Archive for the ‘estrogen deficiency’ Category

Urinary Tract Infections (UTIs) in Women

September 4, 2016

Perhaps one of the most common infections in all women and young girls are UTIs.  Nearly 50% of all women will experience a UTI during their lifetime.

Urinary tract infections (UTIs) are very common in the U.S. In fact, UTIs are the second most common type of infection in the body and are the reason for more than 8 million visits to the doctor each year. About 50% of all women will develop at UTI during their lifetime.

Most UTIs involve the bladder (cystitis) are not serious, but some can lead to serious problems like kidney infections. The most common care or treatment for a UTI is antibiotics. Signs of a UTI involve pain or burning when you pass urine, urine that looks cloudy or smells bad, pressure in your lower abdomen, and an urge to go to the bathroom often. You can get a UTI at any age, but there are peak times in life when they are more common.

Many women report UTIs following sexual activity. Another peak time for UTIs in women is after menopause. This is because of lower vaginal estrogen levels. Lower estrogen levels make it easier for bacteria to grow. A woman’s urethra or the tube from the bladder to the outside of the body is very short, about two inches in length compared to man’s urethra which is 8-10 inches long. This short length makes it easy for bacteria to enter a woman’s bladder. The opening of a woman’s urethra is near the rectum and vagina which happen to be two common places where bacteria dwell.

Prevention of UTIs in women may be as simple as instructing women to wipe from front to back following urination and bowel movements. This helps cut the chance of spreading bacteria from the anus to the urethra.

For women who notice more UTIs after sexual activity, I will often recommend that women take a low dose antibiotic shortly before or right after sexual activity.

Bottom Line: UTIs are common in women.  Most of these infections are not serious and can be treated with a short course of antibiotics.  For women with chronic or repeated infections, low dose antibiotics may be helpful.

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Sex and the Senior or Senior Sex

January 4, 2016

It is not a myth that seniors engage in sexual intimacy or wish to enjoy intimacy perhaps just as much as younger men and women. However, intimacy like many other physical and social interactions that occur as men and women get older. This blog will discuss simple suggestions for seniors to have enjoyable and more fulfilling sex life.

Start your intimacy by engaging your mouth or your communication skills before engaging in sex. You should be able to communicate your thoughts, fears, and desires with your partner. Be frank with your partner and encourage them too to be open with you. Holding back or hiding certain things will only dampen your spirits and diminish your performance.

Be open to new ideas and experiment

Just because you are growing old, doesn’t mean you can’t expand your horizons. Be open to new ideas and discuss them freely with your partner. Don’t hesitate and put your creative mind to use. If erectile dysfunction is an issue for you, try sex with the woman on top, as hardness is less important. If you are used to having sex in the evening, try the morning and visa versa.

Eat right and exercise

High blood pressure and cholesterol can cause the vascular problems that lead to trouble with your erections. It is important to maintain a healthy lifestyle by exercising and keeping your weight and cholesterol in check.

Avoid large quantities of alcohol and smoking

It’s no news that both alcohol and smoking can hinder a man’s ability to achieve an erection. If you are having sexual difficulties, consider abstaining from smoking and alcohol.

Sex does not always mean intercourse

You need to broaden your definition of sex. Holding each other, gentle touching, cuddling, kissing, and sensual massage are also ways which will fulfill you. Try oral sex or masturbation as substitutes to intercourse.

Know when to visit a doctor

Your doctor can help you manage chronic conditions and medications that affect your sex life. If you have trouble maintaining an erection, ask your doctor about treatments. If you have vaginal dryness, see your doctor as help is available.

Be optimistic

You need to maintain a positive approach when it comes to these sensitive issues. Having said that, you need to be realistic too to accept the changes that your body is going through. But nevertheless, accept these natural changes with confidence.

Bottom Line: Sex is enjoyable at any age. Seniors enjoy sexual intimacy just as younger men and women do. You need to know that you can be successful as a senior both in and out of the bedroom.

