Testosterone and Low Libido in Women

— Testosterone plays a major role in a woman’s sex drive. But if that sex drive fizzles, replacing the hormone with a supplement isn’t as simple as it sounds.

One of the issues with testosterone supplements is that they have side effects, such as acne and hair growth.

By Ashley Welch

Testosterone may be known as a male sex hormone, but women need it, too. Testosterone is part of what drives female desire, fantasy, and thoughts about sex. It also plays a role in ovarian function, bone strength, and the overall well-being of women, says Kelli Burroughs, MD, an obstetrician-gynecologist at Memorial Hermann in Houston. Yet while your testosterone level plays a key role in your sex drive, taking it in supplement form to treat low libido remains controversial.

Here’s what doctors know about testosterone’s role in low libido in women and how the hormone might be used as a treatment.

Testosterone Helps Fuel Our Sex Drive

Women’s testosterone levels gradually go down as they age, and lower amounts of the hormone can also reduce muscle mass, affect skeletal health, impact mood, cause fatigue, and decrease sensitivity in the vagina and clitoris, which affects libido, Dr. Burroughs says.

A drop in testosterone levels is believed to be the reason sex drive goes down after menopause, according to the North American Menopause Society.

Research Remains Unclear

Although it’s common for men to take testosterone to treat low libido, the U.S. Food and Drug Administration (FDA) hasn’t approved testosterone replacement therapy for women. Some doctors do prescribe it for women as an off-label use, notes Jenna M. Turocy, MD, an ob-gyn at NewYork-Presbyterian Columbia University Irving Medical Center in New York City. “These products include testosterone skin patches, gels, creams or ointments, pills, implants, and injections, often designed and government-approved for men,” Dr. Turocy says.

Testosterone doses provided by these formulations generally are much too high for females, so women are given a fraction (usually one-tenth) of the dose that men are prescribed, notes Barbara Schroeder, MD, an assistant professor and ob-gyn with UTHealth Houston.

“There is no dose that we can say is absolutely safe for women,” she explains. “There are no large randomized trials that have looked at this.” That’s why Dr. Schroeder says to check baseline testosterone levels and re-check them every three to six months to make sure they’re not too high. “The goal is to aim for testosterone levels that are in the normal premenopausal range,” she adds.

Still, testosterone supplementation for women with low sex drive is rarely recommended in the United States, especially for premenopausal females, given the limited data on safety and efficacy, Turocy explains.

One of the main issues is that testosterone has side effects. Acne and hair growth at the application site are the most common, Schroeder says. Changes in your voice, weight gain, hair loss, oily skin, mood changes, and an enlarged clitoris, may also occur, Turocy adds.

But the biggest concern involves testosterone’s long-term safety in women, as no robust scientific studies have looked at potential lasting effects.

In a review of 36 randomized controlled trials published in the Lancet Diabetes & Endocrinology in October 2019, researchers determined that testosterone therapy is effective at increasing sexual function in post-menopausal women. They noted that when taken orally, testosterone was linked to significant increases in LDL, or “bad” cholesterol, and reductions in total cholesterol, HDL, or “good” cholesterol, and triglycerides. These effects were not seen with testosterone patches or creams. More importantly, the researchers concluded that “data are insufficient to draw conclusions about the effects of testosterone on musculoskeletal, cognitive, and mental health and long-term safety and use in premenopausal women.”

What Else May Help With Low Libido

If you have low libido, testosterone may help, but it’s important to weigh the benefits with the risks. Know that there are other options that may be beneficial.

“If concerned about low sex drive, women should consult a knowledgeable healthcare provider who can evaluate their individual medical history, symptoms, and hormone levels,” Turocy says. “It’s essential to take a comprehensive look at their sexual health, considering not only hormonal factors but also psychological, emotional, and relational aspects.”

Other potential causes of low sex drive, such as stress, relationship problems, medication side effects, or underlying medical conditions, like nerve issues or endometriosis, should be explored and addressed before considering hormone supplementation, she says.

Finally, don’t ignore the power of healthy lifestyle modifications. “Implementing healthy lifestyle changes such as diet and exercise can also boost energy levels and self-image perception resulting in increased libido,” Burroughs says. According to a study published in July 2021 in the Journal of Sexual Medicine, regular exercise one to six hours per week was associated with benefits in desire, arousal, lubrication and sex-related distress in women experiencing sexual dysfunction.

Complete Article HERE!

List of Sex Hormones in Females and Males

By Serenity Mirabito RN, OCN 

Sex hormones are chemicals responsible for reproduction and sexual desire. Common female sex hormones include estrogen and progesterone, while testosterone is abundant in most males.

Sex hormones are produced by the ovaries, testes, endocrine system, and adrenal glands. Menstruation, age, and certain medical conditions can cause fluctuations in sex hormones. Females and males can balance sex hormones through hormone deprivation or replacement therapy.

This article will review sex hormone production, function, and ways to achieve hormonal balance.

Sex vs. Gender

This article uses the terms “male” and “female” as labels referring to a person’s chromosomal, anatomical, or biological makeup without regard to which gender or genders they identify with.

Where Are Sex Hormones Produced?

Females and males have different sex hormones. However, they do share some of the same ones but each with different functions.

Females

The main hormones that contribute to sexual health and desire in females are estrogen, progesterone, and testosterone. Although the ovaries are responsible for most female sex hormones, other tissues can also produce them. These include:1

  • Estrogen (estradiol, estrone, estriol): Although made primarily by the ovaries, estrogen is also produced by the adrenal glands and adipose (fat) tissue.
  • Progesterone: Besides the ovaries, progesterone is produced by the adrenal cortex, corpus luteum, and placenta.
  • Testosterone: Although more abundant in males, testosterone is also essential in females. Testosterone is made in small amounts by the ovaries and adrenal glands.

Males

Androgens are the main sex hormones produced by males. Androgens are responsible for male characteristics and reproduction. Several types of androgens are made in the male body, which include:1

  • Testosterone: Produced in the Leydig cells of the testes and small amounts in the adrenal gland.
  • Dihydrotestosterone (DHT): In adults, about 10% of testosterone is metabolized into DHT by the enzyme 5-alpha reductase. A rise in DHT levels initiates puberty in younger males.
  • Estrogen: This hormone plays a vital role in males. In addition to being produced by the testes, the enzyme aromatase converts testosterone into estrogen.2

Function of Each Sex Hormone

Sex hormones are not only responsible for sexuality and fertility but also are crucial for the growth and development of muscles and organs.1 Additionally, sex hormones help prevent medical conditions such as cardiovascular disease and bone deterioration.

Growth and Development

Estrogen is responsible for the sexual and reproductive development of females. Breast development, pubic and armpit hair, and the start of menstruation are all influenced by estrogen.1

Progesterone contributes to a healthy uterine lining for the implantation and growth of a fertilized egg.3 Progesterone is also essential for maintaining pregnancy and reducing bleeding and miscarriage.

Testosterone and DHT initiate puberty in young males.1 These hormones are responsible for penile and testicular growth, growth in height, and facial hair growth.

Arousal

Estrogen and testosterone are the main hormones affecting arousal and sexual desire. In females, the menstrual cycle causes fluctuations in sex hormones, resulting in feeling more aroused just before ovulation, when estrogen levels are at their highest.4

High levels of progesterone, however, can cause a decrease in sexual desire. Although testosterone may increase libido in some females, estrogen is the primary sex hormone linked to female sexual desire.4

In males, testosterone levels correlate to male libido. Age, obesity, and hypogonadism decrease testosterone, thereby reducing sexual arousal.

Organ Health

Estrogen and testosterone are important in preserving muscle strength as you age. In the first year of menopause, for example, about 80% of a female’s estrogen is lost, resulting in significant muscle loss and frailty.

Decreased estrogen levels can lead to osteoporosis (decrease in bone mass and density) and increased risk of cardiovascular events. Testosterone improves cachexia (complicated metabolic syndrome characterized by muscle mass loss) in cancer and other inflammatory-based conditions.5

Immune System

One study showcased how sex hormones influence immune system cells. Androgens (testosterone and DHT) and progesterone boost an immunosuppressive response (improving autoimmune disorders), while estrogen strengthens humoral immunity (the body’s ability to fight infection). However, more research is needed.6

Mood and Brain Function

Research continues to prove that sex hormones affect the entire brain. Depression, memory loss, brain plasticity, and mood disorders result from decreasing estrogen levels. Cognitive impairment during menopause has been shown to improve with estrogen treatment and may protect against stroke damage, Alzheimer’s disease and Parkinson’s disease.7

How Sex Hormones Fluctuate

Hormone fluctuation is normal in both sexes. Premenopausal females will experience hormonal changes throughout the menstrual cycle. Estrogen and progesterone levels are low just before the start of menstruation but are higher around ovulation. As females age, sex hormone levels drop, leading to menopause.8

In males, testosterone levels are highest in the morning and decrease throughout the day. Testosterone decreases at 1% to 3% yearly between 35 and 40.5

Sex Hormone Disorders

Sex hormone disorders can affect physical and mental quality of life. In some instances, they can even be deadly. Types of sex hormone disorders include:

  • Premenstrual dysphoric disorder (PMDD): Due to falling levels of estrogen and progesterone 10 to 14 days before menstruation, severe depression and anxiety can be experienced by some females. PMDD affects approximately 5% of premenopausal females.9
  • Menopause: Females 45 to 55 will begin to notice the inevitable symptoms of decreasing estrogen and progesterone levels. Brain fog, reduced muscle mass, and hot flashes are common symptoms of menopause.10
  • Erectile dysfunction (ED): As testosterone levels fade with age, having and maintaining an erection can be difficult. ED usually occurs in men over age 50.11
  • Hyperestrogenism (high estrogen levels): Too much estrogen can cause certain types of cancer, polycystic ovary syndrome (PCOS), and infertility.
  • Hyperandrogenism (high androgen levels): Too much testosterone can cause PCOS, hirsutism, acne, male-pattern baldness, menstrual irregularities, infertility, and virilization.

