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Archive for September, 2011

It’s the third Friday of the month, and you know the script by heart—half-hearted foreplay, missionary position, a quick (or not-so-quick) denouement, and your partner’s already snoring while you’re thinking about tomorrow’s chores.

Routine is inevitable in long-term relationships. Routine can feel secure and orderly, but too much routine in the bedroom just feels boring. When you can anticipate every move, when you stay up late to avoid sex, when you wish your partner would just hurry up and get it over with, it’s time to hit “reset,” and crank up the heat with your honey.

It’s worth putting the effort into a good sexual relationship for all the reasons I mentioned in the last post. You’ll probably be spending your golden years with this person, and sexual intimacy (which includes kissing and cuddling) is at the heart of a healthy relationship outside the bedroom. Regular sex is also good for your health, and it’s good for your mental frame of mind. Besides, if you’re going to have sex, you might as well make it good.

But you can’t just jump in bed with sex toys in hand—lay the groundwork I discussed in the last post. Communicate. Try to understand your partner’s needs. Does he or she feel vulnerable? Uncertain? Inadequate? Bored?

Share fantasies. And keep an open mind. Anything new seems awkward and weird at first, but neither your mother nor your pastor is in the bedroom. This is sacred space for just the two of you.

Once you’ve both agreed to sweeten the honey pot, here are some ideas to heat things up:

  • Create a boudoir. Your bedroom should be a place for sleeping and for sex. It’s not the junk room, not the den, not the family photo gallery. Take out the distractions—including the television. Create a private, comfortable, beautiful space for the two of you to be together.
  • Write love letters. Leave notes for each other throughout the day. Make them more lusty as the day goes on. (We found some postcards you can use if you like.)
  • Fantasize. Talk about sexual things you’ve always wanted to do. Write down three for each of you. Put them in a hat and draw one. The other has to at least try. (Not sure where to start? We found these vows when we were looking for postcards!)
  • Focus on foreplay. Forget about scoring a home run. Get creative with the many ways of getting around the bases, from sexy undressing to intimate touching.
  • Focus on skin. Remember that big sex organ? Use that powerful sense of touch to explore your partner’s erogenous spots. Use textured objects, such as feathers or silk, to create new sensations and to stimulate sensitive nerves.
  • Swap roles. One of you is the “giver,” whose sole task is to pleasure the other. Pay attention to what feels good to your partner, how he or she responds to certain touch in certain places. Then switch roles—you get to be the receiver.
  • Change places. Make love in a different room, a different house, outdoors, in front of a mirror. “[Sex] is about the stimulation of your surroundings,” said Jane Seddon, author of Daily Sex in an interview with Cosmopolitan. “Doing it somewhere out of the norm adds an element of fun and makes you feel a little deviant.”
  • Stay healthy. Stress is a sex-killer, and it isn’t good for your health, either. Eat healthfully. Keep your weight under control. Exercise to maintain flexibility and to keep your joints healthy. You’ll be able to make love and do a whole lot more.

The goal, of course, isn’t to become sexual superstars, but simply to reestablish the connection and intimacy that was undoubtedly there in the beginning of your relationship. With decades of life experience behind you, the best is yet to come.

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Maybe your last child left home, as mine just did this fall. Maybe you (or your partner) retired. Maybe your partner became ill. The catalyst could be one of many life events, or it could simply be the realization of time passing, but at some point you look at your partner and realize that you’ll be spending the rest of your lives alone together.

Do you need to hit the “reset” button?

Life passages tend to elicit examination and reassessment. These bittersweet moments give you an opportunity to readjust and re-evaluate. They give you a second (and third, and fourth…) chance to get things right. You tend to be more receptive to feedback and direction during those times. You tend to be less complacent.

Chances are that after years of distraction—raising a family, building a career—your relationship needs some attention, and that includes the sex. “Sex is always where the grit of a relationship settles,” writes a reader to the UK’s Globe and Mail. In that sense, sex is like the canary in the coal mine—an early warning system that all may not be so copacetic in the relationship.

So, how is your sex life? Robust and satisfying? Routine and uninspiring? Or is it non-existent? If your answer falls into the “boring” or “non-existent” categories, it’s time to reset.

“When sex drops off there’s a lot more at stake than missing out on pleasure,” says Joan Sauers, author of Sex Lives of Australian Women. “A healthy sex life is critical to the survival of a relationship. Without it, our happiness and overall health can suffer.”

Begin with reflection. Is infrequent, boring, or non-existent sex perhaps an indication of deeper trouble—entrenched lack of communication, trust, or respect? Is it due to physical changes or limitations that you haven’t risked discussing? In this case, hitting the “reset” button should include some honest soul-searching with your partner and maybe some sessions either with a sex therapist or a marriage counselor. Simply addressing the sexual issues without tackling the underlying problem is like painting over rotten wood. The veneer won’t hold for very long.

However, working to improve your sex life ipso facto improves the relationship as well, because both rely on intimacy, connection, and communication. “Keeping things interesting outside of the bedroom also plays an important part in keeping things exciting in the bedroom,” writes Rhegan Lundborg, sex and relationships expert for the Omaha Examiner. “Doing new and fun things completely outside of the bedroom can be a great way to reconnect emotionally as well as take sole focus off the sex and just spend time enjoying each others company.”

Focus on reconnecting. In a quiet, intimate surrounding, reminisce about the day you met, your first kiss, what attracted you to your partner. Go through a photo album together. Talk about key moments in your relationship—adventures you shared, challenges you got through. Few people in your life know you as well as this person. That’s a rare and precious treasure. Make time to appreciate it.

From memories, move on to fantasies. In a perfect world, what would you like to accomplish or experience together—or separately? What’s still important?

Don’t be stingy with the sugar. Express approval. Say thank you. Notice the small ways your partner is thoughtful.

It takes time and careful tending to reignite a flame. As you rebuild intimacy on other levels, communication about your sexual connection could follow naturally. Or you may have to initiate the conversation when the time is right. Or—you may have to initiate the conversation with professional help.

Start the conversation in a safe, accepting, non-judgmental space. You both are likely to be experiencing changes, whether physical or emotional. You may have fears; you may be vulnerable. And you may also have fantasies—things you’d like to try but never had the guts to ask.

Isn’t it time to hit the “reset” button and get this conversation started?

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We all remember Maslow… don’t we? That noted psychologist who, in 1954, published his famous hierarchy of human needs that we all learned about in high school psychology?

Maslow determined that we all have basic physical and psychological needs that fall into an orderly hierarchy and are necessary to achieve happiness. But, he propositioned, basic survival needs for food and shelter had to be met before we’d benefit from higher levels of need fulfillment, such as the love and belonging or self-esteem.Perfection of character is this...

To test whether Maslow’s theory would hold up under modern scrutiny, two researchers designed a massive Gallup poll of well-being. Almost 61,000 people in 123 countries were quizzed about fulfillment of specific needs and daily feelings of joy and unhappiness as well as on overall life satisfaction. Maslow was correct that people everywhere share the same basic needs, beginning with physical needs and ending with self-actualization (a “fuzzy” term that scientists don’t much like).

However, this survey found that, although Maslow was on target about his list of universal human needs, he was wrong about their orderly nature. People seem to need everything all at once. People can (and do) enjoy the higher-level needs for love and friendship, for example, even if they may be lacking some basic needs. “They’re like vitamins,” said one of the researchers in a recent article in the Atlantic. “We need them all.”

So where do we fit in—midlife women who probably have our basic physical needs met, but who still are actively engaged in life’s endeavors?

While the Gallup researchers were revisiting Maslow, Jaki Scarcello, author of Fifty and Fabulous, was conducting a little survey of her own, interviewing older women between the ages of 45 and 102 around the globe. She wanted to find out what happens when women grow old. How do we evolve?

What she discovered was that many of us do indeed reach Maslow’s highest levels of human development. We become wise, accepting, purposeful—you know, self-actualized—and this at times despite living under difficult challenging circumstances at times.

“I think the Maslow link is that perhaps self-actualization and improved self-esteem are more available to us as we age, which, ironically, may be a time in our lives when our basic needs are once again threatened,” said Jaki.

Jaki calls these the Women of the Harvest.

“Many older women told me they were experiencing a confidence they had never felt before in their lives,” says Jaki, “that they had found their voice, they were daring to do things they had not dared to do before.”

Younger women, on the other hand, tend to look to external sources for validation, to be more invested in appearances, and to be more distressed when basic needs weren’t met.

This serenity and self-acceptance applies to our sexual selves as well. “And so our sexuality is still important to us, but it does not suffer as much interference from self-deprecating mind chatter and from external reactions,” she said.

So, despite the physical and emotional changes of aging, we may be more confident in our own sexuality and look to others less for approval and validation.

“If it seems that the sparkle in a Woman of the Harvest deepens with age, perhaps it’s because her fire is fed in part by the internalization of sexual energy. This beauty is truly no longer skin deep. Instead, it radiates from some knowing place inside a woman who has ceased to need the outer world to know herself,” writes Jaki in Fifty and Fabulous.

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By the time women reach midlife, we’ve experienced all kinds of things in our relationships, some good, some bad. It’s great to think back on the positive experiences once in a while, maybe even relive them from time to time.

For the negative experiences, that’s not such a good idea.

And the more serious the situation, the harder it is to not think about it. Maybe you’ve had to deal with an infidelity or some other kind of betrayal by your partner. If so, its lingering effects may very well be interfering with your ability to fully embrace your partner in a healthy–and even in a literal–way.

If you’re harboring resentment or anger over some past wrong, you need to address it. As psychotherapist and our relationship coach Mary Jo Rapini says on her blog, “When your relationship struggles with resentment, it can feel like you are sleeping with the enemy. The resentment is felt deeply by one of the partners, and although it is rarely discussed openly, the tension can be felt by anyone close to the couple.”

So how do you let go of it? Well, it’s forgiveness. Dr. Fred Luskin, a psychologist affiliated with Stanford University, has made the study of forgiveness his life’s work; he’s written several books on it. The first, Forgive for Good, is based on the successful workshops he conducts using a step-by-step process to teach people how to forgive.

His second book, Forgive for Love, was written specifically for husbands and wives, and came about, he explains, because so many of his workshop participants were women trying to forgive current or ex-husbands.

Dr. Luskin has done studies that show harboring feelings of resentment and anger is not good for us physically or emotionally. It means we’re in a constant state of stress and negativity. In lectures he often quotes Nelson Mandela: “Harboring resentment is liking drinking poison to kill your enemy.” In other words, it’s doing a lot more harm to you than it is to the person who hurt you.

His methods of letting go of anger are similar to stress management and include mind-over-matter techniques like visualization and focusing on positive thoughts rather than negative ones.

Mary Jo, too, advises readers who are angry to “make a peace with your past. Tell whoever hurt you how you feel about what happened.” She also says that “letting go of your ego and learning to forgive your partner for their flaws and weaknesses—as well as forgiving yourself for holding on to that anger—are two of the biggest obstacles to overcome when working through resentment.”

Learning to forgive may not be easy, but it’s worth a try. In fact, it can be a life-changing experience. Because it’s never too late to take action. And you’ll feel much better when you do.

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Vaginal estrogen is the most effective treatment for vaginal atrophy and its symptoms: dryness, itching, irritation, pain with intercourse. There are three low-dose, localized (without systemic absorption) estrogen options: the vaginal ring (Estring), vaginal tablets (Vagifem), and vaginal creams (Premarin and Estrace). I prefer the ring and tablets, because the cream is messy to use and the absorption is somewhat more variable. Studies confirm is no significant or noted changes in circulating blood estradiol levels with the ring and tablet; the creams are more variable and therefore more likely to have transient elevations in estradiol levels. I have many breast cancer patients who use these methods.

Women who are candidates for vaginal estrogen often also consider over-the-counter lubricants and moisturizers. Lubricants make sex more comfortable in the moment, but don’t improve or prevent the progression of the atrophy. Vaginal moisturizers give more lasting comfort. Used independent of sex on a continuous basis, usually two times a week, they can help restore moisture to the tissues. The moisturizers can also help restore a more healthy pH, promote elimination of dead cells, and increase moisture in the tissues.

If there are multiple menopausal symptoms, which may include vaginal dryness, systemic estrogen (like Vivelle) might be considered, weighing all health factors in the decision.

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In 1968, she was Barbarella, the fresh-faced ingénue in shockingly sexy outfits. Then she was Hanoi Jane protesting against the Vietnam War. She was the prostitute in the movie Klute, for which she won an Oscar for Best Actress. She became our Fitness Queen in 1982 literally inventing the workout video. The “Jane Fonda Workout” is still the bestselling video of all time (17 million).

Whatever you might think of Jane, she’s always been at the cutting edge, always willing to forge new paths, and she’s always relevant.

Now Jane is at it again, tackling stereotypes and pummeling barriers with her latest book, Prime Time, an uncensored examination of “love, health, sex, fitness, friendship, and spirit.” This time she’s taking on the stereotypes of aging. With a freshly remade face (about which she is unabashed) and characteristically toned body, she looks many years younger than 73. Yes, you read that right. Seventy-three. In a quintessentially Jane statement, she attributes her appearance to 30 percent good genes, 30 percent lifestyle, 10 percent plastic surgery, and 30 percent good sex.

As you might expect, Jane doesn’t pull any punches about the sex. She has sex, and she likes it. Her frank, 50-page chapter on sex in Prime Time (“The Changing Landscape of Sex When You’re Over the Hill”) is a refreshing peek behind a curtain that is ignored at best and considered unmentionable at worst.

Perhaps the first important revelation is that she is doing what she can to continue enjoying sex with her longtime boyfriend, music producer Richard Perry. She was on hormone replacement therapy until she was diagnosed with breast cancer in 2010. Until recently, she also took testosterone, which “makes a huge difference if you want to remain sexual and your libido has dropped,” she says. She stopped taking it recently when she developed a stubborn case of acne.

In her book, she discusses masturbation, sex toys, and resuming sex after a hiatus. After divorcing Ted Turner, she was alone for six years before meeting Perry. “If you have been celibate for a long time and then begin a new love affair, be aware that your vagina is likely to need some attention,” she said in a recent interview.

Jane’s done her homework, and her advice is solid. But her most important contribution is to broach a subject that is socially taboo. When a celebrity and role model talks about having sex at 73, it becomes okay for other people to talk about.

That was a conscious decision on her part. “I wanted to go into such detail about sex because it can be very important in later life,” she said. “There are all kinds of changes that no one ever tells us how to handle. One of the things I kept hearing from the sex doctors was that very few people come to them with their problems… So I thought it would be helpful to go into detail about that.”

She also reveals another little-known secret of aging in Prime Time—that it can be the best time of your life. People over 50 tend to be less hostile, less stressed, and more capable of maintaining intimate relationships. And the sex can be better, too. According to Jane, all this adds up to happiness.

Thanks, Jane.

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There really are no special considerations specific to your diabetes. While I can’t confidently diagnose the cause of your pain with intercourse, I can’t think of a diagnosis or treatment option that would be eliminated because of your diabetes.

If you or your physician are considering systemic estrogen/progesterone, cardiovascular disease risks are taken into consideration. On the other hand, if localized (vaginal) estrogen could be part of the solution, cardiovascular disease risks are really not pertinent: The estrogen isn’t absorbed systemically to any significant extent. (Don’t interpret this to mean diabetics shouldn’t be on hormone therapy. May of our new studies suggest that starting hormone therapy at a younger age–closer to menopause–may actually be cardio-protective.)

I’m so glad you’re taking the initiative to investigate your health and your options!

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