Do Women Have Low T? The Role Of Testosterone in Women

July 28, 2014

Testosterone is the male hormone produced in the testicles that is responsible for sex drive or libido. Women also make testosterone in their ovaries. After menopause the amount of testosterone is decreased and will affect a woman’s sex drive and libido.
Testosterone, widely and misleadingly understood to be the “male” hormone. Men produce 10 times more testosterone than women, but in their early reproductive years women have 10 times more testosterone than estrogen coursing through their bodies. And many experts now believe that it’s the loss of testosterone, and not estrogen, that causes women in midlife to tend to gain weight, feel fatigue and lose mental focus, bone density and muscle tone — as well as their libido. Testosterone is a woman’s most abundant biologically active hormone. Adequate levels of testosterone are necessary for physical and mental health in both sexes.



Benefits for Women
 
Women, before, during and past menopause, and sometimes as early as in their mid-30s, invariably have low testosterone levels. Not all women will experience its wide variety of symptoms, like low libido, hot flashes, fatigue, mental fogginess and weight gain. For those who do, and who seek to avoid taking synthetic oral hormones (shown by National Institutes of Health findings to pose an increased risk for breast cancer, heart attack, stroke, blood clots and dementia), bioidentical testosterone (whose molecular structure is the same as natural testosterone) has been shown to be safe and effective.

Some testosterone is converted by the body into estrogen — which partly explains why it is useful in treating menopausal symptoms. For those at high risk for breast cancer, or who have had it, that conversion can be prevented by combining testosterone with anastrozole — an aromatase inhibitor that prevents conversion to estrogen. Nonetheless, testosterone has been shown to beneficial for patients with breast cancer. Preliminary data presented at the American Society of Clinical Oncology have shown that, in combination with anastrozole, testosterone was effective in treating symptoms of hormone deficiency in breast cancer survivors, without an increased risk of blood clots, strokes or other side effects of the more widely used oral estrogen-receptor modulators tamoxifen and raloxifene.

Other benefits cited for testosterone therapy include:

Relieving symptoms of menopause, like hot flashes, vaginal dryness, incontinence and urinary urgency.

Enhancing mental clarity and focus. Researchers at Utrecht University in Holland recently found that testosterone appears to encourage “rational decision-making, social scrutiny and cleverness.”

Reducing anxiety, balancing mood and relieving depression combined with fatigue. Dr. Stephen Center, a family practitioner in San Diego who has treated women with testosterone for 20 years, says the regimen consistently delivers “improvement in self-confidence, initiative and drive.”

Increasing bone density, decreasing body fat and cellulite, and increasing lean muscle mass. Testosterone is the best remedy available for eliminating midlife upper-arm batwings.

Offering protection against cardiovascular events, by increasing blood flow and dilating blood vessels, and against Type 2 diabetes, by decreasing insulin resistance.

Countering the Myths

Some women believe, also incorrectly, that testosterone therapy will produce “masculinizing” traits, like hoarseness and aggression. While the hormone may cause inappropriate hair growth and acne in some women, those side effects can be remedied by lowering the dose.

Testosterone therapy has been approved for a variety of conditions in women as well as men in Britain and Australia. But while the U.S. Food and Drug Administration has approved of testosterone for use in men whose natural levels are low, the agency has not sanctioned it for women, for any reason.

How Treatment Works

Women can take testosterone as a cream, through a patch or in the form of pellet implants, which have the highest consistency of delivery. Synthesized from yams or soybeans, and compounded of pure, bioidentical testosterone, the pellets, each slightly larger than a grain of rice, are inserted just beneath the skin in the hip in a one-minute outpatient procedure. They dissolve slowly over three to four months, releasing small amounts of testosterone into the blood stream, but speeding up when needed by the body — during strenuous activities, for example — and slowing down during quiet times, a feature no other form of hormone therapy can provide.

To determine a patient’s dosage, some doctors measure testosterone levels in the blood.

Side effects of the insertion procedure, which are rare, include infection, minor bleeding and the pellet working its way out or being extruded. Some patients notice improvements within a day or two; others do not perceive benefits for a couple of weeks.

Bottom Line: Since implantation is a surgical procedure, and the pellets are manufactured by a variety of pharmaceutical compounders, who may have varying safety standards, it’s important for women to consult with an experienced, board-certified physician about treatment. Ask your doctor if you feel you are having symptoms related to low testosterone and see if testosterone replacement would be right for you

Menopause Doesn’t Mean Goodbye To Sex

June 1, 2014

The loss of estrogen and testosterone following menopause can lead to changes in a woman’s sexual drive and functioning. Menopausal and postmenopausal women may notice that they are not as easily aroused, and may be less sensitive to touching and foreplay — which can result in decreased interest in sex.
In addition, lower levels of estrogen can cause a decrease in blood supply to the vagina. This decreased blood flow can affect vaginal lubrication, causing the vagina to become dry and cause painful intercourse.
A lower estrogen level is not the only culprit behind a decreased libido; there are numerous other factors that may influence a woman’s interest in sexual activity during menopause and after. These include:
Bladder control problems (incontinence)
Sleep disturbances
Depression or anxiety
Stress
Medications
Health concerns
Some postmenopausal women report an increase in sex drive. This may be due to decreased anxiety associated with a fear of pregnancy. In addition, many postmenopausal women often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

During and after menopause, vaginal dryness can be treated with water-soluble lubricants such as Astroglide or K-Y Jelly. Do not use non-water soluble lubricants such as Vaseline, because they can weaken latex (the material used to make condoms, which should continue to be used until your doctor verifies you are no longer ovulating and to prevent contracting sexually transmitted diseases). Non-water soluble lubricants can also provide a medium for bacterial growth, particularly in a person whose immune system has been weakened by chemotherapy or in women who are prone to recurrent urinary tract infections.
Vaginal moisturizers like Replens and Luvena can also be used on a more regular basis to maintain moisture in the vagina. You can also talk to your doctor about vaginal estrogen therapy.
A oral drug taken once a day, Osphena, makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.
Estrogen replacement may help raise the sex drive after menopause which is associated with a decrease in estrogen. Estrogen can also make intercourse less painful by treating vaginal dryness.
Doctors are also studying whether a combination of estrogen and male hormones called androgens may be helpful in increasing sex drive in women.
Bottom Line: Sexual desire and enjoyment from sexual intimacy can be preserved after menopause. It may dry the vaginal lining but it doesn’t have to dry up the desire to be sexually intimate with your partner.

Saying Goodbye To Jumping Jack “Hot” Flash

July 2, 2013

Not all women will experience hot flashes, but three out of four will, with one of 10 experiencing them through their seventies. The cause of hot flashes are the dilation of the blood vessels in the face and upper chest result in increased blood flow to these areas. Some women also sweat during hot flashes. For some women, the hot flashes are not very common and are an inconvenience. For other women, they impact the woman’s quality of life and are incapacitating. The time-honored treatment for hot flashes has been estrogen replacement therapy or hormonal therapy. While hot flashes are not dangerous, they cause discomfort, embarrassment and sleep loss. During menopause some women may have more than 10 a day.

Women with uncomfortable hot flashes now have a medication option that doesn’t involve hormones. The U.S. Food and Drug Administration approved the first nonhormonal drug to treat moderate to severe hot flashes and night sweats associated with menopause. The drug, Brisdelle, contains peroxetine, a selective serotonin reuptake inhibitor (SSRI) that is also the active ingredient in the antidepressant Paxil.

Many women are reluctant to treat menopausal symptoms with hormones including estrogen and progesterone, as a 2002 study conducted by the Women’s Health Initiative implied that a combination of hormones, estrogen and progesterone, with increased cancer risk.

Side effects of the drug included headache, fatigue, nausea and vomiting. Brisdelle will be available starting in November.

Bottom Line: Every woman would like to have her hot flashes disappear like magic. Although estrogen replacement therapy has been effective in reducing hot flashes, many women do not want to take hormones. Brisdelle may just be the solution that many women have been waiting for.

Read more: http://www.nydailynews.com/life-style/health/nonhormonal-hot-flash-treatment-approved-fda-article-1.1388094#ixzz2XvmVGY89

Libido In The Tank? There’s Help For Women’s Sex Drive

April 9, 2013

As both men and women join the mid-life club they have a waning of their sex drive. The desire for sex decreases with advancing age. For men the problem is a decrease in testosterone and for women it is a result of a decrease in estrogen as well as a decrease in testosterone. Well, now help is available and a man or woman’s libido can be restored. This blog will discuss the treatment options available for women who have a decrease in their libido.