Can You Balance Sex Hormones?

Understanding the cause of sex hormone imbalances is essential to creating a treatment plan. If the sex hormone imbalance is due to a medical condition, then treating that condition should be considered. If the hormonal imbalance is due to aging or there is no treatment for the cause, then the following options could help improve sex hormone imbalances.

  • Lifestyle: Eating a well-balanced diet, exercising, maintaining a healthy weight, eliminating alcohol use, and getting enough sleep can impact hormone levels in a positive way.12
  • Herbs and supplements: Some herbs and supplements claim to restore hormonal balance. Nigella sativa could increase estrogen levels, improving the symptoms of menopause.13
  • Hormone therapy (HT): Replacing estrogen, progesterone, and testosterone with synthetic (human-made) forms can help increase low levels of sex hormones. HT can be given as oral medication, patches, creams, vaginal suppositories, subdermal pellets, or injections. Birth control is a form of hormone therapy. HRT is also a vital part of gender-affirming care.14
  • Hormone deprivation therapy: Some medications block hormones, reducing the effects of having too much of a particular hormone. Aromatase inhibitors, for example, prevent estrogen production, and gonadotropin-releasing hormone analogs and antagonists are used to block estrogen, progesterone, and testosterone. Gonadotropin-releasing hormone analogs are used to pause puberty in youths undergoing gender-affirming care.14

If you’re experiencing symptoms of sex hormone imbalances, talk to a healthcare provider about having a sex hormone blood test done to help identify potential imbalances.

Summary

Estrogen, progesterone, testosterone, and dihydrotestosterone (DHT) are sex hormones in males and females. Sex hormones are important in reproduction, fertility, sexual desire, and overall health. Sex hormones fluctuate with the menstrual cycle and with age.

There are several ways you can balance sex hormones, including lifestyle changes and medications. Talk to a healthcare provider if you believe you’re experiencing symptoms of a sex hormone imbalance.

Complete Article HERE!

10 Top Sex Ed Tips for Those 50 and Older

Making love is about more than intimacy. It’s good for your health, too

By Robin Westen

How sexy are your 50s?

If you think sex is the province of the young, you’re wrong. People in their 20s are having less sex now than ever before, studies show, so it’s possible that you’re as active, or more so, as the average millennial. About a third of us are getting busy several times a week, one survey found.

And most of us are still in the game: 91 percent of men and 86 percent of women in their 50s report being sexually active, although activity levels vary widely. So, there’s no “normal” amount of sex for people our age. What matters more is that you and your partner are happy with your sex life. Men and women age differently, and some studies indicate that sexual interest wanes differently as well. Combine that with emotional and physical issues, and it’s possible that you and your partner aren’t on the same wavelength when it comes to making waves.

The upsides, however, go way beyond our cravings for intimacy, pleasure and connection. Sex boosts our immune systems, improves self-esteem, decreases depression and anxiety, relieves pain, encourages sleep, reduces stress and increases heart health. (In one study, men who had sex at least twice a week were 50 percent less likely to die of heart disease than their less active peers were.) Another bonus: You burn more calories making love than by watching The Great British Baking Show.

Not only is there a lot of science around the subject of later-life lovemaking; there’s also a range of products and medicines that can help. Take these steps to revitalize your sex life.

1. Connect emotionally

Women are twice as likely as men to lose their enthusiasm for sex in long-term relationships, research shows. The problem isn’t always reduced estrogen; it could be an absence of emotional closeness. In these cases, try listening more, praising more and showing more kindness. Individual, couples and/or sex therapy can help as well. Look for a sex therapist certified by the American Association of Sexuality Educators, Counselors and Therapists.

2. Address vaginal dryness

It’s one of the top impediments to sex among older women: 34 percent of women ages 57 to 59 experience dryness and discomfort during intercourse, one study found. For help, try over-the-counter remedies before and during sex, such as water-based lubricants (K-Y Jelly and Astroglide), oil-based lubes (olive, coconut and baby oils) and OTC moisturizers (Replens and Revaree). Use these a few times a week, even if you’re not having sex.

3. Emphasize foreplay

“Regardless of the level of dryness, every woman needs to be primed with foreplay before intercourse,” says Elizabeth Kavaler, M.D., a urologist-urogynecologist at Total Urology Care of New York. Another tip: Encourage a woman to orgasm first, which provides more moisture for intercourse and other penetration.

4. Don’t let ED keep you down

Half of men who are in their 50s experience erectile dysfunction (ED), and the gold standard for treatment is prescription meds. Safe, effective options include Viagra (which lasts for four to six hours), Levitra (four hours), Cialis (up to 18 hours) and Stendra (up to six hours).

For the minority of men who can’t rely on a pill, other choices include alprostadil (a drug that’s self-injected into the penis) and Muse (a suppository that slides into the penis). Vacuum pumps use suction to coax erections, and new treatments include platelet-rich plasma (PRP) therapy, which may regenerate nerves and improve blood circulation.

5. Don’t ignore other conditions

Any problem that affects overall health can interfere with sexual pleasure. “Cardiovascular issues such as high blood pressure, as well as diabetes, can negatively impact blood flow,” which isn’t good for sexual arousal, notes New York ob-gyn Alyssa Dweck, M.D., coauthor of The Complete A to Z for Your V. “And depression or anxiety can reduce the desire or ability to have sex.” The problem? Medicines that treat these conditions may also affect sexual desire and response. Speak with your health care provider about side effects and possibly switching meds or adjusting the dosage or timing.

6. Consider estrogen

Women, if over-the-counter lubricants aren’t doing the trick, consider estrogen replacement therapy (ERT), which treats hot flashes and vaginal dryness. The most common delivery methods are creams and pills (you can self-apply Estrace and Premarin with an applicator or take these in pill form), insertable tablets (with Vagifem, you use an applicator to slide a tiny tablet into the vagina) and a ring (Estring, which your doctor inserts, or you can do this yourself; it needs to be replaced every three months). ERT is not recommended for anyone who has or had breast cancer, or for those who have recurrent or active endometrial cancer, abnormal vaginal bleeding, recurrent or active blood clots, or a history of stroke.

7. Think about lasers

A treatment called fractional laser therapy can help reduce vaginal dryness without estrogen. It works like this: A laser creates tiny superficial burns in the vaginal canal. As the area heals, this leads to fresher collagen development and increased blood supply, which makes the area more elastic and responsive, Kavaler explains. (She cautions against vaginal rejuvenation surgery, which is a cosmetic procedure: “It can reduce sensitivity in the area and can make orgasms even more difficult to achieve or, in some cases, sexual intercourse permanently painful.”)

8. Confront incontinence issues

In a national poll of more than 1,000 women, nearly half of those over age 50 reported bladder leakage during sex. The primary reason: Sexual stimulation puts pressure on the bladder and urethra. If you’re hoping to get lucky in the hours ahead, avoid consuming beverages or foods with caffeine, such as coffee and chocolate; caffeine stimulates the bladder and acts as a diuretic (citrus fruits and juices are diuretics, too). Men whose prostates have been removed can also experience incontinence during sex. This condition, known as climacturia, can be treated in a number of surgical and nonsurgical ways. Plus, medications such as Ditropan and Vesicare can decrease urination frequency.

9. Turn down testosterone

In late 2020, the American College of Physicians stated that testosterone replacement should no longer be administered to treat a lagging libido (testosterone can have serious side effects, including an increased risk of prostate abnormalities). Denver urologist David Sobel, M.D., offers three easy alternatives: “sleep, reducing stress, and — the big one — exercise.” Even better: Work out with your lover. Seventy-one percent of runners say that running as a couple plays a healthy role in their sex life, according to a 2021 survey according to a 2021 survey.

10. Overcome arthritis aches

About 58 million Americans have arthritis, and over half are younger than 65, reports the Centers for Disease Control and Prevention. Arthritis can limit your ability to engage in sex. In addition, an empathetic partner may resist sex to avoid creating discomfort. An option: Ask your partner to experiment with more comfortable positions. Also, time sex for when you feel best (rheumatoid arthritis pain is usually more acute in the morning), the Arthritis Foundation advises. Taking a warm bath, alone or together, can help relax joints before making love. If the pain is severe, try an OTC medicine such as ibuprofen before having sex, or speak with your doctor about prescription medications.

Complete Article HERE!

As menopause hit, my libido waned, my brain felt dull.

So I gave testosterone a try.

By Tara Ellison

As menopause hit, I found I wasn’t as interested in intimacy as I used to be. Sex started to feel like a box that needed to be checked a couple of times a week, and that was causing problems in my marriage.

But it wasn’t just sex. I felt was slowing down in many areas. After hot flashes in my 40s had sent me running to the gynecologist for help, I’d been using bioidentical creams to balance my declining hormones.

