Sexual desire, age and a whole lotta debunking…
I can’t tell you the number of times I’ve stumbled across studies or articles about sexual desire. She does, she doesn’t, he does, it doesn’t, take this pill, patch, supplement, eat this food, wear this article of clothing, blah blah blah. Guess what? A lot of it is in your head (or your environment). No really! At least if you are a woman. Granted, waning hormones, namely estrogen, will likely affect vaginal dryness, pliancy and libido, at least to a certain extent. But there is a whole body of literature that points to the importance of the value of, and satisfaction with, partner relationships.
I’ve been writing about sexual desire and sexual dysfunction since I started this blog four years ago. And I continue to be frustrated by the number of solutions and panaceas that overlook integral factors like emotions and intimacy. Consequently, I was truly happy to run across another piece of evidence demonstrating the importance of these factors. This time, researchers looked at a cohort of over 800 women who were as young as 40 and as old as 100 and asked them a number of questions about their emotional health, sexual activity and menopausal status. The results? 90% reported that they were in good health, and about half had had sexual activity within a month of being surveyed, with or without a partner. Notably, a large percentage of these women were using hormones.
However, while a third of women reported that they never or almost never felt sexual desire and a third reported having low sexual desire, most of the women who were sexually active indicated that emotional closeness with their partners was key and in fact, was associated with more frequent arousal, lubrication and orgasm. And, guess what? Although aging has often been thought to be a harbinger of low sexual satisfaction (or activity, for that matter), the percentage of women who reported being sexually satisfied actually increased with age, with about half of women older than 80 reporting that they were always or almost always satisfied! Moreover, these older women also had the same degree of orgasm satisfaction as their younger peers!
One of the study’s most important findings was the fact that sexual activity was not always the litmus for sexual satisfaction, and that emotional and physical closeness were almost equally if not more important. Indeed, lead researcher Dr. Susan Trompeter notes that women in the study “who were not sexually active may have achieved sexual satisfaction through touching, caressing or other intimacies developed over the course of a long relationship” adding that “emotional and physical closeness to the partner may be more important than experiencing orgasm.”
Clearly, this research highlights the need to focus on sexual satisfaction rather than sexual dysfunction or limitations to what is commonly perceived as sexual activity. By ignoring intimacy and partner relationships, we do a huge disservice to women. Moreover, it is certainly refreshing to know that it often gets better, not worse over time.
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Hairy kiri…sexual desire and hairs on your chinny chin chin
Yes, I am taking poetic license with the Japanese term “Hara-Kiri” which literally means to cut or slice the stomach. This phrase has been hijacked by slangers who refer to it as ‘hari kari,’ to off oneself or commit suicide.
I propose that using testosterone in hopes of improving sexual desire is a great way to cut off one’s wellbeing and sense of self Chi, leaving hairs on the chinny chin chin and other undesirable locations.
Hairy kiri? You bet!
Back in 2008, I wrote about Intrinsa, a testosterone patch that was tested in a study of 841 postmenopausal not currently on hormone replacement therapy to test its effects on sexual desire after about a half a year’s use. The results, which were published in the New England Journal of Medicine, showed that compared to a dummy patch, using low or high dose Intrinsa was associated with significant increases in sexual desire and a decline in sexual distress. Overall, the higher dose patch led to modest improvements in sexual function. In other words, wearing a patch was significantly better than using nothing at all but not life-shattering in terms of improving sexual function. However, the caveat was unwanted hair growth, which occurred in about a third of women using the higher dose patch and in about 23% of women using the lower dose.
Once I delved further into androgens and women, I learned that while it has been suggested that local circulating levels of androgens are associated with low sexual desire and sexual dysfunction, the data are contradictory. Moreover, in a fairly recent scientific review, researchers say that no single androgen predicts which women will have sexual dysfunction, making it even harder to address, right? What’s more, they also note that laboratory studies have only limited value and aren’t routinely recommended.
Looking more closely at different formulations of androgens like testosterone, e.g. patches, oral tablets, implants and injections, experts have found that the major side effects are unwanted hair growth and acne. Both are related to dose and how long treatment lasts, and disappear once treatment is stopped. And while rates of hair growth are definitely lower for patches in general (as few as 7% to as high as 23%), as many as 36% of women who use oral testosterone have unwanted hair growth. Among those receiving implants, pellets or injections the number is also high: 20%.
Let’s face it; the trouble is testosterone is that it may only address a miniscule amount of factors affecting a woman’s libido and in literally leave a trail in its place. Don’t know about you but I think it’s a hairy kiri proposition. A few more notches on the desire scale and a few more hairs in your chin, on your chest and lord knows where else.
Committing hairy kiri ain’t for sissies; that’s for sure!