Causes of decreased libido in women

A woman’s sex drive is connected to both psychological issues as well as physical problems. Women who are in a stable relationship and take good care of themselves physically are likely to have fewer problems than those who are not in a good relationship.

The physical issues, including hormonal changes related to menopause or childbirth, or thyroid problems. Also, chronic stress can significantly impact a woman’s sex drive. Certainly depression or other mental health issues will have a a negative impact on a woman’s sex drive. Finally, some prescription drugs may also affect libido, including some types of antidepressants, birth control pills (especially those containing progesterone), anti-anxiety drugs, and blood pressure medications all can have a deleterious effect on a woman’s libido. Also women who have pain during sex may develop low sexual desire It is not uncommon for a woman to have more than one cause of a decrease in her libido.

Reviving Your Libido

The easiest solution is to speak to your physician and be sure that your medications are not the culprit. The doctor can adjust the dosage of your medication or prescribe another class of drugs that doesn’t affect the libido or sex drive. If there is a relationship problem, the doctor may recommend a referral to a sex counselor or sex therapist. I suggest that you look for a gynecologist or a sex therapist who is knowledgeable about the physical, relationship-related, and emotional components of sexual dysfunction.

Now there are medications that can have a favorable impact on a women’s sex drive. Estrogen vaginal creams, which can help if vaginal dryness makes sex painful. This typically happens when estrogen levels fall due to menopause or breastfeeding. Estrogen also comes in other forms, such as a tablet or skin patch. Testosterone and other androgens decline as women age. These hormones may play a role in sexual function in women just like they do in men. In women with low libido just before, during, or after menopause, or in women who’ve had surgery to remove their ovaries, some experts suggest the use of testosterone treatment. Testosterone can be given to women as a pill such as Estratest, a topical gel applied to the skin, or a pellet that is placed under the skin and is replaced every 4-6 months. Wellbutrin, an antidepressant, may be prescribed to treat low sex drive in women who haven’t been through menopause or if other antidepressants have affected their sex drive.

What About Supplements?

Some supplements claim to boost women’s libido, but many lack scientific proof. Most of the these products are based on anecdotes and testimony. My advice: Be skeptical if there isn’t evidence from a clinical trial.

Bottom Line: Women do not have to say goodbye to an enjoyable sex life because of a decrease in libido. Help is available. See your doctor and have a discussion about the treatment options.

Female Sexual Dysfunction-Women, You Can Be Helped

January 20, 2013

It is of interest that women have just as many sexual problems as men. In the past 15 years, more attention has been given to male sexual problems, mostly erectile dysfunction, as medications have been available for treating this common condition. Now women with decreased desire, decreased lubrication, decrased aroiusal, and lack of orgasm can now be treated.

What Causes Sexual Dysfunction?

Sexual dysfunction in women can be a result of a physical and\or psychological problem.

Physical causes. Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart disease, neurological diseases, hormonal imbalances, menopause plus such chronic diseases as kidney disease or liver failure, and alcoholism or drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
Psychological causes. These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, or the effects of a past sexual trauma.

The most common problems related to sexual dysfunction in women include:

Inhibited sexual desire. This involves a lack of sexual desire or interest in sex. Many factors can contribute to a lack of desire, including hormonal changes associated with menopause, medical conditions and treatments (for example, cancer and chemotherapy), depression, pregnancy, stress, and fatigue. Boredom with regular sexual routines also may contribute to a lack of enthusiasm for sex, as can lifestyle factors, such as careers and the care of children.
Inability to become aroused. For women, the inability to become physically aroused during sexual activity often involves insufficient vaginal lubrication. This inability also may be related to anxiety or inadequate stimulation.
Lack of orgasm. An absence of orgasm can be caused by a woman’s sexual inhibition, inexperience, lack of knowledge, and psychological factors such as guilt, anxiety, or a past sexual trauma or abuse. Other factors contributing to an absent orgasm include insufficient stimulation, certain medications, and chronic diseases.
Painful intercourse. Pain during intercourse can be caused by pelvic organ prolapse, endometriosis, a pelvic mass, ovarian cysts, vaginitis, poor lubrication, the presence of scar tissue from surgery, or a sexually transmitted disease. A condition called vaginismus is a painful, involuntary spasm of the muscles that surround the vaginal entrance. It may occur in women who fear that penetration will be painful and also may stem from a sexual phobia or from a previous traumatic or painful experience.