When, at 51, I confided to a friend that I’d had limited success with what my doctor prescribed, she said that she was thriving on something called hormonal “pellets.” I grilled her about them and then made an appointment with her practitioner, an internal medicine doctor.

He ordered extensive lab work, which showed that my testosterone levels were very low, which can happen with aging. The doctor said I had two options: do nothing, which he said would eventually likely lead to loss of muscle, decreased bone density and a host of other health complications. Or up my testosterone.

Testosterone therapy for women is a hotly debated subject. Studies suggest that testosterone can heighten libido in women with hypoactive sexual desire disorder (HSDD), at least in the short term. A recent statement by a group of international medical societies involved with women’s health endorsed the use of testosterone therapy in women for HSDD, and specifically excluded pellets and injectables as “not recommended.” It also cautioned there was not enough data to support the use of testosterone therapy for cognitive performance.

Women make between four to 10 times as much testosterone as estrogen, which the body can convert to estrogen. Despite its significance, no testosterone products designed for women are on the market and approved by the Food and Drug Administration. (Two non-testosterone, libido-focused drugs are available for premenopausal women.)

For men, the benefits of testosterone are well-documented — improved mood, sexual function and stronger bones — and more than 30 FDA-approved products are available, according to the agency. But long-term studies in women are lacking, including the effects on those who have a history of breast or uterine cancers and liver or cardiovascular disease. Although studies say testosterone is widely used in women, its use is considered off-label.

The pellets my doctor proposed are unregulated, and not recommended by the North American Menopause Society (NAMS) because of their high doses of testosterone and unpredictable absorption.

“There are a lot of misconceptions for the potential benefits of testosterone,” said Cynthia A. Stuenkel, clinical professor of medicine at the University of California at San Diego’s School of Medicine and past president of NAMS. “You’re going to lose fat mass. You’re going to gain muscle mass. You’re going to think more clearly. You’re going to reduce your risk of breast cancer. You’re going to improve your mood, and I think the global consensus pretty much dispels those proposed benefits.”

But I was desperate to feel better and at the time wasn’t deterred by some possible side effects, which included acne, facial hair growth and a lowered voice. And my friend was clearly convinced testosterone had helped her. The tiny dissolvable pellets, containing estrogen and testosterone, were inserted beneath the skin on my mid-buttock and would last between three to five months. If I developed any side effect, on the next re-up date we could adjust the dose or discontinue, my doctor said.

The insertion process took less than 10 minutes and about five days to kick in. I didn’t have to wait long to see improvement.

Within weeks, I was feeling good — my brain felt clearer — and my libido was in full swing again. It was hard to pass my husband in the kitchen without reaching over to touch him.

I can’t rule out a placebo effect of course, but having a jolt of testosterone seemed to make me more focused — I got things done. One morning in the magnifying mirror, however, I noticed a definite uptick in facial hair.< My husband liked the increased sexual activity and joked that he didn’t have to endure discussions about my feelings anymore since I had gotten more direct in my conversations with him. I also found I was more driven to work. Just generally, I felt more confident and it seemed like people responded to me differently because of that. And rather than being finely attuned to my spouse’s desires, I was pursuing my own. Was all this biochemical or, again, could it have been a placebo effect? “There are strong placebo effects for sexuality in research on aids for sexuality and research on testosterone,” she said. “Our culture has long painted women’s sexuality as a problem; when women have lower desire than men, the women’s desire is seen as too low or ‘hypoactive’ and, when their desire is higher than male partners, the women’s desire is seen as too high or ‘out of control.’ As a result, medical and other interventions for women’s sexuality, especially desire, are best viewed with a healthy skepticism: Are these interventions addressing a problem within the women or a problem created by gendered norms? Should the solution address women and their bodies or gendered prescriptions?” Women and the waxing and waning of sexual desire is a complex and tricky subject. But I was starting to wonder why there seemed to be fewer options available for women and less research about those options. Was the gender disparity slowing down progress for women’s sexual health? There seems to be an attitude of, “You’re past menopause, you’re not making babies anymore, what does it matter?” said Sharon J. Parish, a professor of medicine in clinical psychiatry and of clinical medicine at Weill Cornell Medical College. James Simon, clinical professor at George Washington University and a past-president of both the International Society for the Study of Women’s Sexual Health and NAMS, said “a lot more money” is available for research into men’s sexual health and “where there’s money, you have direct-to-consumer advertising. You have additional research and development. You have glitzy ads and promotions, et cetera., this is not a new subject for men or men’s sexual health.” Viagra, he said, which men can take for their sexual performance issues, just had its 23rd birthday. He added, “I think women’s sexual health has been largely neglected or put aside or denigrated or minimized because it took more time, was harder to measure, had less money and cachet involved, and it was easy for many in the medical community to do that, and women did not, and still to some degree, do not demand more, and that allows this to perpetuate.” Six months later, when I saw my gynecologist and said that I was using pellets, she looked alarmed and advised me to get off them as soon as possible. “They’re scary,” she told me and referred me to a recent article and study about worrisome side effects, among them mood swings, abnormal uterine bleeding and also greater likelihood of having to undergo hysterectomy when on the hormonal therapy.

Where you get into trouble is when women are given super high doses of testosterone.

“Keeping the total testosterone in the physiologic range, closer to where women were pre-menopause, without exceeding that level and giving excess testosterone, is the goal,” Parish said. “Pellets are extremely problematic; we don’t support those, because they result in what’s called super-physiologic ranges and can result in toxicity, and we don’t have safety data supporting that.”

Susan R. Davis, an endocrinologist and director of the Women’s Health Research Program in the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia, said instead of pellets women seeking help “would be better off using a testosterone gel or equivalent that’s approved for men and using a micro dose or a fraction of the dose. . . .

“You can do a blood test to make sure [a woman] is not going over the female limit,” she added. “You can vary the dose, and you can cut back the dose if she starts getting side effects” — unlike pellets, which stop working only after they’ve slowly disintegrated. Once a pellet has been inserted, it’s very hard to get it out if an issue develops.

“I think testosterone is important for women,” Davis said, “but we’ve got to be very cautious how we administer it and we need products approved for women. That’s what we need. It’s a bit like Goldilocks: there’s too much, too little, and just right, and if you use too much it’s bad. Higher doses are actually worse for sexual function. Women start to feel agitated, irritable, negative mood, so too much is bad. So, there is a ‘just right’ dose.”

Stuenkel, past president of NAMS, added: “If you’re going to do it, I think the transdermal preparations [patches that stick on the skin] make sense [since they] are FDA approved” — although for men’s dosing. “And so that’s not great, but I think in many ways it’s safer.”

Yet, for many women, dissatisfied with gels and the like, pellets can seem worth the risk — at least for a trial run.

In my case, I had gone from having no interest in sex to wanting lots of sex. But it hadn’t been the salve that I had imagined.

My relationship with my husband was undergoing a systems update. While I was feeling much better and my behavior reflected that, there were some things about the old operating system that my husband missed. Our relationship had always been a bit “old school” — my world revolved around keeping my man happy. I could take his emotional temperature at a glance. I tried to match his hectic pace, even when I knew I needed rest, and I had always been willing to put his needs before my own. But that wasn’t sustainable over the course of a marriage.

I wondered what if my lack of sexual interest before pellets wasn’t just physiological but reflected the result of needing something different from my relationship to fuel and sustain our intimacy?

Low testosterone didn’t create the problems in my relationship but it made us more aware of them. We had long standing dynamics that needed to shift and change. We needed to have some difficult conversations to help us develop a deeper connection. A more satisfying emotional intimacy that could then naturally lead to increased sexual desire.

Testosterone may make you feel like having sex again but I discovered it’s not a magic bullet to solve everything.

It has been two years and given the long-term safety concerns about the pellets, I’ve decided to give them up when the current batch melts away — but I’m not giving up testosterone entirely. I’m considering using a patch or gel next.

The absorption might not be as effective, but at least I’d have more control over the dosage.

It may not fix everything, but finding the right balance between estrogen and testosterone — one that feels right in both my body and my marriage — seems worth it.

Complete Article HERE!

Having an Amazing Sex Life During and After Menopause

By

When cartoonist Sharon Rosenzweig was 45 and going through a divorce, she felt the pressure to meet someone new right away. “By the time I’m in my fifties,” she remembers thinking, “I’m going to be so old, I won’t even be interested in sex anymore.” She had this idea that menopause would eradicate her sex drive.

Turns out, she was wrong. She met the man who would become her second husband in the middle of menopause and was surprised to find her sex drive was still quite active. But she did have things to figure out, namely vaginal dryness, a common issue of menopausal and post-menopausal individuals.

Her doctor prescribed her estriol cream and it has made all the difference. For Sharon, sex is now better post-menopause. “I’m surprised how [my body] keeps getting more responsive. Orgasms are longer and more powerful than they used to be. I don’t know if that is me being more comfortable, like being older actually helps, or if it’s this cream or it’s just having figured out a little bit more.”

By the way, estriol cream can be expensive. Sharon recommend looking into https://www.womensinternational.com/contact/ — an affordable pharmacy that does mail order.

Sharon tells her story in the new comic collection Menopause: A Comic Treatment. The embedded video is a promotion for the collection and tells Sharon’s story.

Sharon’s story is not uncommon. MaryJane Lewitt, PhD, RN, CNM, FACNM, is a nurse, midwife, and qualitative researcher who studies the sexuality of post-menopausal individuals. She is finding that, like Sharon has discovered, post-menopause is a time of life where many folks are able to prioritize their own sexuality and overall quality of life.

I interviewed MaryJane about her research. Below, you’ll find tips on navigating sex, relationships, and a holistic sexual self during and post-menopause from MaryJane and Sharon.

But first, a note on the gendered terms used in this article. Since MaryJane’s research has focused primarily on cisgender individuals born with vulvas, for this article, when I quote MaryJane, that’s who we are referring to; however, I hope anyone experiencing menopause can feel included.`

And actually, much of the advice is applicable to anyone in their later years regardless of gender, because much of the changes related to aging aren’t just about menopause. This is really about embracing your whole self through all of life’s changes.

1. Redefine Your Sexual Self

Many aspects of aging can impact one’s sexual desires and goals. You may experience changes in your relationships and your lifestyle, along with physical changes. Menopause (and aging in general) will bring changes to the texture, tone and sensitivity of your skin, including your erogenous zones. You’ll also experience changes to your body hair and natural lubrication.

Combined, these changes can impact what you find pleasurable, as well as how you view yourself as a sexual being. “Women have to deal with the way their body is now versus their expectation of who they were sexually before,” MaryJane said.

What’s important to remember is that these changes do not have to stop you from being a satisfied sexual being, they may just change what that means. And it does not need to be the same as what it was before or what it means to your neighbor.

“Every woman defines what her ideal sexual state is and what her own personal sexuality can be,” MaryJane explained. “It’s not the same for every single individual. Some people want to make sure that they continue sexual intimacy in their lives. Other women don’t necessarily need sexual intimacy in their lives for them to be sexual creatures.”

2. Schedule Time To Talk to Your Healthcare Provider About Sex

“One thing I’m hearing over and over again is that conversations about sexuality with healthcare providers — even OBGYNs, nurse practitioners and midwives — are not happening at the frequency that most patients’ desire.”

These conversations can be uncomfortable for both parties involved, and often, neither the provider nor the patient wants to initiate.

Another reason these conversations aren’t happening is that people assume that the problems they’re facing with their sex life can’t be helped. MaryJane explained this isn’t necessarily true: “A lot of things are starting to become available to women for addressing different elements of their sexuality.”

For instance, during menopause, the body produces less natural lubrication and some over-the-counter lubricants can dry out the skin even more and can aggravate the skin. Physicians can prescribe or offer suggestions for lubricants that will work better.

This is what Sharon experienced. She assumed her doctor would just suggest using generic OTC lubricant, but he was actually well-versed in this issue and had something better for Sharon to try (the estriol cream).

“You have to get past the embarrassment of saying what it is that you are having trouble with. I’ve known my doctor for 25 years, and it was really hard to bring up this topic of vaginal dryness and say those words to my doctor, even though he’s delivered babies,” she explained.

MaryJane recommends scheduling a specific appointment to talk about sex. “These take longer conversations with their healthcare providers to almost give women permission to explore different toys and really figure out what works best for them.”

To prepare for these appointments, she also recommends taking an inventory about what you want and what you’re experiencing. Here are examples of questions to ask yourself from MaryJane:

  • What are the things that you’ve tried to help improve your own personal satisfaction?
  • What are some of the things that have not worked?
  • When have you wanted to experience something different?
  • Was it related to desire? Was it related to something physical?
  • Were you having issues with urine leakage during intercourse which made you feel uncomfortable so you could not reach orgasm? Or was it a lack of that sensation?
  • Are you comfortable with masturbation?”

3. It’s Time to Play

If traditional sexual intimacy (penetrative sex and masturbation) is important to you, but you’re experiencing changes in what’s pleasurable, it’s time to play.

As you age, what feels good changes more quickly. “You’ve got to shift and adapt on a regular basis in order to continuously create those moments of pleasure and intimacy,” Maryjane explained.

To learn to shift and adapt, try new strategies in bed when alone and with partners, which will allow you to rediscover new avenues for pleasure and navigate your body’s changes.

As an example, let’s talk about orgasms. Per MaryJane, post-menopause, it can take people with vulvas longer to achieve orgasm, and the nature of the orgasms can change. “They have to either pregame with a lot more foreplay or different lubricants or, for the first time, they have to try more specific forms of external stimulation from the variety of toys out there.”

And play does not need to involve a partner. Want to really understand your body’s changes and get a sense of your sexual self? You’ll learn new things on your own and it’s good for you.

“Masturbation gives both short term and long term health benefits for women moving through the menopausal period,” MaryJane explained. “The act of masturbation itself increases circulation and lubrication and can maintain elasticity.”

4. Find Companions

Find folks you can open up to about changes to your body, your sex life, and your relationships. You might find that it’s a relief for them to open up as well. And if you’re dating and exploring, you might also find some partners-in-crime.

“Other women are your best allies,” Sharon explained. “They’re not your competitors, they’re your allies because they’re going to be out there dating and meeting people that they wind up not wanting to stick with, and they can pass them along. That’s what happened to me.” (Sharon was introduced to her second husband through a friend who’d dated him first.)

There’s no age limit on meeting new friends and lovers. There are rich opportunities through activity groups, alternative living communities, and more where older individuals are finding friendship and companionship. And people perimenopause are enjoying short-term or casual relationships perhaps more than they have in the past.

One dilemma, according to MaryJane, is that many older individuals were raised in cultures that did not encourage them to ask for what they need or be comfortable talking about sex or sexuality. This becomes a battle of habit and conditioning.

5. Consider The Opinion of Those Around You, But Live Your Own Life

After Sharon got divorced, she had to navigate dating with her teenage daughter in the house. She made the mistake of talking about moving for one potential partner without considering how it would affect her daughter. Here’s her advice for others navigating kids and dating: “I think it’s about being sensitive to what is going on with them. I missed it because my own needs were so central.”

It’s okay for your needs to be central; just be sensitive about how your own life changes affect those closest to you.

6. Be Proud

If you’ve gotten this far in the article, this issue is important to you, so let me leave you with one more thought. However you embrace this stage of life, you can set the example for future generations. You get to be a role model for younger folks like me on what it means to be vibrant and beautiful in the midst of life’s inevitable changes.

Here’s MaryJane: “There is a renaissance in terms of the sexuality of older women in the media right now. We’re seeing a lot of the women with dark gray or white hair — classic beauties — reassert themselves as very strong women at the end of their life. And they’re doing it from a sense of being alone or not having a partner, but their sexuality is very clear and very consistent in the images and in what they’re saying and what is coming forward from them.”

Case in point: about life at 59, author Gail Konop writes, “Contrary to the menopause myth, I am experiencing the sexiest, most vibrant, most intellectually and professionally fertile time of my life. Liberated from waiting for the next stage or event or person to define or save me, I am the leader of my own pod.”

Complete Article HERE!

Is Testosterone Therapy Safe for Women?

Testosterone is often prescribed to boost a low sex drive, but the research on its long-term effects remains questionable.

by Sarah Ellis

The hormone testosterone (called “T” for short in medical circles) has long been associated with the male physique, athleticism, and a heightened sex drive. But now, there’s an idea making the internet search rounds that testosterone therapy may be the secret sauce to revamping a woman’s shuttered sex drive.

Even health-conscious celebrities have gotten in on the hype. In 2011, Jane Fonda told The Sunday Telegraph that she started taking the hormone in her 70s to boost her sex drive. But before you run to your doctor to ask for a prescription, you should know that testosterone therapy is a controversial approach that is not FDA-regulated for women at this time. Despite its mythical reputation, this hormone isn’t a cure-all for sexual dysfunction, and it could even be dangerous for your health if not taken carefully. Let us explain.

How Does Testosterone Work in Women?

Testosterone may be known as a male hormone, but women’s bodies naturally produce it, too. It’s one of many hormones that work together to control our mood, metabolism, sexual desire, bone and muscle growth, and reproductive system. As you age, your hormone levels change, with one of the biggest shifts occurring during menopause when your menstrual cycle stops for good. Menopause causes your estrogen and progesterone levels to decrease, but interestingly, it is not associated with a sudden decrease in testosterone, according to the North American Menopause Society.

That said, there is evidence that testosterone decreases throughout your life. “Testosterone drops with age more than with menopause,” says Margaret Wierman, M.D., professor at the University of Colorado Anschutz Medical Campus in Aurora, CO and former Vice President of Clinical Sciences at the Endocrine Society. This may explain why testosterone pills, gels, and patches are sometimes touted by drug marketing campaigns (and celebs) as a sex drive booster for older men and women whose testosterone is naturally lower than it used to be.

The problem with this approach, according to Chrisandra Shufelt, M.D., associate director of the Barbra Streisand Women’s Heart Center at the Cedars-Sinai Smidt Heart Institute in Los Angeles, CA, is that testosterone is not necessarily the miracle drug you may be reading about on the internet. “If you search online, it seems like testosterone could be the panacea of all hormones, relieving everything from fatigue to weight gain to depression,” Dr. Shufelt says. But interestingly, she notes, there is no scientifically proven list of symptoms directly correlated to low T in women. Everyone’s hormone levels are naturally different, and what looks “low” on a testosterone test for one woman may be a perfectly normal T level for another.

Does Testosterone Impact Sex Drive?

To some extent, yes—but it’s not the end all, be all. Dr. Wierman explains that there are many different causes of sexual dysfunction (the term for when you’re no longer craving or enjoying sex). “There are mechanical hardware causes, there are relationship causes, there are mood causes,” she says. “There are rarely hormonal causes, and [in those cases] it’s usually estrogen deficiency that is causing abnormalities.”

What Is Testosterone Therapy?

Testosterone products are supplemental versions of the hormone that people take to increase their existing T levels. They come as a patch, gel, pill, tablet, or injection. Prescription testosterone products are FDA-approved for men whose bodies cannot produce adequate testosterone, due to genetic conditions like Klinefelter syndrome or damage from infection or chemotherapy. Testosterone products are not–we repeat, not!–approved for people whose testosterone is decreasing with age.

Nevertheless, this hasn’t stopped people from taking T (and doctors from prescribing T) for reasons other than it is officially intended. This practice has become so widespread, in fact, that the FDA issued a safety announcement in March 2015 urging doctors not to prescribe testosterone to anyone other than men with testosterone-lowering medical conditions. The statement noted that testosterone therapy could possibly increase your risk of cardiovascular problems or stroke.

For women, the risks of testosterone therapy are even less clear. “What we know about safety and what has been studied in women is the short-term effects, up to two years,” Dr. Shufelt says. “Longer effects are not known, and we do not know the effects in women who have risk factors for heart disease and breast cancer.” She stresses that longer-term studies will be necessary to determine whether low-dose testosterone therapy has detrimental effects on a woman’s body.

When testosterone is taken in excess quantities, Dr. Shufelt explains, it can lead to some pretty severe medical issues for women. “Too much testosterone in women can result in deepening of voice, hair loss, acne, anger, and negative changes to the cholesterol panel,” she says. Dr. Wierman remembers seeing a perimenopausal patient who had been given testosterone pellets at an anti-aging clinic. The high levels of T caused an increase in bad cholesterol, increase in blood pressure, excessive body hair growth, and loss of scalp hair.

Yikes! Are There Any Medical Guidelines for Women and T?

In September 2019, the Endocrine Society, International Menopause Society, European Menopause and Andropause Society, and others got together to publish a global consensus statement on the safety and efficacy of testosterone therapy for women. Dr. Wierman, one of the principal authors, explains the major takeaway: testosterone therapy has only proven to be useful for one specific subset of women–post-menopausal women with hypoactive sexual desire disorder.

Hypoactive sexual desire disorder (HSDD) is characterized by an absence of sexual desire, to an extent that it causes emotional distress and relationship problems for a couple. HSDD can be caused by a variety of factors, from medication use and chronic health conditions, to chemical imbalances and hormone deficiencies. It is diagnosed by a healthcare provider using a questionnaire and treated with anything from counseling to hormone replacement therapy, depending on the situation.

Dr. Wierman says that for post-menopausal women with HSDD, “controlled studies showed that getting high physiologic doses [of testosterone] increased satisfying sexual relations by one per month, with some other potentially good effects on sexual function,” such as arousal and ability to orgasm. The consensus statement specified that these doses should mimic – not exceed – natural levels of testosterone in premenopausal women. The statement authors urged that more research be done on testosterone therapy for women, and that testosterone products for HSDD should be created specifically with women in mind.

So, What Does This Mean for Me?

If you’re curious about testosterone therapy and wondering if you fit into the subset of women who may benefit, Dr. Wierman suggests talking to your regular women’s healthcare provider. “I think that most providers, whether they’re gynecologists or endocrinologists or primary care doctors who specialize in menopausal women, can discuss the issues related to testosterone pros and cons,” she says.

But before you walk away with a prescription, keep in mind that your low sex drive may not have to do with your hormones. “The first thing when someone has abnormalities in their sexual function is to discuss all the different other causes of it, and try to be a detective,” Dr. Wierman says. “If she is having painful intercourse, maybe it’s local vaginal estrogen she needs. If there’s stress in the relationship, maybe therapy is what they need.” Testosterone therapy is one option to increase libido, but it’s certainly not a foolproof key to amazing sex. And unless you’re a postmenopausal woman with HSDD, you probably want to steer clear.

Complete Article HERE!

How estrogen and testosterone change your body as you age

By

Every part of your body — from your brain to your heart — needs hormones.

They’re your body’s “chemical messengers,” according to the Hormone Health Network.

“The glands of the endocrine system send out hormones that tell each part of your body what work to do, when to do it, and for how long,” the organization reported.

There are many different hormones and each contributes to different processes over time, including growth, physical development and sexual function.

The key reproductive hormones are estrogen and progesterone for women and testosterone for men. They’re all required for good sexual health and reproduction, but they can also affect things like energy level, weight and mood.

These hormones need to be balanced to work well, but their levels decrease as you age. This often causes many physiological changes.

How estrogen and testosterone work

Estrogen and progesterone are produced mainly by the ovaries “in a cyclical fashion, which results in a monthly period,” said Dr. Caitlin Dunne, an infertility specialist at the Pacific Centre for Reproductive Medicine in Vancouver.

“Beyond pregnancy … estrogen is essential for building and maintaining strong bones and for keeping women’s arteries healthy to avoid heart disease,” she said. “[It] also plays an important role in cognitive functioning, moods, sexuality, breast development and breastfeeding, to name a few.”

However, women are born with a finite number of eggs that decreases over time. As the eggs disappear, so does the source of a woman’s estrogen and progesterone. When she has no eggs left, she enters menopause.

“On average, that occurs at age 51,” said Dunne.

Similarly, the pituitary gland controls the production of testosterone by the testes in men.

As men age, the testes can slow down or stop producing testosterone altogether. This is known as andropause, or male menopause.

How your body could change

For women

The sudden drop in estrogen levels can lead to menopausal symptoms like “hot flashes, night sweats and changes in mental functioning,” said Dunne.

However, it has been known to also cause more subtle side effects.

“Some menopausal women describe difficulty concentrating, memory issues and mood changes,” she said. “Weight and body composition changes can also occur.”

Dunne said menopausal women have a propensity to lose muscle and gain fat tissue, especially around the waist and hips.

For men

Men continue to make sperm for the rest of their lives, but the decrease in testosterone can have other effects.

These can include fatigue, erectile dysfunction, loss of muscle mass, low libido and low sperm production.

It’s not uncommon for men to lose body hair, muscle and strength as they age. Body fat may also increase over time.

Managing the changes

Both men and women are advised to maintain a healthy diet and exercise regimen.

Women should concentrate on “weight-bearing and balance exercises to offset the effects of bone loss and the risk of fractures or falling,” said Dunne.

Calcium and vitamin D can also help to support bone maintenance.

“Heart disease is consistently one of the top threats to women in our society, particularly after menopause,” she said.

“Having a healthy body weight and avoiding high blood pressure and diabetes are some of the most important things we can do to mitigate this risk.”

There’s also the option of hormone therapy for both men and women.

Testosterone replacement therapy can be done several ways, including using gel or patches that you put on your skin.

It can improve “sexual interest, erections, mood and energy, body hair growth, bone density and muscle mass,” according to the Hormone Health Network.

Hormone therapy for women is considered one of the most effective treatments for bothersome hot flashes and night sweats, Dr. Lindsay Shirreff previously told Global News.

“We aim to individualize treatment and offer women the lowest hormone therapy dose to provide relief from her symptoms,” said Shirreff, an obstetrician/gynecologist at the Mature Women’s Health and Menopause Clinic at Mount Sinai Hospital in Toronto.

She said that as long as a woman has no contraindications to starting hormone therapy and is within 10 years of her last period, this type of therapy is safe and effective.

“Women who still have their uterus are typically prescribed estrogen and progesterone,” she said. “The estrogen is often given through the skin in the form of a patch or gel to decrease the risk of blood clot and heart attack that was previously attributed to hormone therapy.”

The treatment, however, has gotten a bad reputation because of associated breast cancer risks. However, Dunne said these have often been misinterpreted as much scarier than they really are.

“I would suggest that women who are suffering with hot flashes should see their doctor to have an informed discussion,” she said.

“In general, when we use a low dose of hormone therapy for a short duration of time, it carries minimal (if any) increased risk of breast cancer and it can help make women’s lives more manageable.”

Complete Article HERE!

New treatments restoring sexual pleasure for older women

By Tara Bahrampour

[W]hen the FDA approved Viagra in 1998 to treat erectile dysfunction, it changed the sexual landscape for older men, adding decades to their vitality. Meanwhile, older women with sexual problems brought on by aging were left out in the cold with few places to turn besides hormone therapy, which isn’t suitable for many or always recommended as a long-term treatment.

Now, propelled by a growing market of women demanding solutions, new treatments are helping women who suffer from one of the most pervasive age-related sexual problems.

Genitourinary syndrome, brought on by a decrease in sex hormones and a change in vaginal pH after menopause, is characterized by vaginal dryness, shrinking of tissues, itching and burning, which can make intercourse painful. GSM affects up to half of post-menopausal women and can also contribute to bladder and urinary tract infections and incontinence. Yet only 7 percent of post-menopausal women use a prescription treatment for it, according to a recent study.

The new remedies range from pills to inserts to a five-minute laser treatment that some doctors and patients are hailing as a miracle cure.

The lag inaddressing GSM has been due in part to a longstanding reluctance among doctors to see post-menopausal women as sexual beings, said Leah Millheiser, director of the Female Sexual Medicine Program at Stanford University.

