Feeds:
Posts
Comments

Posts Tagged ‘libido’

A Libido Boost over the Counter?

Posted in Condition News, tagged , , , on August 9, 2012 | 1 Comment »

According to a recent New York Times article, women now have available a plethora of products meant to boost “feminine arousal.” And they’re appearing not behind the pharmacist’s counter, but in over-the-counter products in major pharmacies, right beside the Vaporub and Ace wraps.

Yahoo—I think.

Many of these products contain blends of botanicals and oils and “secret-recipe” ingredients designed to boost a woman’s sexual response. I wish some of them would carry more information for the user so that, for example, some oils aren’t unintentionally used internally when they’re best only for external massage. As with many beauty products, some strike me as setting unrealistic expectations (or even sending unfortunate messages), as with “anti-aging creams” for the vagina, clitoris, and inner thighs.

Few of these products have been objectively tested for efficacy or safety, so it’s a “buyer beware”—or, I’d rather say, “buyer be informed” marketplace.  Zestra’s oil is the only arousal product that has been subjected to a randomized clinical trial in which it “significantly” outperformed a placebo. Too many products are promoted with only survey results, which are not the same thing as a clinical trial.

As the Times article noted (and we’ve stated many times), the trouble with female libido is that it’s complicated. Everything from mood to culture and personal beliefs to hormonal imbalances can affect a woman’s ability to “get it on.”

And in fact, a woman’s lack of libido also affects her partner’s sexual pleasure. Dr. Michael Krychman, gynecologist and MiddlesexMD advisor, notes that men often neglect to fill their Viagra prescriptions because their partner’s sexual issues remain unaddressed.

Finding a one-size-fits-all silver sex bullet is like looking for fairy dust. Most of us have to develop a multi-pronged regimen to keep our sex drive functional, especially as we get older. We could abide by the Hippocratic principle to “do no harm,” and given that these products are, by-and-large, indeed harmless, and that they may do some good, why not give them a trial of your own? Use a site like ours to inform yourself about what might be worth looking for or avoiding (we have this advice, for example, about choosing a lubricant), and then make some room for some playfulness.

“Do they work for serious issues? No. But do they work to make your sex life more fun? Maybe. There’s certainly no harm in trying,” says Dr. Bat Sheva Marcus in the Times article.

Read Full Post »

A Hot Time Tonight

Posted in The Good Stuff, tagged , , on July 16, 2012 |

Let’s face it. When you get to this stage of the game, and especially if you’ve been with the same partner for years, you may be wondering whether sex is really worth all the bother. Is it really worth the time, the mess, the mental energy? Why not just let it go the way of your vanishing waistline?

Well, you might consider that many couples in their mature years have discovered a kinder, gentler sex life that enriches their relationship and keeps their finger on this essential juiciness of life. You might think twice about closing the door to this most lovely of intimacies with a person you love. You might reconsider losing this thing that keeps you in touch with sensuality in the broadest sense. As Dr. Christine Northrup said in an interview, “Menopause is the fork in the road where one side says ‘Grow,’ and the other says, ‘Die.’ Menopause… like the fall of the year, is an open window.”

Libido is a fragile flame at this stage of life. We can snuff it out, or we can coax that flicker into a cozy fire. And like other parts of our life, with some nurturing, some honesty, and some practice, sex can become one of the delights of our mature years.

So, maybe it’s time to rethink attitudes and values you’ve carried with your throughout your adult life. Your body, your libido, and your responses—and maybe your partner’s vim and vigor—are changing anyway, so maybe it’s time to bring some open-mindedness, more compassion and patience (and maybe some new moves) to the bedroom.

First, you have to discover what pleases you sexually. You might have a hard time articulating or even knowing what turns you on. Maybe you haven’t thought about it, or you’ve focused on your partner’s pleasure, or you’ve never enjoyed sex all that much, or you’ve been too self-conscious for that kind of exploration.

Have you ever considered that the biggest turn-on for your partner is when you’re turned on? And that it doesn’t even take penis-in-vagina sex to turn you on? “The good news is, men do not need a penis to pleasure a woman,” says Dr. Northrup, “and it’s very important to a man’s self-esteem that he know how to pleasure a woman.”

So, the first order of business is to find out what pleases you and then to communicate that to your partner.

So—explore your sexual parts! Get to know yourself and what feels good and where. Practice. Masturbate. You’ll probably discover that, rather than a full-on attack, a gentle tease, a buildup of tension, then backing off is both effective and pleasurable. Consider using a vibrator if you need more stimulation.

Now, have a little tutorial with your partner. How is he supposed to know this stuff if you don’t show him? Maybe he can show you what pleases him as well.

Next, broaden your definition of sex. According to sex therapist JoAnn Loulan, sex should begin with willingness and end with pleasure, with or without orgasm in between. Lots of intimacies count as sex—cuddling, kissing, touching. As long as it’s emotionally pleasurable and fulfilling and keeps the spark alive, it all counts.

Your mind can be the pink Viagra that everyone’s looking for. Harness your creativity and imagination. Fantasize. Read or watch erotica. Many women are gathering ideas from the latest 50 Shades of Gray series. (More on that later.) Or read this for our own list of movies that turn us on.

Finally, a few wrap-up thoughts:

  • Don’t compare. Your sex life is unique and sacred. There’s no magic number of times or ways to do it. At this stage of the game, we can do it any way we want.
  • Your partner is a lot more accepting of your body than you are, so let go of the self-criticism.
  • If you have a hard time loosening up and you can’t turn off that judgmental voice in your head, try a glass of wine with sex. (As long as alcohol isn’t a problem for you.) It’s a nice way to release inhibitions.
  • Take belly dancing. I still remember watching a friend who had learned to belly dance walk onto the dance floor with her husband. That woman had the roll of the hips down pat—it was sexy even for me to watch. You’ll develop some great musculature, and you’ll learn a truly female art form.

And most important: Have sex! However it works for you, just don’t stop.

Read Full Post »

An Update on Testosterone Therapy

Posted in Condition News, tagged , , on July 9, 2012 |

Recently, Dr. Sheryl Kingsberg, chief of behavioral medicine at University Hospitals Case Medical Center, professor in Reproductive Biology and Psychiatry at Case Western Reserve University, and a MiddlesexMD advisor, was interviewed by Dr. Michael Krychman, another MiddlesexMD advisor, for an online feature about the state of testosterone therapy for women.

Since we were able to be a fly on the wall, here’s the takeaway:

Despite a few advances in the research, the general state of affairs surrounding testosterone therapy for women remains fairly untested and inconsistent.

Unlike in Europe, which has approved Proctor & Gamble’s testosterone patch for women, the US Food and Drug Administration has no approved testosterone therapies. Women who receive testosterone therapy in the US get it “off-label,” meaning that either products designed for men are prescribed in small doses for women, or it’s compounded by a pharmacist without regulation or oversight. And that’s the way it’s been done in the US for decades.

In the meantime, research on testosterone products for women proceeds in fits and starts, and there simply hasn’t been a lot of it. Two large efficacy trials of BioSante Pharmaceuticals’ new LibiGel testosterone product found no significant difference between it and a placebo. The company is continuing with five-year safety trials, however, to determine if long-term use causes adverse health effects in women—specifically, cardiovascular disease or breast cancer.

“They’re moving forward with the [safety] trial, so that is hugely exciting,” says Sheryl.

The goal of testosterone treatment is to return a woman’s testosterone to pre-menopausal levels; treatment protocols for clinicians are fairly undefined, although the North American Menopause Society has recently updated its practice guidelines. Most blood tests aren’t sensitive enough to pick up such low levels of testosterone, and there’s no correlation between blood testosterone levels and libido. That means that while blood tests to establish baseline levels can be helpful, a clinician has to rely on observation and the patient’s reported experience.

And determining whether a woman is a good candidate for testosterone therapy also remains something of an art as well as a science.

“Testosterone is an important option for women—but it’s not for every woman,” says Sheryl. “We know that testosterone therapy won’t necessarily be effective in all women, so it’s important not only to measure efficacy and safety, but also to think about other treatment options.

“The first thing a clinician needs to assess is which women would really make use of testosterone replacement, and which women have something else going on,” she adds.

