Feeds:
Posts
Comments

Archive for April, 2014

Remember in middle school (we called it junior high in those days) when the boys and the girls were shepherded into separate rooms for those awkward films? It might have been presented by the gym teacher or the guidance counselor; maybe your school was large enough to have a health teacher who presided as we were introduced to the signs and effects of puberty—and the dangers of acting on urges.

My conversations with women lately have reminded me that while we take great pains to introduce our younger selves to their biology, we don’t quite follow through. In the sex ed I’m familiar with, the story stops with the fertile years. We don’t introduce the full cycle we can all expect to experience if we only live long enough.

Yes, breasts bud and menstrual cycles begin. We have children, or we don’t; we may have illnesses or surgeries. At some point, the cocktail of hormones shifts, and the parts of our bodies once prepared for reproduction begin to change once more. Our periods become unpredictable and eventually stop (a year without defines menopause). Our tissues become dryer, more fragile, less elastic. Without care and attention—and often in spite of them—our vulvovaginal tissues atrophy, which means they actually shrink.

And where do we learn this? Not in a gym or a cafeteria with a hundred of our same-sex classmates! For too many of us, we learn it only through our own experience, at a point in life when there aren’t many people we’re talking to about sex. We’re tempted to think this is an odd thing that’s happening only to us. We’re a little embarrassed, maybe a little ashamed.

There’s so much more common about our experience than most women think! If only there were a middle school for midlife, so we could all get together and learn about this next phase of physical transitions. As we thought (or it was hoped we were thinking) back in the original sex ed, knowing what’s ahead is the first step in making good decisions and taking charge of our own sexual health.

I haven’t yet figured out where to offer my midlife sex ed classes, or how to get busy women to attend! So I’ll keep having conversations with women one on one in my practice and through the MiddlesexMD website. I hope you’ll be having conversations, too, because even without the awkward films, we’re all in this together.

Read Full Post »

Let’s first acknowledge that women—and men, too—come to sex with a host of different backgrounds, value sets, cultural expectations, emotional foundations, and experiences. It’s very difficult, given that variety, to assert that anything is or should be true for every woman.

It is theoretically possible to have a strong physical attraction and enjoy sex with little emotional intimacy involved—whether we are men or women. There are differences between us, though: Research suggests that for women there are six neurotransmitters involved in sexual activity, and that the areas that “light up” in our brains with sex are completely different from men’s responses. Women release oxytocin with sex, a very strong bonding hormone; men don’t.

Cultural stereotypes may exaggerate the differences between men and women when it comes to sex, but the science is there to prove there are differences.

Among the women in my practice and in the rest of life, I observe that women often go into sexual experiences with an expected outcome that includes some emotional connection. Most of the women I see desire emotional intimacy as a cornerstone for their enjoyment of physical intimacy. And the study I recall that went the furthest in qualifying sexual enjoyment (“A Portrait of Great Sex“) implied emotional intimacy as intertwined with physical intimacy.

All of that said, I come back to the fact that women come to sex with enormous variety of experience and expectation. As long as she is caring for her own emotional and physical safety and health, each woman can choose, I hope, the right combination of emotional and physical intimacy.

Read Full Post »

What you ask about specifically is your clitoris, which, along with other genital tissues, does typically shrink with the loss of estrogen—whether through menopause or some other medical event. Because you’re under 40, which is young for what you’re describing, I’d encourage you to express your concern to your health care provider and have a thorough pelvic exam. The exam will be helpful in finding out whether there’s another vulvar condition causing the tissue changes—or whether you’re experiencing normal changes.

As we lose estrogen, we do face something of a “use it or lose it” proposition. That is, circulation and stimulation keep our genital tissues healthier; left to their own devices, they’ll atrophy. If you don’t have a partner right now, a vibrator is a great choice to provide stimulation and increased blood supply to the area. Maintaining your health means you’ll be ready for intimacy when—just when you least expect it—a relationship emerges!

Read Full Post »

That sounds like a bad riddle, right? Like one I heard on NPR last week: What goes up a hill and down a hill but doesn’t move? The answer to that one is a road. And the answer to what subtracts more than it adds is sex.

Here’s the disturbing—but not, when I think about it, surprising—statistic I ran across this week, courtesy of colleague Sheryl A. Kingsberg, a PhD and chief of the Division of Behavioral Medicine at the University Hospitals Case Medical Center: “When sex is good, it adds 15 to 20 percent additional value to a relationship. When sex is bad or nonexistent, it plays in inordinately powerful msmd-features-368x368_bookrole draining the relationship of positive value—about 50 to 70 percent!”

I was so struck by that statistical picture, I’m on the trail of the original research to understand more. But in the meantime, what I know from other studies—and my own experience and conversations with women—suggests that’s about right.

Let me first say that good sex doesn’t automatically make a relationship good. And a good, loving relationship doesn’t automatically mean that the sex will be good. But if I think back to a study done a couple of years ago, “The Components of Optimal Sexuality,” I’m reminded of how many of the characteristics of good sex are also characteristics of good relationships.

I won’t revisit the whole list, because you can read the series of detailed blog posts we did on each of the components. But here are just a few that come to mind in this context:

  • Being present. It’s so easy to take our partners (and, of course, others in our lives) for granted. Truly paying attention to one another—today—is a great gift.
  • Connection. When we feel connected to our partners, intimacy comes naturally (especially when we’re overcoming obstacles together). If you’re feeling “together but alone,” there are steps you can take.
  • Authenticity. At this point in our lives, I find that many of us are more willing than ever to own what we think and feel. Whether we’re in longstanding or new relationships, this helps us to be ourselves—and to be open about what we like and need, in the bedroom and the rest of life.
  • Vulnerability. Having sex is perhaps the ultimate act of making yourselves vulnerable to each other. What a reinforcement of the bond that a couple has with each other!

If those parts of your relationship are important to you, too, you’ve got more reason to understand how to stay healthy and be intentional about nurturing this part of your life.

Read Full Post »

%d bloggers like this: