Loss of Libido

By Ellen Dolgen

Do you find yourself suddenly needing to mop the kitchen floor or organize the recycling when your spouse suggests it’s time for bed, hoping he or she will have fallen asleep before you get there? Do you find yourself wondering whatever happened to that wildcat who couldn’t wait to get her partner alone? And more importantly, do you find lack of intimacy time is creating an emotional chasm with your partner? Thanks to the changing levels of hormones women experience during menopause, your libido may be taking a nosedive.
You may have noticed the countless television and print ads for pills and creams and power drinks that support a man’s virility—there’s that “little blue pill” and that couple who inexplicably watch a sunset in separate bathtubs (last time I checked, you need to be in the same tub if you want to get busy).
So where’s the help for women? Research shows that sexual dysfunction occurs in about 30% to 50% of women (and that’s just those who report it). Common complaints include low sexual desire, difficulty attaining or maintaining sexual arousal, and inability to achieve an orgasm.
Are we meant to resign ourselves to live out the second half of our lives as though we’re holed up in a convent? No! Just because you’ve reached a certain age, it doesn’t mean you no longer have a need for good sex in your life. In fact, some people find mid-life sex far better than the sex they had when they were young. “As we age, most of us become more aware of what we need in the bedroom and how to get there. We feel more deserving of sexual pleasure and are more willing to ask for what we want from our partners,” says Hilda Hutcherson, M.D., Clinical Professor of Obstetrics and Gynecology at Columbia University Medical Center. “In our 50s we are more likely to focus on our pleasure than in our 20s, when we tend to focus almost exclusively on his experience.”
Women have the right to toe-curling, earth shattering orgasms, just like men. But due to this double standard, having a fulfilling sex life after menopause may not be a reality for all women.
However, all is not lost. Read on.
If your sex drive seems to be firmly stuck in park—or worse, reverse—and you’re worried that it may never come back, there are several things to consider.  Is low estrogen to blame or could something else be going on? Dr. Hutcherson suggests for many women it’s just boredom, although “Medical problems and medications certainly can wreak havoc on desire.” Whatever you do, don’t fake it! “Faking orgasms will guarantee that your sex life with your partner never improves,” she says.

There is some good news for women!  For women who experience what the experts call hypoactive sexual desire disorder (HSDD), we finally have a “pink pill”. Addyi (pronounced add-ee), known generically as Flibanserin, is the first ever FDA-approved treatment for women’s most common form of sexual dysfunction made by Sprout Pharmaceuticals. It is a once-daily, non-hormonal pill.
Dr. Michael Krychman, Executive Director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach, California, explains, “While estrogen is critical, it is my belief that there is interplay between lowered estrogen and lowered testosterone levels in women as they age.”
Here is a testosterone 101, courtesy of Dr. Krychman:
Testosterone is part of our hormonal makeup. Testosterone is a steroid hormone primarily found in men, but smaller amounts are also produced in women’s body: one specific place is the ovaries. Testosterone is necessary for muscle tone, a healthy libido, and strong bones. Women begin experiencing low “T” during their menopausal journey, which may begin a decade earlier than when menstrual periods stop.

Testosterone isn’t just for guys. Women with low testosterone levels can experience depression, fatigue, weight gain, bone and muscle loss, and cognitive dysfunction. Then there is the whole “loss of libido” issue, which can be dramatically decreased. As for orgasms, if we have them, they can be more “ho-hum” than “woo hoo!” if your “T” level is down, according to a report from the North American Menopause Society.
There are many benefits of testosterone supplementation. Supplementing with testosterone can benefit your heart, mood, energy, and bone and muscle health.  Additionally, testosterone can sustain skin elasticity and tone, encourage heart health, boost libido, help prevent osteoporosis risks, decrease body fat and increase muscle strength.

Here are some tips to help you find that lost libido:
Schedule a visit with your menopause specialist to rule out any other medical problem. Underactive or overactive thyroid, for example, can also affect your energy level, libido and general physical health or well being.

Talk to your specialist about testosterone testing. Total testosterone and  “free” testosterone are typically measured and calculated.  Free testosterone, measures your levels of bioavailable testosterone that is not bound by the blood proteins. It is the active portion. Ranges vary between post-menopausal and premenopausal women, with a gradual decline as we age, says Dr. Krychman. However, he adds, “I advise treating symptoms, not lab values. A comprehensive assessment with a good differential is the rule. Testosterone supplementation is not the panacea.  It is important to remember that this there is also approximately 40% placebo effect.”

Discuss the various treatment options with your menopause specialist. If your testosterone levels are below norm and you have the symptoms, your health care professional may suggest an “off-label use” of testosterone, with or without estrogen. Why “off-label? Because the FDA has yet to approve any testosterone drug for women. According to WebMD, when you take it orally (by mouth) and it gets processed by the liver—which can result in a change of cholesterol levels. But that same effect doesn’t occur when testosterone is administered by skin patch, gel or cream (a.k.a. transdermal) or in pellet form (the size of a grain of rice) inserted under the skin. “What form to use depends on many facets including patient tolerability, patient price, side effects and clinician preference,” says Dr. Krychman.

Weigh the risks vs. benefits with your menopause specialist. Dr. Krychman has a frank and candid conversation with his patients about the benefit versus the risk – safety and efficacy are always balanced, he states. He further recommends that before starting therapy you are aware of the benefits and risks and that once you start therapy, you need to have regular blood work to keep track of your levels. It is important to monitor your blood count and lipid panel, coupled with testosterone levels.

For some women, the sex drive is fine, but the ability to cross the finish line is a problem. If you’re having trouble achieving orgasm, or your orgasms aren’t as powerful as they once where, there are several ways you can strengthen your Big O.
*    Strengthen and tone the pelvic floor muscles with Intensity, an intimate health and stimulation device that improves a woman’s sexual experience by exercising the pelvic floor muscles and providing targeted stimulation to specific areas of the anatomy. Intensity is scientifically designed to restore intimacy and pleasure.
*    To strengthen pelvic floors to prevent unexpected bladder leakage, turn to Apex, an automatic pelvic floor exerciser. It’s a medical device that will strengthen and tone the pelvic floor muscles to eliminate accidental bladder leakage. You’ve been told to “do your kegels,” but actually doing them correctly is tricky. This is the first in-home device that exercises your muscles correctly, every time.
*    Recurring vaginal dryness can make everyday comfort and sex painful and can put unnecessary strain on your relationship. As baby boomers reach menopause, they are saying no to “sandpaper sex.”

Get the info you need to take charge of dealing with your faltering sex drive.   Remember, sex is more than just fun. It’s integral to most intimate relationships, and it’s also great for your overall health (but, yeah, it’s also really fun). Check out these benefits you probably weren’t even thinking about when you started reading this chapter!
Stress relief. When you have an orgasm, the hormone, oxytocin, is released from the hypothalamus of the brain into the bloodstream. This creates an instant feeling of release and relaxation. And what better way to start off a good night’s sleep than with an orgasm?
Pain relief. Research shows that endorphins can help women increase their pain tolerance by as much as 75%. So rather than popping pain-relieving pills for your headache, try a little self-pleasure instead.
Improved creativity. Increased blood flow to the brain helps it to receive the nutrients and oxygen it needs to function at a high level. So if you’re in need of some fresh ideas, want to rejuvenate your artistic goals, or want to be able to express yourself more freely, try getting it on more often.
The old motto “use it or lose it” is still true, so you might as well enjoy every second.
Ellen Dolgen is a health and wellness advocate, menopause awareness expert, author, and speaker. After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause Mondays was born.