sexual health

Hung Out To Dry

Posted by Liz on Aug 10, 2008 in sexual health | 0 comments

[Credit: Raphel Bunuel]

Vaginal atrophy affects up to 40% of postmenopausal women in the United States. It refers to the thinning of vaginal tissues as a result of estrogen depletion. And it can lead to vaginal dryness, burning, itching and painful intercourse.

Physicians have traditionally prescribed estrogen replacement, along with over-the-counter lubricants and moisturizers to counteract the problem. Now researchers are touting the benefits of a new agent called Ophena.

Ophena is a type of drug known as a selective estrogen receptor modulator or SERM.  SERMS mimic the action of estrogen in the body without necessarily causing some of its harmful effects, such as increasing the risk of breast and uterine cancer. The only other SERM that is available is Evista, which is indicated to treat osteoporosis and has been shown to reduce breast cancer risk but does not improve vaginal atrophy.

In a recent 12-week study reported at the 12th World Congress on Menopause this past May, one or two Ophena tablets daily were shown to significantly improve vaginal dryness and painful intercourse symptoms. Reports claim that Ophena was well tolerated, although I’ve not seen the actual data.

Are SERMS really safer than estrogen?

The first SERM to be introduced to the market was Tamoxifen.  Tamoxifen is breast cancer treatment that has been associated with increased risk for uterine cancer and blood clots. Evista, the second SERM to be approved in the US, does not act on the uterus so it is not linked to an increased for uterine cancer. But it has been associated with an increased risk for stroke.

Newer SERMS, such as Ophena, are in various stages of clinical testing. However, based on prior experience with its predecessors, it appears that the jury is still out when it comes to using these agents for menopausal symptoms.

If you are looking for an alternative, there is some indication that regular sexual activity actually helps to increase circulation to the vaginal tissues and pelvic area. Avoiding products (e.g., soap, detergents, feminine hygiene spray) that increase dryness may also help. And of course, there are many types of OTC lubricants available at your local pharmacy.

What is your experience with SERMS? Good, bad? Let me know!

Let’s talk about sex

Posted by Liz on Jun 5, 2008 in sexual health | 0 comments

[youtube=http://youtube.com/watch?v=qzfo4txaQJA]

I’ve heard that menopause is often linked to problems in sexual functioning.

Now mind you, this is one issue that many of my gal pals, present company included, have yet to experience but I believe that it’s an important topic nevertheless. Indeed, other women have expressed issues around desire, capacity for orgasm, and frequency of intercourse. The question is, are these problems related to menopause and hormones or to aging? Well, apparently both.

For example, some studies have found that the sharpest decline in sexual interest for women occurs around the mean age of menopause, while others have found that menopausal status (i.e., the point of the transition) negatively affects sexual function independent of age.

Interestingly, one of the largest studies – the Melbourne Women’s Midlife Health Project – which followed 438 women through menopause for more than 10 years, found significant declines in female sexual functioning, responsiveness, frequency of sexual activity and libido. When the researchers compared women who went through the transition during the study to those who remained pretty much in the same phase, they found that only sexual responsiveness declined. What this implies is that our ability to respond to sexual activity is paired with aging, while all the rest of the issues, are affected by menopause.

Interestingly, among the variety of factors that may contribute (e.g. quality of intimate relationship, degree of stress, general well-being) androgen levels (i.e., testosterone) may play a role.

In a fairly recent review of 14 controlled trials in women undergoing natural or surgical menopause, researchers found a benefit from “adding back” testosterone, in terms of sexual desire, frequency, pleasure, and satisfaction. Testosterone was administered via patch, a gel, and inhaled, among others. While some of the benefits may be attributed to the so-called “placebo effect,” the results are interesting and lend promise for future studies.