“Unfortunately, many clinicians have their own biases and they assume these women are not sexually active, and that couldn’t be farther from the truth, because research shows that women continue to be sexually active throughout their lifetime,” she said.

With today’s increased life expectancy, that can be a long stretch – another 30 or 40 years, for a typical woman who begins menopause in her early 50s. “It’s time for clinicians to understand that they have to bring up sexual function with their patients whether they’re in their 50s or they’re in their 80s or 90s,” Dr. Millheiser said.

By contrast, doctors routinely ask middle-aged men about their sexual function and are quick to offer prescriptions for Viagra, said Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause.

“If every guy, on his 50th birthday, his penis shriveled up and he was told he could never have sex again, he would not be told, ‘That’s just part of aging,’” Dr. Streicher said.

Iona Harding of Princeton, New Jersey, had come to regard GSM, also known as vulvovaginal atrophy, as just that.

For much of their marriage, she and her husband had a “normal, active sex life.” But after menopause sex became so painful that they eventually stopped trying.

“I talked openly about this with my gynecologist every year,” said Mrs. Harding, 66, a human resources consultant. “There was never any discussion of any solution other than using estrogen cream, which wasn’t enough. So we had resigned ourselves to this is how it’s going to be.”

It is perhaps no coincidence that the same generation who first benefited widely from the birth control pill in the 1960s are now demanding fresh solutions to keep enjoying sex.

“The Pill was the first acknowlegement that you can have sex for pleasure and not just for reproduction, so it really is an extension of what we saw with the Pill,” Dr. Streicher said. “These are the women who have the entitlement, who are saying ‘Wait a minute, sex is supposed to be for pleasure and don’t tell me that I don’t get to have pleasure.’”

The push for a “pink Viagra” to increase desire highlighted women’s growing demand for sexual equality. But the drug flibanserin, approved by the FDA in 2015, proved minimally effective.

For years, the array of medical remedies has been limited. Over-the-counter lubricants ease friction but don’t replenish vaginal tissue. Long-acting mosturizers help plump up tissue and increase lubrication, but sometimes not enough. Women are advised to “use it or lose it” – regular intercourse can keep the tissues more elastic – but not if it is too painful.

Systemic hormone therapy that increases the estrogen, progesterone, and testosterone throughout the body can be effective, but if used over many years it carries health risks, and it is not always safe for cancer survivors.

Local estrogen creams, suppositories or rings are safer since the hormone stays in the vaginal area. But they can be messy, and despite recent studies showing such therapy is not associated with cancer, some women are uncomfortable with its long-term use.

In recent years, two prescription drugs have expanded the array of options. Ospemifene, a daily oral tablet approved by the FDA in 2013,activates specific estrogen receptors in the vagina. Side effects include mild hot flashes in a small percentage of women.

Prasterone DHEA, a naturally occurring steroid that the FDA approved last year, is a daily vaginal insert that prompts a woman’s body to produce its own estrogen and testosterone. However, it is not clear how safe it is to use longterm.

And then there is fractional carbon dioxide laser therapy, developed in Italy and approved by the FDA in 2014 for use in the U.S. Similar to treatments long performed on the face, it uses lasers to make micro-abrasions in the vaginal wall, which stimulate growth of new blood vessels and collagen.

The treatment is nearly painless and takes about five minutes; it is repeated two more times at 6-week intervals. For many patients, the vaginal tissues almost immediately become thicker, more elastic, and more lubricated.

Mrs. Harding began using it in 2016, and after three treatments with MonaLisa Touch, the fractional CO2 laser device that has been most extensively studied, she and her husband were able to have intercourse for the first time in years.

Cheryl Edwards, 61, a teacher and writer in Pennington, New Jersey, started using estrogen in her early 50s, but sex with her husband was painful and she was plagued by urinary tract infections requiring antibiotics, along with severe dryness.

After her first treatment with MonaLisa Touch a year and a half ago, the difference was stark.

“I couldn’t believe it… and with each treatment it got better,” she said. “It was like I was in my 20s or 30s.”

While studies on MonaLisa Touch have so far been small, doctors who use it range from cautiously optimistic to heartily enthusiastic.

“I’ve been kind of blown away by it,” said Dr. Streicher, who, along with Dr. Millheiser, is participating in a larger study comparing it to topical estrogen. Using MonaLisa Touch alone or in combination with other therapies, she said, “I have not had anyone who’s come in and I’ve not had them able to have sex.”

Cheryl Iglesia, director of Female Pelvic Medicine & Reconstructive Surgery at MedStar Washington Hospital Center in Washington D.C., was more guarded. While she has treated hundreds of women with MonaLisa Touch and is also participating in the larger study, she noted that studies so far have looked only at short-term effects, and less is known about using it for years or decades.

“What we don’t know is is there a point at which the tissue is so thin that the treatment could be damaging it?” she said. “Is there priming needed?”

Dr. Millheiser echoed those concerns, saying she supports trying local vaginal estrogen first.

So far the main drawback seems to be price. An initial round of treatments can cost between $1,500 and $2,700, plus another $500 a year for the recommended annual touch-up. Unlike hormone therapy or Viagra, the treatment is not covered by insurance.

Some women continue to use local estrogen or lubricants to complement the laser. But unlike hormones, which are less effective if begun many years after menopause, the laser seems to do the trick at any age. Dr. Streicher described a patient in her 80s who had been widowed since her 60s and had recently begun seeing a man.

It had been twenty years since she was intimate with a man, Dr. Streicher said. “She came in and said, ‘I want to have sex.’” After combining MonaLisa Touch with dilators to gradually re-enlarge her vagina, the woman reported successful intercourse. “Not everything is reversible after a long time,” Dr. Streicher said. “This is.”

But Dr. Iglesia said she has seen a range of responses, from patients who report vast improvement to others who see little effect.

“I’m confident that in the next few years we will have better guidelines (but) at this point I’m afraid there is more marketing than there is science for us to guide patients,” she said. “Nobody wants sandpaper sex; it hurts. But at the same time, is this going to help?”

The laser therapy can also help younger women who have undergone early menopause due to cancer treatment, including the 250,000 a year diagnosed with breast cancer. Many cannot safely use hormones, and often they feel uncomfortable bringing up sexual concerns with doctors who are trying to save their lives.

“If you’re a 40-year-old and you get cancer, your vagina might look like it’s 70 and feel like it’s 70,” said Maria Sophocles, founding medical director of Women’s Healthcare of Princeton, who treated Mrs. Edwards and Mrs. Harding.

After performing the procedure on cancer survivors, she said, “Tears are rolling down from their eyes because they haven’t had sex in eight years and you’re restoring their femininity to them.”

The procedure also alleviates menopause-related symptoms in other parts of the pelvic floor, including the bladder, urinary tract, and urethra, reducing infections and incontinence.

Ardella House, a 67-year-old homemaker outside Denver, suffered from incontinence and recurring bladder infections as well as painful sex. After getting the MonaLisa Touch treatment last year, she became a proslyter.

“It was so successful that I started telling all my friends, and sure enough, it was something that was a problem for all of them but they didn’t talk about it either,” she said.

“I always used to think, you reach a certain age and you’re not as into sex as you were in your younger years. But that’s not the case, because if it’s enjoyable, you like to do it just as much as when you were younger.”

Complete Article HERE!

The Thrill Is Gone

Name: Billy
Gender: Male
Age: 46
Location:
I have heard it’s normal for sex drive to diminish as you age. I’ll run this by you. I’m a 46 year old male and the last time I was at a strip club with bare boobs bouncing around me, you may as well have rolled a grapefruit across the floor. Actually, I can see more use from the grapefruit. I don’t recall the last time I did it, and jerking off was almost disgusting. My tool has shrank to nothing. I barely touch it and it just dribbles, it doesn’t fire off anymore. I don’t even like to touch it to go piss anymore. I’ve had to shave around it, so I actually find it, to keep from pissing my pants. Is this normal?

No, Billy, this isn’t normal. I think you already know that too, right?

andropauseDo you know anything about andropause? If not, you ought to. Here’s what I suggest. Use this site’s search function in the sidebar. Type in the key word: “andropause” and you will come up with a wealth of information about this issue.

You can also use the CATEGORY pull down menu. Look for the subcategory: Sex and Aging, under the main category: Aging. Everything is alphabetized.

But for the time being, here’s a typical question and response —

Name: Wilson
Gender: male
Age: 58
Location: Lancing MI
I’m a successful entrepreneur, in decent health (I could stand to lose a few pounds.) I have just about everything a man could want in life, but I’m miserable. I have no energy and I feel like I’m sleepwalking through my life. I have no sex drive at all; my wife thinks I’m having an affair…I wish. Even Viagra doesn’t do the trick anymore. Is this just old age, or what?

Old age, at 58? Middle age, perhaps! Regardless what we call it, you sound like you’re in the throws of andropause — male menopause — ya know, the change of life!

Never heard of such a thing? You’re not alone. It’s only been recently has the medical industry has begun to pay attention to the impact changing hormonal levels has on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!andropause-1

Every man will experience a decrease testosterone, the “male” hormone, as he ages. This decline is gradual, often spanning ten to fifteen years on average. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.

There is no doubt that a man’s sexual response changes with advancing age and the decrease of testosterone. Sexual urges diminish, erections are harder to come by, they’re not as rigid, there’s less jizz shot with less oomph. And our refractory period (or interval) between erections is more pronounced too.