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Wednesday Bubble: Are you in the moo? Sex and a sense of purpose
What are we bursting this week? How about midlife and sexual desire. Frankly, I’ve got sex on the brain, sex in midlife, that is. And what we need to do to insure that it continues to be enjoyable, that we desire it and that we please our partners as much as we hope that they please us. Consequently, I am reposting this piece from earlier in the year, with the hope that with a sense of purpose, you’ll become more in the moo. Or mood. Whatever the case may be.
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: Exercise and Sexual Health – How you move affects how you groove. Guest post by Alexandra Williams, MA
Every now and then I like to shake things up in this space, which is why I asked fitness professional writer, speaker and radio host Alexandra Williams (aka @alexandrafunfit on Twitter) to lend me her expertise for a day. What I didn’t expect, however, was for her to rock the sexual health world with the revelation that exercise, i.e. how you move, affects how you groove. Frankly, if all it takes is exercise, you will find me adding an extra hour or so a day at the gym!
Show Alexandra some love. She’s witty and has been putting the fun back into fitness for for some time now…
Image: http://vectorportal.com
Sexual health is defined by Mosby’s Medical Dictionary. as “a capacity to enjoy and control sexual behavior without fear, shame or guilt.” Sexual dysfunction is broadly defined by the Gale Encyclopedia of Medicine as “disorders that interfere with a full sexual response cycle. These disorders make it difficult for a person to enjoy or to have sexual intercourse.”
The good news, especially for older adults, is that most sexual dysfunctions can be treated or alleviated through exercise. It has been found to increase sexual drive, functioning, activity and satisfaction, due to the physical endurance, muscle tone and body composition derived from exercise. In addition, exercise activates the sympathetic nervous system, which encourages blood flow to the genital regions. Even low levels of physical activity can elevate mood and help keep sex organs and muscles in better working condition. A 2000 study found that after just 20 minutes of vigorous exercise, women became more sexually responsive, while men had increased testosterone levels after short, intense bouts of exercise.
Frequency, level of desire, and enjoyment are also affected positively for those who engage in regular exercise, at any age. In 2004, a study of college-age students a strong correlation was found between fitness levels, self-perception, body image, social meaning, outward appearance and sexual performance and desire. These findings were replicated in studies of people in their forties and sixties. And of course, sexual activity itself counts as exercise!
One really interesting comparison of exercise and sexual activity, looked at heart rate and blood pressure during treadmill exercise and sexual activity (not simultaneously)! Unsurprisingly, participants spent more time in sexual activity than they did on the treadmill, but here’s the intriguing point – the treadmill exercise duration predicted sexual activity duration. For each minute of treadmill time, there was 2.3 minute increase in sexual activity duration!
There are also a number of sexual diseases and dysfunctions that are radically improved through exercise. For example, exercise has a protective effect on Type 2 diabetes, with pelvic floor exercises of specific value. A minimum of approximately 50% of overweight men with Type 2 diabetes have erectile dysfunction, a frustrating condition that is helped enormously by cardiorespiratory fitness.
Urinary incontinence is markedly improved via pelvic floor muscle training, with 100% of women reporting decreased incontinence frequency and duration. And it works for men too – after the strengthening training, incidences of urinary and fecal incontinence decreased, and erectile function increased. Pelvic floor exercises are also an effective modality for primiparous (giving birth only once) women who have vaginal deliveries. Desire and satisfaction go up, and pain goes down for these women.
Breast cancer survivors consistently report an improved quality of life (better physical functioning, reduced fatigue and pain) when they participate in physical activity. In addition, prostate and bladder cancer are positively affected by exercise, including its stress-reducing aspects.
Sexual activity itself has been found to help with cardiovascular disease, with researchers finding that sexual activity corresponds to light to moderate physical exercise and entails no significant risk to the majority of patients with cardiovascular disease (severe angina or chronic heart failure are exceptions).
There’s been a lot of research on the relationship between exercise and erectile dysfunction, which affects over 100 million men. The link between cardiovascular disease, metabolic syndrome and erectile dysfunction is strong, and exercise is a mitigating factor on all three. Doctors who prescribe movement to patients with these three issues have reported high success rates. This is good news, especially considering that exercise is a less invasive treatment than medications, surgery or testosterone replacement therapies.
Sexual functioning and health is something everyone should have at any age. Exercise just may be the magic pill!
About the author…
Alexandra Williams, MA, has been in the fitness industry for over 25 years. She is the co-owner of funandfit.org. Together with her twin sister, she writes, teaches and speaks on fitness-related topics, using wit and research! For more, be sure to write to Alexandra and Kymberly at info@funandfit.org.And if you are the sort of person who likes to put a voice to an image, be sure to check Alexandra and Kymberly out on their radio program ‘Fun and Fit.’
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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.
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