The diagnosis of female sexual dysfunction begins with a physical exam and a thorough evaluation of symptoms. The doctor performs a pelvic exam to evaluate the health of the reproductive organs and a Pap smear to detect changes in the cells of the cervix (to check for cancer or a pre-cancerous condition).

An evaluation of your attitudes regarding sex, as well as other possible contributing factors (such as fear, anxiety, past sexual trauma/abuse, relationship problems, or alcohol or drug abuse) will help the doctor understand the underlying cause of the problem and make appropriate treatment recommendations.

Treatment of Female Sexual Dysfunction

Most types of sexual problems can be corrected by treating the underlying physical or psychological problems which include:

Providing education. Education about human anatomy, sexual function, and the normal changes associated with aging, as well as sexual behaviors and appropriate responses, may help a woman overcome her anxieties about sexual function and performance.
Enhancing stimulation. This may include the use of erotic materials (videos or books), masturbation, and changes in sexual routines.
Providing distraction techniques. Erotic or non-erotic fantasies; exercises with intercourse; music, videos, or television can be used to increase relaxation and eliminate anxiety.
Encouraging non-coital behaviors. Non-coital behaviors (physically stimulating activity that does not include intercourse), such as sensual massage, can be used to promote comfort and increase communication between partners.
Minimizing pain. Using sexual positions that allow the woman to control the depth of penetration may help relieve some pain. Vaginal lubricants can help reduce pain caused by friction, and a warm bath before intercourse can help increase relaxation.

The success of treatment for female sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a treatable or reversible physical condition. Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners.

Hormones play an important role in regulating sexual function in women. With the decrease in the female hormone estrogen that is related to aging and menopause, many women experience some changes in sexual function as they age, including poor vaginal lubrication and decreased genital sensation. Low levels of the male hormone testosterone also contribute to a decline in sexual arousal, genital sensation, and orgasm. Women can use a topical gel containing testosterone or receive a small pellet of testosterone, the size of a grain of rice, placed under the skin which can result in enhancement of their libido and sex drive.

Many women experience changes in sexual function after a hysterectomy (surgical removal of the uterus). These changes may include a loss of desire, and decreased vaginal lubrication and genital sensation. These problems may be associated with the hormonal changes that occur with the loss of the uterus. Furthermore, nerves and blood vessels critical to sexual function can be damaged during the surgery.

The loss of estrogen following menopause can lead to changes in a woman’s sexual functioning. Emotional changes that often accompany menopause can add to a woman’s loss of interest in sex and/or ability to become aroused. Hormone replacement therapy (HRT) or vaginal lubricants may improve certain conditions, such as loss of vaginal lubrication and genital sensation, which can create problems with sexual function in women.

I think it is important to mention that some postmenopausal women report an increase in sexual satisfaction. This may be due to decreased anxiety over getting pregnant. In addition, postmenopausal woman often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

Bottom Line: Many women experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the women and her partner, and can have a negative impact on their relationship. If you consistently experience these problems, see your doctor for evaluation and treatment.

For more information on women’s health, I suggest my new book, What’s Going On Down There-Everything You Need To KnowAbout Your Pelvic Health. the book is available from Amazon.com

New book on women's health

New book on women’s health

Hot Flashes? Exercise Your Way To Cool The Fire

January 20, 2013

Hot flashes are one of the most disturbing aspects of menopause. It makes women uncomfortable and can wreck havoc on their lives. This blog will describe how exercise can cool the hot flash.

Increased energy and a fit body are just a few of the benefits of exercising. There is another advantage of working out for women. For menopausal women who exercise, they experience fewer hot flashes in the 24 hours after physical activity.

Women who are inactive or obese are more likely to have a higher risk for hot Women in a study at Penn State had fewer hot flash symptoms following exercise. As well, women who were identified as overweight, had a lower level of fitness, or experienced more frequent or more intense hot flashes, sensed the smallest reduction in symptoms.