Good candidates are women who have lost their biological drive for sex, which is the classic definition of hypoactive sexual desire disorder: They have no desire, no fantasies, no dreams, no “hunger for sex,” as opposed to women who may have lost interest in sex, but who may have relationship issues or other stressors in their lives.

Because of the dearth of research and treatment protocols, clinicians should monitor their patients who are on testosterone therapy to make sure that it’s both effective and at safe levels, although, as Sheryl points out, the amount of testosterone in most treatments is very low.

And despite the frustrating lack of options and research surrounding testosterone therapy, women who are troubled by low libido shouldn’t be embarrassed about asking for help. “Hypoactive sexual desire disorder is the most common sexual problem across all ages,” says Sheryl. “About 10 percent of women have it, and they deserve to be assessed and treated because sex is important to overall health and quality of life.”

Read Full Post »

Sex and Depression: A Tricky Combination

Posted in Condition News, tagged , , on June 29, 2012 | 1 Comment »

Even if you’ve been an emotional Rock of Gibraltar throughout your life, menopause can brew up a perfect storm for jittery moods, anxiety, and depression. And in addition to its psychological punch, depression and anxiety can put a definite crimp in your sex life.

According to the North American Menopause Society, “Women suffering from depression (which is associated with a chemical imbalance in the brain) report symptoms of prolonged tiredness, loss of interest in normal activities [like sex], weight loss, sadness, or irritability.”

Who feels like sex when the rest of you feels like this?

Menopause and depression make such cozy bedfellows because

  1. hormonal and endocrine-related turmoil are the very hallmarks of menopause, and they are intimately related to our moods. And
  2. certain predictable but challenging life events tend to coalesce during this period.

Ever since puberty, you’ve made a sometimes uneasy peace with the normal hormonal fluctuation of your monthly cycle. But now your hormones are all over the map. And in this case, a hormone like estrogen affects the functioning of a whole lot of other stuff.

For example, estrogen affects serotonin levels in your brain, and serotonin is the happy juice that regulates sleep, mood, energy, and libido. “It’s central to our well-being,” writes Colett Dowling, psychotherapist and author of The Cinderella Complex in an article on her website.

Dowling is no stranger to the emotional and physical punch of those hormonal changes. “It was only when I was a year past menopause that I began to address the sleep problems I was having, as well as the loss of energy and libido.… It took far longer than it should have for me to learn that menopausal depression, related to a drop in estrogen, was causing my symptoms, and to get the treatment that put me back on track.… I was stuck in this pattern for many many months, and it became hard not to think: Is this it, the end of my vitality and productivity?”

Research also suggests that women with depressive bouts in the past or who suffer from more severe or prolonged hot flashes are also more susceptible to depression during menopause.

And don’t count on life giving you a break during this stormy period. You may have to adjust to your children leaving, maybe to the death or disability of a parent, maybe to health issues of your own or of your partner. You may struggle with the emotional transition of a changing self-image or the inevitable and final loss of youth. Cultural stereotypes being what they are, you have to make peace (or not) with different social roles and perceptions.

Given these hormonal and psychological transitions, is it any wonder that depression often dogs the menopausal years? Is it any surprise that our sex life is an early casualty?

To get a handle on this dance between depression and loss of libido, begin by understanding how common and treatable it is. Give yourself a break and don’t be embarrassed to ask for help. Dowling writes, “Women at mid-life often feel guilty about their mood changes and avoid seeking treatment. ‘This will pass,’ they think, and while that may be true, depression can seriously affect the quality of life, including one’s ability to make a living.”

Loss of libido is another of those quality-of-life issues. It can strain a relationship and affect your sense of well-being. You don’t have to compromise either your happiness or your sex life. And you shouldn’t suffer in silence.

A few additional issues with regard to depression and libido:

  • Antidepressants that affect serotonin levels (SSRIs and norepinephrine reuptake inhibitors) also affect libido, and not in a good way. If you’re on an antidepressant and have lost any interest in sex, talk to your doctor about a change in medication.
  • Low thyroid function (hypothyroidism) looks a lot like depression. It might be beneficial to have your thyroid levels checked. Also check your iron levels for anemia.
  • Consider whether unresolved relationship issues might be involved with your lack of interest in sex. Many doctors think a multi-pronged approach to depression and loss of libido is a more effective treatment. This may involve antidepressants as well as psychological counseling and perhaps lifestyle changes.
  • Ask your doctor about trying testosterone therapy to boost your sex drive. The jury’s still out, but there’s some indication that it can be effective.
  • Don’t overlook the basics. Your salad years of hopping in the sack for a quickie in the afternoon may be over, but you can still enjoy long, slow evenings of sweet intimacy. Just don’t forget the lube—and maybe a few pillows to keep things comfy.