While most all of us have heard of a mid-life crisis, and it’s tragic consequences — red convertible sports cars, comb-overs, and the trophy wife or lover — fewer have heard of andropause. A mid-life crisis is essentially a psycho-social adjustment to aging — bored at work, bored at home, bored with the wife or partner — that sort of thing. Andropause, although it may coincide with a mid-life crisis, is not the same thing. Andropause is a distinct physiological phenomenon that is in many ways akin to female menopause.

Unlike women, men can continue to father children after andropause, but like I said, the production of testosterone diminishes gradually after age 40. I suppose you know that testosterone is the hormone that stimulates sexual development in the male infant, bone and muscle growth in adult males, and is responsible for our sexual drive. But did you know that by the age of 55, the amount of testosterone secreted into our bloodstream is significantly lower than at 45. And by age 80, most male hormone levels have decreased to pre-puberty levels.

Men, are you over 50? Are you feeling weak, lethargic, depressed, and irritable? Do you have mood swings, hot flashes, insomnia, and decreased libido, like our buddy Wilson, here? Then you too may be andropausal. You need to get some lead back in your pencil!

mutateAll kidding aside, andropausal men might want to consider Testosterone Replacement Therapy (TRT). Ask your physician about this. Just know that some medical professionals resist testosterone therapy, mistakenly linking Testosterone Replacement Therapy with prostate cancer. Even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. However, before starting a testosterone regiment, insist on a complete physical, including blood work and a rectal examine. Mmmm, rectal exams!

Testosterone is available in many forms — oral, injectable, trans-dermal and by way of implants. The oral form is not recommended because of the high risk of liver damage. But injections, patches, pellets, creams and gels might be just the answer. I encourage you to be informed about TRT before you approach your doctor, because the best medicine is practiced collaboratively — by you and your doctor.

Good luck

Too pooped to pop

Name: Djon
Gender: Male
Age: 54
Location:
I’m a 54-year-old man, who 3 years ago managed to finally come out and live the life I so desperately longed for all my life. My question — is there a biological clock in men like the issues women have to deal with in menopause. During the last years of my marriage there was no sex life other than with myself. Now I’m living a fantastic life, with a great man who I love very much. I know there is more to life than sex but now that I’m finally able to express myself physically with a man my ability to perform is just not working.

I’ve tried Viagra and such years ago. They used to work in maintaining an erection, it was just by myself, but I always had fun. The headache’s and discomforts from the meds bring up the question — do I really want to take this?

But now the med’s don’t even help, and as for my libido it suffers with my lack of ability. I’ve been tested for testosterone levels and they say I’m right where I should be at for my age. I’ve seen two doctors about the issue and when they find out my partner’s sex they don’t want to deal with it and seem to just pass it off as an age thing.

I’m in fairly decent good shape, I exercise 3 – 4 days a week at the gym, can you send me any advice on a path to take.

A little frustrated: Djon

A little frustrated? Holy cow, darlin’, you sound a lot frustrated. I don’t blame ya. You finally find what’s been missing throughout your whole life only to discover that your plumbing is now givin’ out on you. Ain’t that a bitch! And before I continue I want to tell you and all the other alternative lifestyle people in my audience, don’t settle for a sex-negative physician no matter what. Dion, find yourself a sex-positive doctor that will look beyond your choice of partner and give you the respect you deserve! Damn, I hate shit like that.

andropause2258You raise an interesting question about the aging process when you ask if men experience something similar to menopause in women. The short answer is — yeah, you betcha! In fact, it even has a name; andropause.  I’ve written and spoken extensively about this very subject. Here’s what I want you to do. Look for the CATEGORIES section in the sidebar, look for the category — AGING. There you will find everything I’ve written and said about Andropause, and Sex and Aging.

You’ll find a whole lot more information there than I can put together for you in this posting. However, I can offer you an overview. It’s only been recently that the medical industry has started to pay attention to the impact changing hormonal levels have on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!

Every man will experience a decrease testosterone, the “male” hormone, as he ages. This decline is gradual, often spanning ten to fifteen years on average. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.

And listen, when a physician says that your testosterone level falls within an acceptable range, he/she isn’t telling you much. Let’s just say you had an elevated level of testosterone all your life, till now. Let’s say that you now register on the lower end of “acceptable”. That would mean that you’ve had a significant loss in testosterone. But your doctor wouldn’t know that, because he has no baseline for your normal testosterone level to begin with.andropause

There is no doubt that a man’s sexual response changes with advancing age and the decrease of testosterone. Sexual urges diminish, erections are harder to come by, they’re not as rigid, there’s less jizz shot with less oomph. And our refractory period (or interval) between erections is more pronounced too.

Andropausal men might want to consider Testosterone Replacement Therapy (TRT). Just know that most medical professionals, like yours, Dion, resist testosterone therapy. Some mistakenly link Testosterone Replacement Therapy with prostate cancer. Even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. I encourage you to be fully informed about TRT before you approach your doctor, your new sex positive doctor, because the best medicine is practiced collaboratively — by you and your doctor.

Finally, getting the lead back in your pencil, so to speak, may simply be an issue of taking more time with arousal play. Don’t expect to go from zero to 60 in a matter of seconds like you once did. Also, use a cockring.  But most of all, fuckin’ relax, why don’t cha already. Your anxiety is short-circuiting your wood, my friend. And only you can stop that.

Good luck

SEX WISDOM With Toni Newman — Podcast #299 — 09/21/11

[Look for the podcast play button below.]

Hello sex fans! Welcome back.

Holy cow, I’m giddy with excitement, because I have an extraordinary program in store for you today. I am honored to be welcoming my first transgendered guest to the show. Just to be clear, it’s not like I haven’t reached out to other transgendered people in the past; I have. It just that I was never was able to seal the deal.

So when I contacted Toni Newman, the author of the groundbreaking: I Rise – The Transformation of Toni Newman, I kind of expected the same kind of noncommittal response I got from the other prospective guests. I was so pleasantly surprised to find that not only was Toni willing to come speak with us, she has an inspirational story of survival and triumph over the most amazing odds to tell.

But wait; that’s not all! This show is a twofer, don’t cha know. My guest, our conversation and the themes discussed in this podcast easily fall into both the SEX WISDOM series and the Sex EDGE-U-cation series.

Toni is, of course, among the movers and shakers in the field of human sexuality; who are making news and helping us take a fresh look at our sexual selves. But she’s also a former sex worker who honestly and forthrightly speaks about her life on the streets and as a tranny dominatrix. Hold on to your hats, sex fans, you’ll not find a more startling and revealing interview anywhere on the net.

Toni and I discuss:

  • Being the first African-American transgendered person to write a memoir;
  • The unique perspective of transgendered people or color;
  • Transgender/transsexual;
  • Gender and genitalia;
  • Being shunned by other sexual minorities;
  • Transgender and sexual orientation;
  • Her life before her transition;
  • The difficulties she faced in her transition;
  • The phenomenal expense of a transition;
  • Being a sex worker.

Toni invites you to visit her on her site HERE!  She’s on Facebook HERE! And enjoy her twitter feed HERE!

(Click on the book art below to buy Toni’s book.)

BE THERE OR BE SQUARE!

Check out The Lick-A-Dee-Split Connection. That’s Dr Dick’s toll free podcast voicemail HOTLINE. Don’t worry people; no one will personally answer the phone. Your message goes directly to voicemail.

Got a question or a comment? Wanna rant or rave? Or maybe you’d just like to talk dirty for a minute or two. Why not get it off your chest! Give Dr Dick a call at (866) 422-5680.

DON’T BE SHY, LET IT FLY!

Look for all my podcasts on iTunes. You’ll find me in the podcast section, obviously. Just search for Dr Dick Sex Advice. And don’t forget to subscribe. I wouldn’t want you to miss even one episode.

Today’s Podcast is bought to you by: DR DICK’S — HOW TO VIDEO LIBRARY.

drdickvod.jpg

Sex Advice With An Edge — Podcast #47 — 01/21/08

[Look for the podcast play button below.]

Hey sex fans,

I have a nice load of provocative questions from the sexually worrisome. And I respond with an equal number of astounding, amiable and oh so informative responses! Hey, it’s what I do.

  • Amy’s vibrator don’t work no how!
  • Dan is dating a woman with a blockage. But what kind of blockage?
  • Jon’s meds eliminates his spooge output. Pity that!
  • LD’s partner died, but he wants to get back in the swing of things.

FINALLY, ANOTHER SEXUAL ENRICHMENT TUTORIAL

  • The Big Tease; How to Strip for Someone Special

BE THERE, OR BE SQUARE!

Check out The Lick-A-Dee-Split Connection. That’s dr dick’s toll free podcast voicemail. Don’t worry people; no one will personally answer the phone. Your message goes directly to voicemail.

Got a question? No time to write? Give dr dick a call at (866) 422-5680. Again, the TOLL FREE voicemail number is (866) 422-5680. DON’T BE SHY, LET IT FLY !

Look for my podcasts on iTunes. You’ll fine me in the health section under the subheading — Sexuality. Or just search for Dr Dick Sex Advice With An Edge. And don’t forget to subscribe. I don’t want you to miss even one episode.

Say, would you like to become a sponsor for one or more of my weekly sex advice podcasts? As you know, I plug a product or service at the beginning and end of each show. Each podcast has its own posting on my site along with the name of the podcast sponsor and a banner for the product or service.