Bottom Line: Becoming and staying active on a regular basis as part of your lifestyle is the best way to ensure healthy aging and well being, regardless of whether you experience hot flashes or not.

The findings are published in the current issue of Menopause.

Brain Health and Your Blood Pressure-One More Reason To Check For and Treat Hypertension

Researchers at University of California, Davis found that high blood pressure could damage the brain’s structure and function in people as young as 40.

They found accelerated brain aging among hypertensive and prehypertensive individuals in their 40s, including damage to the structural integrity of the brain’s white matter and the volume of its gray matter.

This suggests that vascular brain injury develops insidiously over the lifetime with discernible effects. The study is the first to demonstrate that there is structural damage to the brains of adults in young middle age as a result of high blood pressure.

Structural damage to the brain’s white matter caused by high blood pressure has been associated with cognitive decline in older individuals.

The research emphasizes the need for lifelong attention to vascular risk factors for brain aging.

Normal blood pressure has a systolic blood pressure below 120, and a diastolic pressure below 80. Prehypertension blood pressure range is a top number between 120 and 139, and a bottom number between 80 and 89.

Elevated blood pressure affects about 50 million Americans and is associated with a 62 percent risk of cerebrovascular disease, and a 49 percent risk of cardiovascular disease.

The study says there is evidence that lowering blood pressure among people in middle age and in the young elderly can help prevent late-life cognitive decline and dementia.

Bottom Line: People can influence their late-life brain health by knowing and treating their blood pressure at a young age, when you wouldn’t necessarily be thinking about it.

For more information on women’s health, I suggest my new book, What’s Going On Down There-Everything You Need To KnowAbout Your Pelvic Health. the book is available from Amazon.com

New book on women's health

New book on women’s health

Viagra For Women -A New Drug To Help Women Achieve An Orgasm

October 30, 2012

It seems a bit unfair that men have access to medications such as Viagra, Levitra, and Cialis to treat erectile dysfunction or impotence. There are also hormones that men can take if they have low testosterone and suffer from a decreased libido. But what about women who have decreased sex desire or decreased lubrication? Now there is a treatment for women who have sexual dysfunction.

There is a the spray that can boost the sex drive of one in three women. Tefina is a testosterone gel that is sprayed up the nose. Researchers say that the testosterone is then absorbed within minutes and will become effective two hours after it is administered for up to six hours.

Researchers said the drug will be taken in the context of sexual activity, but will produce no adverse testosterone-related side effects like bad skin, body or facial hair or a deepened voice.

Researchers say that Tefina will be used as needed and that the drug will be used with the intention that it will increase the occurrence of orgasm for pre-menopausal women with sexual dysfunction or anorgasmia.

I anticipate the treatment will work like Viagra for women. Rather than a long-term, therapy-based approach, this drug can be taken when a woman anticipates sexual activity. For women with low sexual interest, testosterone therapy not only improves sexual desire and arousal, but also enhances a woman’s ability to reach orgasm.

Up to a third of women are affected by life-long problem of difficulty achieving orgasm after ample sexual stimulation, researchers say that until now the only available treatments are psychotherapy and sex therapy.
The new drug would be most helpful for patients who say that sex has become a chore rather than a pleasurable experience.

It has been shown through many documented studies that women who report poor sexual functioning have lower wellbeing, despite not being depressed. Doctors have little to offer women who are experiencing an absence of orgasms, and this could be a breakthrough study for women who currently are frustrated by the lack of any treatment option
.
Clinical trials are taking place in the US and Canada and researchers are currently recruiting participants between the ages of 18 and 49 who experience an absence of orgasm to take part in clinical trials in Australia.

Bottom Line: Men have treatment options for the treatment of erectile dysfunction or impotence. On the horizon is a new treatment for women with sexual problems.

Sex Life In the Tank? Suggestions For Getting Back on Track

August 18, 2012

Sex Life In the Tank? Six Suggestions For Getting Back on Track

The movie, Hope Springs, with Meryl Streep and Tommy Lee Jones, which describes a couple that, have fallen out of love and had their sex life in the tank. With the help of a therapist, staring Steve Carrell, they were able to rekindle the sexual fire that they once had. What can you do if the same thing is happening to you?

Try Something New-It Is The Spice of Line
There’s biological evidence that novel experiences, both sexual and non-sexual, cause the release of dopamine in the brain. Dopamine is a chemical messenger that’s connected to the pleasure center in your brain. Remember how exciting your romance was when you first met and first had sexual intimacy? That’s because the romance was novel and everything is novel and your brain responds accordingly.

Be creative. Try a different place, a different time, a different position, a new sex toy. Sex every Saturday night in bed with papa on top for 4 minutes is not going to cut it. Try having a morning quickie. Attempt sex in the shower, or on the kitchen island. Do it on the floor or in the changing room at Victoria’s Secret. It isn’t a secret that you won’t be the first couple that tried that venue! Try it at 25,000 feet on your next flight.

Got a headache or are too tired? Take a Romantic Break
All couples are tired at the end of a long day with many demands. By the time you get everyone to bed and deal with unavoidable chores, you just don’t have the energy for a romantic evening.
Instead of waiting until just before you put out the lights, take a break from the computer the newspaper or a TV show (unless it is Modern Family) for a romantic encounter before going night-night.

Take Your Sex Life Off of the Back Burner
Make a date with your partner. Set aside one day a week to have time together. Hire a baby sitter and leave the home for something special. I don’t suggest that you go for the humdrum such as dinner and a movie thing, which seems like it’s supposed to be a lead-in to sex. Instead tray a shared experience such as biking, bowling, or something silly. Return from your night out with new sexual vigor and you can be sure you will be singing, “Come on baby light my fire!” Now don’t make date-night a once upon a time event. Make it a priority and stick to it like you stick to the other obligations on your schedule. Let it become a habit, and you’ll feel reconnected, and the desire will just grow from there.

If It Hurts, Get Help-NOW
Sometimes it’s not that you’re not feeling in the mood, it’s that your body isn’t cooperating because sex is actually painful. This can be a big issue for women approaching menopause, and you might be too embarrassed to tell your partner. It is entirely normal for women to have vaginal dryness after menopause. When the vaginal lining becomes thin and dry this can result in painful intercourse. This pain is due to an estrogen deficiency and can be corrected with oral or topical estrogen creams or vaginal tablets.

For women who have had breast cancer and should not use any estrogen supplements, there are lubricating jellies like K-Y jelly Vaseline, or Replens that do not contain any estrogens but do decrease the friction and pain associated with sexual intimacy.
Some men have a condition called Peyroine’s disease, which results in a significant bend of the penis resulting in pain for both the man and the women. There are treatments for this condition and men should see their urologist. (For more information on Peyroine’s disease see my YouTube video at http://www.youtube.com/watch?v=qkZZPBdWztY)

Your Libido or Sex Drive Has Mysteriously Disappeared
A dwindling libido may not just be a sign of aging. It may be the sign of another health problem or behavioral issue. For example: Depression, anxiety, and hormonal imbalances can all contribute to sexual dysfunction. In men, the inability to get an erection can be an early warning sign of diabetes or heart disease, or testosterone deficiency. Some medications, including antidepressants and blood pressure drugs, can lower your sex drive. Smoking and excessive alcohol consumption can put a damper on sexual response. Even too much time on the bike can lead to problems in bed. Both men and women who are always on their spin bike or the small seat on a road bike can have problems with orgasm and arousal, because of the pressure put on the nerves and blood vessels that supply the penis or the vagina. Sleep apnea can also be a culprit and can lead to lack of oxygenation of the genital tissues. See blog (https://neilbaum.wordpress.com/2012/08/17/not-enough-sleep-can-lead-to-not-enough-sex/) for more information on sleep apnea and its treatment.

Bottom Line: Sex at age 20 is easy and fun and occurs without any effort. Sex in mid life can take some work, effort, and time. Invest in your relationship; you will be happier, healthier, and will have more love and affection from your partner. If that isn’t reason enough to get your sex life back on track, tell your partner that Dr. Baum prescribed it!

If you have any ideas for putting the fire and passion back into your relationships, let me hear from you. I’m always looking for new ideas. Don’t hold back. No idea is too wild or far out.

This blog was modified from a recent post on WebMD by Gina Shaw (https://mail.google.com/mail/u/0/?hl=en&shva=1#inbox/13939af485fb6048)