Posts Tagged "sexual desire"

Bouquet-Worthy, a guest post by Dr. Barb DePree, M.D., Menopause Care Specialist and founder of MiddlesexMD.com

Posted by Liz on Sep 10, 2010 in sexual desire, sexual health | 2 comments

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.

Women, O, pause! The book

Posted by Liz on Sep 3, 2010 in menopause | 4 comments

If you’ve ever visited the ‘About’ section, you know that a key reason I started this blog was that I took a look around the interwebz to see what was being written about menopause and it gave me “pause.”  I felt that there were voices that were being ignored or talked down to. And, I felt that the information was too limiting, too medical, not broad enough.

Hence, when I was approached by the publicity folks at Planned Television Arts/Ruder Finn to examine a new self-help book on menopause: Womenopause: Stop Pausing and Start Living (Authors Lovera Wolf Miller MD and David C Miller, MD), I thought, “sure, why not?”

Womenopause has an interesting approach in that it encourages women to be proactive rather than reactive to menopause.  This philosophy is one that I’ve long ascribed to because I do believe that prevention is often the best medicine. In fact, when younger women tell me that this blog is not for them, I usually tell them that there are steps that they can take now to prevent some of the challenges that accompany the transition, such as weight gain/redistribution, bone loss and heart disease.

Moreover, I love that the authors acknowledge menopause as a milestone, not for its finality but for the fact that is simply another stage that “transforms women within the context of an already convoluted life and within the complexities of a marriage and/or dynamic relationships.” I love that Womenopause offers thorough, readable information about the processes that are going on in a woman’s body to cause various symptoms of menopause, an area that I’ve been hesitant to approach simply because I feel that there is a lot of good information out there, if you know where to look (for example, check out the Flashfree Blogroll on the home page).  And I applaud the authors for their inclusion of real-life cases.

However, this is where my love affair with the book ends and the questions begin.

The authors of Womenopause ask their readers to chart their baseline symptoms and basic health and then record their course through four weeks using something they have named the ‘ωScore.’ Theoretically the goal is to help identify health problems, for example, the severity and emotionality of hot flashes, sexual or skin issues or sleep problems to raise awareness and potentially, spark conversations with their healthcare practitioners. Each of these areas is thoroughly discussed in the book in both a serious and thoughtful fashion, accompanied by an attempt at a lighter side. Although I think that records can help identify issues and promote helpful dialogue, I know that personally, I don’t want to take a quiz, keep a journal or score a “hot dread.” Huh? Hot dread is defined as emotional components – aura and anxiety, that may accompany a hot flash. The overall tone of the Womenopause interactive program — “fit, feminine and fabulous in four weeks,” feels a wee bit touchy feelie, “woo woo” to me, and frankly, when I am night sweating or flashing, I’m really not feeling my fabulosity or my femininity.  As I’ve mentioned time and again, this ain’t no tropical vacation and I’m not really interested in ‘Menopauseland,’ the theme park.

When it comes to physical information, Womenopause is truly, a great guide. However, buyer beware! The majority of solutions to the common problems of menopause are medically/pharmaceutically-based and in fact,  the authors repeatedly dismiss alternative and complementary therapies as unproven and no better than placebo. As someone who is well-versed in reading and analyzing data, and who has devoted the past two years to examining and sharing the evidence behind alternatives to hormone replacement, I take great issue with this approach and it makes me pause; by not taking adequate time to thoroughly explore studies on alternative approaches, the authors have truly done a huge disservice to women who are hungry for information and need to be empowered to make the right decision for themselves, even if that decision does not involve HRT. Moreover, for a book that devotes more than on thorough discussion to sexual desire and other menopausal issues, I am very surprised not to find Christiane Northrup, MD, listed in the Recommended Books section.

Overall, I would encourage readers of this blog to take a look at Womenopause, with the full understanding that this may not be your cup of tea. It certainly is not mine. However, if you are looking for concise medical information about the changes that are occurring in your body during the transition, and a wee smattering of helpful advice, Womenopause is a great resource. Just be mindful that fab, fabulous and fit in four weeks sounds like a dream, not a reality.

Tell me, what are your favourite resources or reads?

[Disclosure: I was not paid to review Womanopause. However, the publicity folks did send me a free copy of the book.]

This Just In! FDA Advisory Panel Unanimous Against Flibanserin

Posted by Liz on Jun 18, 2010 in sexual desire, sexual health | 0 comments

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.

Female Viagra hits a new low in the bedroom

Posted by Liz on Jun 18, 2010 in sexual desire, sexual health | 4 comments

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.”

The female Viagra rears its head…yet again

Posted by Liz on Apr 19, 2010 in sexual desire, sexual health | 3 comments

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?