Sex, midlife and a sense of purpose
Sexual desire. In midlife, sexual function and sexual desire aren’t well understood, primarily because there are so many factors that enter into equation. This may be why certain silver bullets, like a female viagra, has failed to show any significant improvements in the desire department. And yet, researchers continue to accrue more information about the things that influence desire in women, ranging from the quality of intimate relationships to social support and overall wellbeing. The manufacturer who discovers a pill that addresses all of these will have struck gold. Meanwhile, back in reality, as many as 75% of women in midlife rate sexual health as important enough to warrant further exploration.
Fortunately, we may have another piece of the puzzle: ‘sense of purpose,’ which appears to be associated with greater wellbeing, happiness, life satisfaction, self-esteem, personal growth and optimism. A sense of purpose also appears to improve health, prevent certain diseases and may even improve cognitive function, thereby staving off mental diseases associated with aging. In a study that appears in the online version of Menopause, 459 menopausal women who were sexually active with a partner were followed over three years. Each year, they were asked about their emotional wellbeing (including their general mood, anxiety and depression as well as how often they engaged in and enjoyed sexual activity (specifically desire, type of activity and hugging and kissing). In the final year, they took a test that rated their sense of purpose on a five point scale ranging from ‘there is not enough purpose in my life’ to ‘the things I do are all worthwhile.’
The findings?
A greater sense of purpose equaled a great enjoyment of sexual activities, independent and regardless of other specific life circumstances. In other words, psychosocial functioning, e.g. social support, quality intimacy and overall wellbeing influenced the quality of these women’s sexual lives. On the other hand, menopausal status and use of hormone therapy did not appear to play a significant role in how often women engaged in sex or if they enjoyed it. This is important, as it means that psychosocial wellbeing may ultimately be more important than hormones.
In so far as the desire to engage? Women who were younger, had more social support, felt better about themselves and weren’t suffering from vaginal dryness tended to want sex more than their older peers who didn’t enjoy these factors.
Not surprisingly, many of the factors that researchers stress may help desire and engagement are associated with greater nitric oxide levels, which Dr. Christina Northrup says can help combat sexual dysfunction and improve pleasure.
When it comes to sex in midlife? It may help to think ‘sense of purpose,’ a real sense of purpose, now. (Poetic license, Chrissie!) I’m all for it if improves activity and desire without drugs.
Read MoreWednesday Bubble: Let’s talk about sex…again
[youtube=http://www.youtube.com/watch?v=qzfo4txaQJA]
True confession: I’ve already posted this video previously but I love the song so indulge me won’t you? And while we’re at it, let’s indulge in these two completely divergent headlines:
Middle-aged Americans unhappy about sex vs. We may be broke, but at least we’re having more sex than ever before!
Um, Okay. So..are we or aren’t we?
The first headline belongs to a Washington Post article highlighting results from a recent Associated Press survey of Boomers (45 to 65 year olds). The findings? In summary, “faced with performance problems, menopause blues and an increased mismatch of expectations between the sexes, middle-aged Americans are the unhappiest people of all when it comes to making love.” For example:
- 24% of 45 to 65 year olds express dissatisfaction with their sex lives
- Nearly three in five women and half of men have stopped experimenting and claim to know all they need to about sex
- 48% of men’s expectations are not being met in the bedroom in terms of their partners not desiring sex however, two in five men in this age group have problems with sexual functioning, compared to 19% of women
The second headline belongs to a piece that appears on an Irish website regarding a Durex survey geared towards a slightly younger age group (25 to 34), but like the AP study, also makes comparisons to younger and older groups. Not only does this piece highlight results of the large study that appeared in the Journal of Sexual Medicine suggesting that Americans of all ages were having more sex than ever, but also reports that:
- The ‘over-55’ set is having sex at least once weekly
- Almost three-quarters of respondents believe that sex gets better with age
- Women are as eager as their male counterparts to have sex
- A growing number of Irish men and women are broadening their sexual horizons and re-engaging in the Swinger scene
Confused yet? Which of these bubbles needs to be burst?
All three of these reports are surveys, although only one qualifies as a bonefide study (the National Survey of Sexual Health and Behavior). And this particular survey doesn’t necessarily highlight major issues when it comes to sex and Boomers. Even more ironic is that the AP survey appears to have been done for a website that features an article on sex over age 50 that actually disputes the findings.
Wow! So, shall we talk about sex? I mean, really talk about it. I truly don’t believe that the generation that brought sexual exploration out of the closet is driving it back into the closet and abandoning it altogether. Life changes, physical changes, environment changes, relationship changes…sex changes. Let’s talk about something that matters for a change, like the “why’s,” “how’s” and “what if’s.”
I’ve said it before and I will say it again. No matter what life transition you are in, work it, don’t let it work you. That includes sex.
Read MoreBouquet-Worthy, a guest post by Dr. Barb DePree, M.D., Menopause Care Specialist and founder of MiddlesexMD.com
I recently had someone comment that I write about sex often.
I wasn’t aware of that.
In fact, I don’t really. But reader impressions are always welcome; who knows what people see or read or think or interpret, right?
So, on the heels of the write about sex comment, I thought it would be appropriate to include a post about sex, more specifically a website geared towards sexual desire, function and expectations in mid-life. I liked what I saw when I perused the site, so much so that I felt that this post would be most appropriately written by MiddlesexMD.com’s founder, healthcare provider and menopause care specialist, Dr. Barbara DePree.
A big bouquet of roses waited for me at the front desk of my clinic. It wasn’t my anniversary or my birthday. When I saw who sent them, I smiled that special “good sex” smile, even though the sex I was smiling about wasn’t my own.
I’ve been a women’s health doctor for more than 20 years, focused on midlife women for the past four. These flowers were not from a new mom or a patient with a difficult disease. These came from a patient who got her sex life back. That may not seem like a big win in the scheme of things, but it was a wake-up call for me.
My patient, now in menopause, was distraught that her sex life seemed to be over so soon — too soon. Sex was effortless for most of her life. It had been very satisfying. And suddenly, it wasn’t any more.
We talked about sexual response with her hormonal changes, all of the many factors that could be influencing her experience. Then we talked about her options for managing these changes. She tried different routes, but when I introduced her to a device — she had not used them before — that made the difference for her. With the help of a simple tool, she was able to adapt to her new reality, and enjoy sex again.
It was a fairly straightforward doctor-patient exchange, but not a common one. Women rarely talk to their doctors about sex. As a menopause practitioner, though, I know that changes in sexual response are a key source of distress for a lot of women and their partners at this age.
Is it a Doctor’s job to help their patients have good sex? I think it is, absolutely. A healthy sex life sustains our overall health and well-being. Sex is good for us, and helps us to remain vibrant and strong. Menopause isn’t a disease. It’s a natural process. The more we understand this process, and discuss it openly, the easier it will be for us to make adjustments to accommodate our bodies’ changes.
The roses were evidence that my patient’s sex life had been restored.
How many women like her have never raised the question with their doctors. Their gynecologists? Or sisters? Or friends?
I founded MiddlesexMD.com for women who aren’t ready to close the door on sex, and who aren’t sure how or when to talk with their doctors about their experiences.
MiddlesexMD is organized around five “recipe” elements – Knowledge, Vaginal Comfort, Genital Sensation, Pelvic Tone and Emotional Intimacy – that are essential to sexual well-being. It provides a factual guide on how they contribute to a healthy sex life, how they change with menopause, and how to use different techniques and products to make up for those changes.
I hope that MiddlesexMD gives you a trustworthy (and hopefully bouquet-worthy!) resource to explore issues you might be having, conditions that could be causing them, and steps you can take to enjoy sexuality for life.
About the Author
Barb DePree, MD, is a women’s health provider in West Michigan, specializing in menopause care. She founded MiddlesexMD.com, a safe, comfortable place where women can learn how aging affects sex after 40, find advice and techniques, and purchase specially chosen aids such as a personal vibrator, moisturizers and lubricants.
Read MoreThis Just In! FDA Advisory Panel Unanimous Against Flibanserin
The verdict’s in! The Reproductive Health Advisory Committee did not consider flibanserin, the female Viagra equivalent, to be any more effective than placebo.
Shocking eh?
Here’s the AP report. And more information from this morning’s post on Flibanserin.
Read MoreFemale Viagra hits a new low in the bedroom
I was going to devote another post to “Low T’ and male “menopause” today. Check back on Monday for that because the early news out of the Food and Drug Administration, whose Reproductive Health Advisory Committee is set to meet today to decide on a final verdict, is that flibanserin falls short of its promise to improve women’s sexual desire. Citing issues with the manufacturer’s data, the FDA says that studies do not show significant improvement in a woman’s sexual desire and also fails to note the significant side effects associated with flibanserin, including depression, dizziness and nausea. The ultimate decision could possibly deal a huge blow for profits that could exceed $2 billion dollars.
Importantly, it appears that hype about flibanersin (and more specifically, low sexual desire) has reached a new low. Not only have the company’s marketing efforts pushing the “fact” that one in 10 women suffer from low sexual desire (this figures varies in the medical literature), but the company even funded a Discovery Channel documentary to promote greater awareness of the disorder, a documentary that featured company-paid experts and was reviewed by the company before it aired.
As I’ve written time and again, low sexual desire is a serious and troublesome problem in women that can significantly affect quality of life, self-esteem and relationships. Some experts dispute that female sexual disorder even exists (although clinical experience in postmenopausal women speaks otherwise). However, whether or not you believe in low sexual desire, one thing remains true: when it comes to sex, women operate on a different plane than their male peers. Studies have shown that sexual desire in women is highly reliant on context, experience and personal attitudes. Therefore, you can’t simply fix the symptom without exploring underlying contributing factors.
Do we need another pill in the bedroom? Do we need a female viagra? I hope that the FDA Reproductive Health Committee tells Boehringer “no.”
Read MoreThe female Viagra rears its head…yet again
Got sexual dysfunction? Big pharma continues to search for that magical fountain to restore your libido, desire and ‘vavoom’ in the bedroom. This time, the airways are abuzz with data from a study of rabbits. Yes, rabbits. Seems sort of appropriate that a bunny might be the one to get women back into the bedroom, doesn’t it?
Last November, I told you about the antidepressant flibensarin, which research shows may have the ability to positively affect brain receptors and neurotransmittors that play a role in sexual response. In other words, flibensarin may help boost sexual desire in women who have lost an interest in sex. Now, mind you, hypoactive sexual desire and female sexual arousal disorder, which affects up to 40% of women, are serious, distressing conditions. However, there are data that show that sexual desire cannot be put into a neat box, that the mind, body, soul and environment play key roles in women’s sexual health. Once, again, I refer back to Dr. Christiane Northrup, who I maintain, has provided a healthy, non-pharmaceutical approach to overcoming some of the key variables that play a role in loss of desire. If you haven’t checked out that post, I encourage you to do so.
And yet, the pursuit of the gold ring continues.
In the latest bit of research to reveal the “secret garden” investigators found that by stimulating the pelvic nerve, they were able to promote the release of a neurotransmitter (an endogenous chemical responsible for signals between cells and neurons in the body) called VIP (vasoactive intestinal peptide), a hormone that resides mostly in the gut but also increases blood flow. Under normal circumstances, the action of VIP is broken down by an enzyme called NEP. However, by giving the rabbits an experimental drug, they were able to block NEP, thereby allowing the VIP hormone to do its job better to increase and maintain blood flow to the genital organs.
The key takeaway messages from this highly experimental study were as follows:
1) The drug was able to block an enzyme that plays a role in preventing blood flow to the genital area during arousal, meaning that it revealed a potentially important pathway for the development of drugs that might do the same
2) This action happened without affecting the rest of the body’s cardiovascular system, which indicates it might be safe
Interestingly, in a press release, company representatives distinctly stated that the particular agent used in the rabbit study was not appropriate for further development and that the company had no interest in developing a drug for female sexual arousal disorder.
So, why did the media jump on this story?
I’ve said it before and I’ll say it again: sex sells.
The moral – be careful and delve deeper. Sexual desire is tricky. In women, it entails a lot more than stimulation. What’s more, do we really need another pill in the bedroom? Thoughts?
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