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Wife's disinterest in sex
Q. My wife and I, who both read your column, have always enjoyed our intimate relations. Since she went through the change last year, however, she's lost interest in sex. She's only 53, and although I'm 8 years older, I'm as amorous as ever. Do you have any suggestions for us?
A. We're glad to have you both as readers; in many households, after all, it's women who watch over men's health.
Doctors have learned a lot about the male sexual response in the Viagra era, but there is less information about female sexuality. Menopause signals an abrupt drop in female hormones such as estrogen and progesterone, but that shouldn't affect the female sex drive. In fact, libido depends on testosterone, the male hormone, in both men and women. Testosterone levels are very much lower in women than men, but they drop even lower as menopause approaches, then remain stable during and after menopause as the adrenal glands continue to produce small amounts of male hormones. Still, some women are testosterone deficient and might benefit from testosterone therapy. Unfortunately, however, data are scant, and much more research is needed to learn if testosterone is safe and effective - and if it is, which women should receive it and what dose and preparations are best. At present, those answers are a long way off; in fact, the same questions about testosterone replacement remain to be answered for men.
Another area for research is the use of Viagra for women. An early trial found the drug safe but not beneficial for healthy postmenopausal women. More research is under way, and other drugs are being developed for sexual dysfunction in both genders. The FDA has already approved a hand-held battery-powered clitoral stimulator for women with sexual dysfunction. Your wife's problem, though, may be a good deal simpler. Postmenopausal women who do not take hormone therapy (and with research showing more harm than good, most should not) develop vaginal dryness, which can make intercourse unpleasant or even painful. So a simple place to start would be a nonprescription vaginal lubricant such as Replens. If that doesn't help, your wife should ask herself if she might be feeling subtle stress or unhappiness or if she may be reacting to personal, marital, or family conflicts. Her doctor may be able to help her sort out possible physiological and psychological issues.
Discuss the problem with your wife frankly, but be patient and supportive, always looking for mutually satisfactory ways to achieve intimacy and express love and affection.
- Harvey B. Simon, M.D. Editor, Harvard Men's Health Watch
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| Last updated: | August 21, 2006 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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