Menopausal Concerns


If you are a woman past the age of 50, you may have found that over time your sexual desire has diminished or even disappeared altogether. This is actually a fairly common situation for women who are adapting to the changes brought on by menopause.

You may experience little interest in or desire for sex, or you may have a harder time getting aroused. Some women even report the loss of the ability to have an orgasm or they report it is “muted”. These physical changes – which affect more than half of women over the age of 50 – can be surprising and discouraging, and they may take a toll on your relationships and your quality of life.

As a postmenopausal woman myself – and as a sex therapist with unique understanding – I can assure you that there is hope for your sex life!

Menopause usually results in lower levels of the hormones estrogen and progesterone. In addition, most menopausal women lose up to 60% of the hormone testosterone they had at age twenty. (Yes, women’s bodies produce testosterone, which not only stimulates the libido, but promotes higher levels of energy and overall well-being in both genders.)

Hormones are chemical messengers in the bloodstream. They relay communication between the brain and the different parts of the body. That lovely warm feeling you get from a lover’s touch is generated by the brain, felt in the body, and delivered in part by certain sex hormones and other chemical messengers in the brain.

Hormone replacement therapy (HRT) can help alleviate the effects of menopause, and testosterone replacement therapy can be a key to restoring your libido.

When I worked at UCLA’s Female Sexual Medicine Center, I witnessed many sexual transformations, especially as a result of testosterone therapy (or “T-therapy”). A classic study done in the 1980’s by Barbara Sherwin of McGill University studied the effect of testosterone replacement therapy in women whose ovaries had been removed (for other medical reasons). Those who received treatment reported that their sexual interest soon returned.

Your levels of testosterone, estrogen and progesterone can be determined by a blood test. If any of your levels are low, you should consider the pros and cons of replacing those hormones in discussion with your physician. Although there are potential risks and side effects associated with HRT, a physician can help you determine your best course of treatment. I counsel clients about HRT and can recommend doctors who support this type of treatment.

Whether or not you consider HRT, talk therapy can be of enormous help as well. Sometimes a realignment of priorities can make a difference. Better communication and setting expectations with your partner are also important. Learning to accommodate changes in your body as you age can require a shift in attitude, which I can help facilitate.

NOTE: If you do consider HRT, I strongly recommend that you get prescriptions for what are called “bio-identical hormones,” which are exact molecular copies of the hormones that occur naturally in your body.

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