Read Full Post »

Q: What does higher libido in perimenopause mean to my future?

Posted in Questions...and answers, tagged , , on November 8, 2011 |

Libido is, at best, complicated. Testosterone is the hormone that is linked to libido for women as well as men. After about age 25, our testosterone levels are slowly dropping. It’s estimated that a 50-year-old has about half the testosterone she once had.

I see this phenomenon with increased libido in perimenopause from time to time. Testosterone interacts with other circulating hormones, and it seems to be the relative balance and interaction of these hormones, not the absolute levels of each, that for some women works very favorably during perimenopause. Relatively speaking, testosterone may have some “dominance,” even though the levels are lower than they used to be. Enjoy!

There are some other possible factors: Obese women tend to have slightly higher testosterone levels, and some women have had weight gain in perimenopause. Or, because we’re complicated sexual creatures, it could be the empty nest or something else entirely (for some, the absence of “that bothersome uterus”).

In general, women do experience a loss of libido with menopause, but the loss is not uniform across the board. We can hope you are that woman who doesn’t lose interest. In the meantime, seize the moment!

If you’re wondering when you might move from perimenopause to menopause, I’m afraid we can’t accurately predict that timing. We can only say that women, on average, become menopausal about age 50. Ninety percent of women have four to eight years of changed—and changing—menstrual patterns before becoming menopausal. Blood work is accurate in understanding estrogen, progesterone, and FSH levels for the day of the test, but it doesn’t accurately predict anything. Testosterone levels have fewer day-to-day fluctuations, so accurate measures can be made.

Perimenopause is a time to tune into your body, because as you move into menopause, your symptoms will be the best indicator of what’s actually happening.

Read Full Post »

Testosterone: Not for Men Only

Posted in Condition News, tagged , , , on August 22, 2011 |

Testosterone, of course, is the hormone that makes guys hairy, muscular, and sexual. But testosterone isn’t only for guys. Women produce it, too, but at much lower levels, and for us, the effects are less linear and more subtle: More testosterone doesn’t necessarily mean more libido. Yet, in many studies, a little touch of testosterone has been strongly linked to a better sex life for women.

So, what’s the big deal about testosterone, anyway? What’s its role in women’s sexuality, and what are the pros and cons of testosterone therapy for women?

First, a refresher: The most common cause of pain with intercourse for the peri-menopausal and menopausal woman is vaginal dryness that comes from the absence of estrogen—in medical terms, vaginal atrophy.  The solutions are to restore vaginal estrogen (available by prescription) or restore moisture with regular use of non-hormonal, over the counter options, like Yes or Replens.

So while estrogen is primary, we also produce testosterone—mainly in our ovaries, and only at about one-tenth the level as in men. Testosterone levels peak in our 20s and early 30s and steadily decline until, surprise!, we’ve lost about 80 percent of our testosterone-producing power after menopause. Women whose ovaries are removed are also cast immediately into “surgically induced menopause.” While we may still be sexual creatures, we’re no longer procreative creatures, so the hormonal stream is reduced to a trickle.

Enter testosterone therapy. Testosterone may be one rabbit in the bag of tricks that addresses the single biggest sexual complaint in women: lack of interest. Testosterone has been called the “hormone of desire” for women. “Women need estrogen for lubrication and comfort during sex. But they need testosterone to feel desire in the first place,” according to author and “Today” show correspondent Judith Reichman  in a 2005 “Washington Post” article. In many studies over the years, replacing testosterone has been linked to greater sexual desire, more intense orgasm, and improved sexual performance in women. There’s evidence that it might also improve muscle tone and increase energy levels and mental acuity.

