kim. I take great pleasure in helping women with midlife issues because the issues are usually easy to treat and treated quite successfully, if only women will ask. I encourage women all the time to ask your doctor about the problems you’re having. There’s no nobility in suffering.

A big problem women encounter during menopause is a loss of sex drive. What usually causes this?

Yes, a loss of sex drive is a very common complaint, but the answer isn’t always that simple. Female sexuality is much more complex, we think, than male sexuality. Stress, fatigue, relationship issues, self-esteem issues, health, sleep, and body image can all play a part in loss of sex drive.

I believe it’s important for women in midlife to ask themselves these questions: “Is my sex drive down because I’m not taking care of my own needs? Am I exhausted all the time? Am I stressed? Am I not talking to my spouse enough and not feeling emotional intimacy?” All this issues come into play with female loss of libido.

This is why self-care is so important. What’s your schedule like? What time do you wake up? How crazy is your day after that? Women can often feel hopeless that they can’t get out of the bind of a crazy life. This can really necessitate speaking to their partner and possibly seeing a therapist to learn to manage their time to make sure they’re talking care of their own needs. It is often then that an increase in sex drive can happen.

I’m glad you mention the importance of self-care is and how that can affect a woman’s sex drive. However, can loss of libido ever be a medical condition?

Yes. If loss of sex drive is a medical condition, I will know by just taking a full medical history of the patient. If I do find that it’s a medical condition, one of the products that can help with female libido is a small amount of testosterone supplementation. So far, the FDA has not approved a product for female libido, although there’s plenty of research being done. This seems to work in at least half of women and it does have to be made by a compounding pharmacist. Another medication that can help with libido is Wellbutrin.

Karen, can you explain what vaginal atrophy is?

The fact is that the lining of the vagina changes after menopause. As estrogen levels decline, so do those levels decline in the lining of the vagina. This results in a vagina that doesn’t lubricate, stretch much, and is thin and fragile, which can be very painful during sex. This can lead to an aversion to sex in general. It can also cause problems in relationships especially when your partner doesn’t understand that you are having pain that is valid and real and it’s not just a rejection.

Are there any solutions to vaginal atrophy?

There are two fabulous solutions to this so-called vaginal atrophy. The bulk of the solutions are topical estrogens. The amount of estrogen in these products is very small and is like a fountain of youth for the vagina. It can also help you hold your urine and not have to get up at night so frequently to have to urinate. There is even now a non-hormonal pill you take once a day. It’s a really neat product called “selective estrogen receptor modulators.” These drugs selectively act like estrogen on certain part of the body and on other parts they don’t. The one I’m referring to is called Osphena.

Painful sex is a valid issue. The unfortunate truth is that we know that insurance companies pay for Cialis and Viagra for men, however, they haven’t been quite as good at picking up the cost for these vaginal atrophy products for women. I must say, though, that things are coming along and they’re getting a lot better.

Karen, anything else you’d like to share with women in their fifties?

A misconception has gotten out there that menopause causes weight gain and it doesn’t. What does cause weight gain in this time and beyond is that our metabolism begins to slow as we get older. Going on estrogen will not help you lose weight. I encourage my patients in their fifties to exercise. This is important not only for building muscle, but burning fat during menopause.

Finally, I want to strongly encourage women in midlife to take your complaints seriously and bring them to your doctor because your life deserves to be improved.

Wishing you joyful health in your 50’s,
Kim