The beauty part about this unique opportunity is that once a sponsor’s ad is included in a particular podcast that sponsor is embedded there forever.

Your sponsorship also underscores your social conscience. Your marketing dollars will not only got to promote your product, but you will be doing so while helping to disseminate badly needed sex education and sexual enrichment messages. Simply put, ya just can’t get a better bang for your advertising buck!

For further information, contact me at: dr_dick@drdicksexadvice.com

Today’s podcast is once again bought to you by: Eden Fantasys — for all your adult toys!


Sex Advice With An Edge — Podcast #09 — 04/09/07

[Look for the podcast play button below.]

Hey sex fans,

I have a great show for you today and it has a very international flair. We have correspondents from all over the globe…and LA! —

  • Hiroshi, from Japan, is no fan of lace curtains.
  • Fay, from LA, is a silly twit with zero social skills.
  • Karol, from Poland, wants to find a nice gal who will bugger him senseless with a strap-on!
  • Joanne, from Toronto, can’t be naked no how. Even the BF can’t see the goods.
  • William, from the UK, is a fledgling butt pirate.

And finally, a Sexual Enrichment Moment

  • Finessing That Ass Fuck — A Tutorial For a Top

BE THERE, OR BE SQUARE!

Check out The Lick-A-Dee-Split Connection. That’s dr dick’s toll free podcast voicemail. Don’t worry people; no one will personally answer the phone. Your message goes directly to voicemail.Got a question? No time to write? Give dr dick a call at (866) 422-5680. Again, the toll free voicemail number is (866) 422-5680.

DON’T BE SHY, LET IT FLY!

Dr Dick is now on iTunes.  You’ll fine me in the podcast section under the heading — Health, subheading — Sexuality. Or search for Dr Dick Sex Advice With An Edge. And don’t forget to subscribe. I don’t want you to miss even one episode.

Today’s podcast is bought to you by: Dr Dick’s How To Video Library.

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Body Image Blues

Happy New Year everyone!

Did ya’ll survive the holidays? Dr. Dick just barely made it through this annual ordeal by the skin of his teeth. The holidays are supposed to bring out the best in folks, right? Then, what’s with all the lunatic behavior this time of the year?

Leave it to all the wretched holiday hype to spike our self-critical nature. Just when ya thought it was safe to take a peek in the mirror, along come those age-old bugaboos to scare ya back into the closet of self-doubt. Consider this month’s grab bag of frightened souls.

Hey Dr. Dick –
I’ve always had a low self-image. Then about two years ago I decided to do something about. I began going to the gym regularly and eating better. It paid off…now I have a better image of myself and have been dating more. Imf_nipple.jpg am seeking a LTR but only seem to met and slept with unavailable women. I’m starting to turn this back on myself…sure now I’m good enough to sleep with, but not have a relationship with! Thoughts?
K in NYC

Dear K,
You’re looking for a LTR and you’re sleeping around with unavailable women? Darlin’, what do you suppose is wrong with this picture?
Dr. Dick suspects that you still need to do some serious work on the self-image thing. I applaud your efforts to get in shape and eat right. Good for you! However, heaping recriminations upon yourself for your lack of success in the dating game, particularly while pursuing the unavailable, is downright self-defeating.
Rethink this strategy immediately.
Good luck,
Dr. Dick

Doctor Dick,
I only have one testicle. I was born that way. It has a huge effect on my self-confidence. I consider myself a good-looking guy and I work out at the gym to try and look and feel the best I can. But even so, whenever I meet a guy and we have sex, I am always terrified that when he notices, he’ll freak out or suddenly be turned off. Even though the guys I have been with (not that many) haven’t had a problem with it, I feel it is a problem. And also, I have trouble ejaculating—whether that is physiological or psychological, I don’t know.
I have two questions. 1) Would having only one testicle reduce my sex drive and make it harder for me to ejaculate? 2) I have pondered the idea of having a prosthetic testicle inserted (so at least I wouldn’t LOOK any different to other guys). Do you know much about this procedure and if it is safe?
Thanks very much
David

Dear David,

y1.jpg Whoa, aren’t you all tied up in a BALL of knots? (Big pun intended!)

You’re obsessing about something that apparently is of no consequence to your partners. Hey, if they don’t give a shit that you’re shy a nut, why should you?
Celebrate your uniqueness, instead of living in shame. Your “irregularity” is neither life threatening, nor is it particularly obvious.
Consider the great length some guys go to in an attempt to hide the “shame” of what they perceive as a personal inadequacy. Like the guy who wears a really terrible toupee (or any toupee for that matter) in an effort to mask his hair loss. Is this not completely ridiculous, not to mention counterproductive? I mean, doesn’t his folly call even more attention to the very thing he wishes to conceal?
I propose that it’s your anxiety about “being found out” that’s getting in the way of your sexual performance, not having just one testicle. Nor do I believe that it’s interfering with your sex drive. But I advise you consult your physician if you think you have a hormonal imbalance. A regular injection of testosterone will remedy that.
You ask about surgery; well, it’s a simple enough procedure. But there are always risks, like the possibility of infection for example. Besides, you’ll always know that one of your balls is a fake. And in time, you’ll probably begin to obsess about that, too.
David, this problem of yours can be solved in a less drastic and invasive manner than surgery. Choose self-acceptance over the knife and be happy.
Good Luck,
Dr. Dick

Dr. Dick:
I am writing because I am a very self-conscious person and am afraid to date anyone because of how I look underneath my good-looking clothes. I was born with problems that left scars and veins on my body, making my younger years hell. I am very self-conscious when it comes to wearing shorts, which I never wear, and being naked with someone. I want to be with someone and look normal, like all the other people. I enjoy looking and feeling good about myself, but when it comes to revealing my true identity I lose all confidence. I am afraid of rejection because I am different.
I want a boyfriend who hot and has a body to die for, but I don’t base my dating prospects on looks, but on personality. I know there are others out there with the same philosophy, but it is hard to see. What should I do? I want to meet someone and have fun, but I have this fear of being rejected and not being what they expect.
Jordan

Dear Jordan,
I can’t tell from your comments if you are a man or a woman. That’s actually a good thing, because my advice is the same regardless of your gender. Our society can be an.jpg heartless place for those of us who don’t fit the “ideal” of youth and beauty perpetuated by the popular culture. And it looks to me like you’re guilty of the same bullshit you accuse others of perpetuating. You want a lover who is physically perfect, but you don’t want others to discriminate against you for not being so. Aaaa, hello! If you allow this unhappy double standard to control your sense of wellbeing, you have only yourself to blame.
Throw off the shackles that ensnare you. They’re all self-imposed, not to mention self-defeating. Learn to accept yourself for who you are, with all your assets and liabilities. And you’d do well to be a little less of a snob where others’ looks are concerned.
Good Luck,
Dr. Dick

Dear Dr. Dick,
I’m an attractive, talented and fun loving guy who has never had a lover in the 23 years that I’ve been openly gay. Sure I get a lot of looks and flirtations but rarely from the ones I’m attracted to. It seems that unless you work out 4 to 5 times a week you’re not worth their time or attention. In fact, if you read personal ads you’ll find that the majority of them use that as a prerequisite. Mind you, I’m not flabby or out of shape, I’m just tall and thin (6’3″, 175#). This has made me very self-conscious about myself and in turn has produced performance anxiety. I find myself working so hard to please a man sexually that I can’t “get it up” to save my life. I joined a gym a couple of times. But after a year of religiously working out (both times), I never saw any visible improvement in my body so I stopped going. Another aspect of my frustration is the fact that I have been HIV+ for 12 years and I am developing the “skinny arms and legs syndrome” from my drugs. Sex has become a very complicated issue for me. Half the time I’m self-conscious about my body and the other half afraid of passing on HIV or getting some new sexual disease. Any advice?
Sex Fan

Dear sex fan,
n-1.jpg You bet I have some advice. In fact, if you’ve taken the time to read this far in this column, you already have a good idea of what my take on all of this is.
Some gay men have turned discriminating against other gay men into an art form. If it’s not about muscles, then it’s about age, race, HIV status, where one lives, the clothes one wears, the car one drives—the litany goes on and on. If you buy into this dehumanizing nonsense, as it appears you have, you do it at your own peril, darlin’! You give this ugly thing power over you, and it will erode what little self-confidence you have left.
Let me make a couple of quick comments. First, do you use the same superficial standards to measure potential partners that you say others reject you by? That’s a common enough scenario (check out the letter above). But this cycle of oppression needs to stop somewhere; why not with you?
Second, working to please a partner is a good thing. But taking it to an extreme is not. Obsessing about pleasing a partner, so much so as to let it interfere with your sexual performance, or worse, your mental health, is very dangerous.
Finally, fear, whatever its guise, will always and everywhere diminish your ability to pursue and enjoy your sexuality. I guarantee that being so afraid of getting or passing on a disease or being afraid of rejections because of your body type will cripple your sexual performance.
I suggest you begin 2004 by taking your fears, apprehensions and frustrations to a professional. A sex-positive therapist will help you overcome these stumbling blocks so that you can happily get on with the rest of your life.
Good Luck,
Dr. Dick

It’s my sincere hope that, with the dawn of the New Year, we’ll find the courage to scuttle all this self-defeating crap, and in doing so, make the word a much better place in which to live.