Yet, it’s still only available “off-label,” meaning that there’s no pharmaceutical brand approved by the Food and Drug Administration (FDA).  Testosterone can be prescribed by using the male FDA-approved products, at significantly lesser dosing regimens, or by compounding at pharmacies. Testosterone, in natural or synthetic form, is available in long-lasting injections, pellets, patches, and transdermal creams or gels. Oral testosterone or testosterone pills are not recommended because they are metabolized by the liver and the possible changes that result from that.

Testosterone therapy remains controversial. Unlike in men, there’s no direct relationship between libido and blood testosterone levels in women. A woman can have a good sex drive with low testosterone or no interest in sex with high testosterone levels. Additionally, appropriate levels of testosterone for women have been hard to establish since we produce so little of it. Measuring testosterone levels in women is difficult, because of the very low levels and other factors that affect the circulating testosterone. The use of testosterone in women is usually well-tolerated but side effects may include acne and unwanted hair growth. The phase III clinical trials for testosterone use in women appear as though testosterone use in women will be safe, but finalization of these studies and FDA approval are still pending

Before beginning testosterone therapy, it’s important to address other causes of loss of libido, such as depression, medications, painful intercourse, lack of emotional intimacy, or chronic stress. But, if lack of interest in sex or the inability to experience orgasm continues to be a problem for you or in your relationship, testosterone therapy might be something to explore with your health care provider.

Read Full Post »

Sex on the Brain

Posted in The Good Stuff, tagged , , , on July 18, 2011 |

We’ve talked before about mindfulness – making a conscious effort to become more fully aware of something and thinking more deeply about it – and how being more mindful of sex can help increase your desire for it.

Because like many things in our busy lives, it’s easy to put sex on the back burner, along with items like haircuts and ironing. And if that burner’s not turned on, things can cool down pretty quickly.

And let’s face it, as we get older, our sex drive can diminish as hormone levels drop after entering menopause. So unlike when we were young and our hormones were raging, sex isn’t always “on the brain,” as it used to be. And unless you’re pro-active about putting it there, it might go away. Which would not be a good thing because sex and intimacy are such important parts of a well-balanced, healthy relationship.

But once you make the decision to become more mindful about sex, you’ll find many opportunities to incorporate sexual thoughts into your life. And it starts in places other than the bedroom.

Like the kitchen, for example. There’s always been a great relationship between food and sensuality (remember the movie Tom Jones?). You might want to check out The New InterCourses: An Aphrodisiac Cookbook on our website. It explores the history of aphrodisiacs and offers a guide for pairing dishes with relationship stages and different times of year. It also includes easy recipes for massage and bath oils. Why not give it a try? It might just lead to a romantic encounter.

Speaking of baths, next time you’re in the tub, put out some candles and invite your mate to come in and chat while you soak. It’s a peaceful and relaxing setting (no phones allowed) that’s ideal for conversations about intimate topics like… your sex life!

Remember, too, that we women are much more responsive when we’ve received sexual stimuli — thoughts, sights, smells, and sounds — than we are to just diving into sex spontaneously. Getting in the mood might just be a matter of giving some thought to what turns you on – and telling your mate about it.

As the old saying goes, “Sex starts between the ears,” and that means in your head. So if you want to keep your sex life active – or get it cooking again – start thinking about it more. And watch what happens.

Read Full Post »

Q: My libido is higher than ever! Will it last? Should I be concerned?

Posted in Questions...and answers, tagged , , , on August 18, 2010 |

When you’re in perimenopause, we say that your hormone levels are, in general, declining. While they are declining “in general,” it’s likely that your levels of estrogen and progesterone are fluctuating erratically from day to day. Testosterone is usually more steady, not particularly fluctuating day to day or month to month. As a result, the mix of hormones changes, and for some women testosterone seems to play a more dominant role; one effect of testosterone is enhanced libido (it’s sometimes considered as part of therapy to restore sexual function).

This may explain what you are experiencing. You asked whether you should be tested for hormone levels. While it’s possible to measure hormone levels, and those measurements are accurate, the levels are accurate only for that hour or day and are not particularly helpful to predict what to plan on in the upcoming days or months.

I would say, enjoy the current state! I hope this is your ‘new norm.’

Read Full Post »

Follow

Get every new post delivered to your Inbox.

Join 215 other followers

%d bloggers like this: