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 You have come a long way baby.
This can describe how sex is after age 35.
Today there is a fresh, new attitude about midlife sex.
Just a decade or two ago, people didn't think that folks
over 35, even had sex. People were assumed to be just sitting around in their Lazy Boys
watching Wheel of Fortune and drinking some herbal tea. Within the last 15 years sex at
midlife has made it to the talk show circuit and countless of books are now available on
jump starting anyone's sex life.
   Laurie Ashner and Dr. Alan Altman have worked
together to write the complete guide to regaining the intimacy, love, and yes, the fun
that you shared before hitting 35. Laurie, as an established health author and Dr. Altman
a prominent gynecologist and expert on midlife sex, have written an in depth, easy to
read, and most importantly, easy to use handbook.
Making
Love The Way We Used To. Or Better explains the various ways both men
and womens' bodies and lives change as we grow older. They illustrate how these natural
changes can affect our sexual selves. Dr. Altman
and Ms. Ashner cover ideas and ways to surmount these challenges and
to gain a satisfying and loving sex life. Sex does not have to stop at 35.
Making Love The Way We Used To. Or Better is a hopeful and
practical guide to help every couple enjoy a sex life that they both want and deserve.
 Interview
with Dr. Altman & Laurie Ashner
"Libido?
Where did it go?"
Excerpted
from Chapter 6: Making Love The Way We Used To. Or Better
Reprinted with permission of the author from "Making Love The Way We Used To. Or
Better" ©2001 Alan Altman, MD and Laurie Ashner. May not be reproduced without the
expressed written permission of the authors.
" My husband really thinks he's the cat's meow. When
we had sex last night, he rolled over on his back after he finished, stared up at the
ceiling, and said, "I am Spartacus!" I thought, I'm glad this is doing something
for him, because it's not doing a damn thing for me. I just don't seem to want sex
anymore. Where has my desire gone?"
"Mornings used to be very special for my wife and me.
Now when I get up in the morning, I just don't have the same urge to have sex."
"He's fifty-five, new in my life, and a very exciting
man. I really want to marry this guy. The problem is I think our sex life is great, but he
keeps saying things like " I wish you had known me twenty years ago. " I don't
understand. We make love, and I can't tell that anything is missing. He seems disappointed
because he isn't what he used to be. What is it with him? What in the world does he
want?"
" I just need more intensity these days than I ever
needed before to be in the mood for sex. My wife gets upset about this and calls me the
once-a-month man."
" Rich and I planned a weekend away from our kids, our
phones, and my parents, who were driving me crazy. At the last minute my sister told me
that she didn't mind taking our eight-year-old for the weekend but that her husband was
giving her major grief about taking the baby for the weekend. I told Rich that we'd have
to take the baby with us. He said, " You know if we take her and she sleeps in the
same room, we aren't going to be able to make love. We'll wake her up." I almost
laughed out loud. "Rich when was the last time you heard me scream in ecstasy?"
There are changes in midlife sex.
But what do the changes mean? If you've always had a healthy appetite for sex and
suddenly you'd just as soon visit the dentist as make love, is something wrong in your
relationship?
There's no question about it: twenty years of marriage can
lead to familiarity and boredom, which can cause a lack of libido. But so can two years of
marriage. They say that when sex is good, it's 20 percent of the marriage, but when it's
bad, it's 80 percent.
And what if you're single and you've found "the
right" person in midlife? Thousands of people do. You want to have the best sex ever.
Can you turn back the hands of time? What if it feels like something is missing?
This chapter is about libido, or sex drive. Libido very
simply, is the desire for sexual activity or fantasies of sexual activity. Libido is
affected by many factors, including hormones, social and psychological factors, work,
children, parents, and more.
In this chapter you'll learn:
- How to quickly rule out physical factors, such as hormonal
changes.
- What to do if you've never gained back your libido following
surgery or menopause.
- How to know if it's depression or unexpressed anger that's
undermining your sex drive or his.
- What to do about bad sex in good relationships-why it
happens, why you needn't accept it, and what you can do to revive your sex life.
- How to talk to your partner in a way that will excite him
about new possibilities rather than demoralize him with the problem.
Interview
with Dr. Altman & Laurie Ashner
Interview
with Dr. Altman
Sue:
I hear from hundreds of women every week who say that they just can't "get
it together" in the bedroom. They're looking for "natural"
ways to get their sex drive
going in the right direction. What ideas could you give these women?
Dr. Altman
This is an important question, but first we need to look at how we define our
terms. "Natural" can mean "exists in nature" and thus if you use
something that is herbal or part of a plant that actually exists in nature, that might be
natural. A second way to define it would be what naturally exists in our bodies. If the
level of a woman's own natural hormone is low, then replacing it with the same hormone
could be natural. Still a third way to think about natural would be lifestyle changes.
Next we have "get it together". Does this pertain
to sexual desire/libido as an issue, or to arousal
and orgasm problems? Let's begin with the "get it together" part first, and then
look for "natural ways" to correct the problems. With respect to sexual desire
or libido, which includes sexual fantasy, men and women differ in what drives this desire.
Men are different from women
Men are far more goal oriented; they have a goal of intercourse and orgasm. Women
are more intimacy driven. Intimacy can lead to desire, which can then lead to arousal and
orgasm. Desire or libido is a very separate concept from arousal and orgasm. Desire begins
in the brain, the main sex organ in humans. It is central or cerebral. Arousal and orgasm
are more peripheral or genital. Desire is a complex interaction of many external factors
as well as internal hormones.
Many things can affect desire.
The kind of day you had, the kind of power struggle you're having with your
partner, your parents pulling on you with their elder care needs. If you have children,
the needs of your children that are constantly popping up; the problems and stress at
work; general disease processes, can affect desire as well. Midlife is, after all, the
taffy-pull of life.
Arousal and orgasm,
in contrast, has more to do with blood flow issues, more physiological. Our
bodies have evolved to send blood where it's needed. That means that when you're eating,
blood flow will increase to the gastrointestinal tract; when you're exercising blood flow
increases to the muscles; when you're doing a puzzle, blood flow will increase to the
brain. Engaging in sexual activity increases blood flow to the genital organs. Normally,
as we age, blood flow tends to diminish to organs that depend on it. If it diminishes to
the heart it can cause a heart attack; to the brain, a stroke; and finally, to the
genitalia, decreased arousal in women, similar to erectile dysfunction in men.
The changes most frequently seen in arousal and orgasm were
summed up by one of my patients;
"My orgasms are no longer the Rocky Mountains, now
they're the Blue Ridge Mountains and it takes a lot longer to get to those
mountains."
Translation; "It takes me longer to lubricate and
become aroused, longer to achieve an orgasm, and the peak of that orgasm is lower in
intensity.
If these changes are more dramatic, there can be total lack
of desire and anorgasmia, an inability to achieve an orgasm when it could be achieved
previously.
Natural Methods to Improve libido
What are the natural methods available to help improve desire or libido and to
minimize the changes in arousal and orgasm? I'm going to treat "natural" as
meaning non-drug and non-herb related. Natural to me is what you can do on your own, what
you can do about your lifestyle. First, the things you can stop doing that might help.
Look in your medicine cabinet and see what you're taking.
There are medications that can affect libido and desire as well as those that can affect
arousal.
- Antihistamines can cause vaginal dryness in some sensitive
people.
- Antidepressant medications can decrease desire, arousal and
orgasm in many women as well as men.
- The birth control pill can diminish free testosterone and
thereby diminish desire/libido.
- Even hormone replacement therapy can sometimes diminish
libido by decreasing blood levels of testosterone.
- Alcohol can have an affect.
- Smoking can affect arousal and orgasm by diminishing blood
flow to the genitalia, just as it might diminish blood flow to the brain or to the
coronary arteries and cause serious problems.
There are also many positive changes you can make that will
impact your sexuality.
- The first is exercise.
The medical literature has demonstrated that libido and mood can be improved by
strength training. Both kinds of exercise, aerobic and strength training, are important.
Aerobic is generally good for fat loss and endurance, while working out with weights or
resistance machines, known as strength training, increases lean body mass, energy,
metabolism, strength and body image, and decreases fatigue. These can result in a better
mental and physical sex life.
- Strength training
naturally raises your testosterone levels. Don't expect to lose weight when you
strength train because muscle tissue weighs more than fat tissue, but do expect to lose
dress size.
- Longer penis
By the way, an interesting fact about weight loss in men; for every thirty pounds
lost, they can gain almost an inch of penile length because of loss of fat in the fat pad
at the base of the penis.
- Lifestyle changes
include drinking plenty of water during the day, which is good for your skin,
your kidneys, bladder and also good for the vagina.
- Vaginal Health
Anything that promotes vaginal health is good for your sexual function,
especially use it or lose it. This concept means the more your vagina is involved in some
kind of sexual activity, the better the blood flow will be maintained to the tissues and
keep the vagina healthy and functional. This can further translate into more responsive
arousal and orgasm.
- Avoid Irritants
Vaginal health can also be maintained by avoiding irritants that can diminish the
vagina's natural lubrication and oils. Harsh soaps, too frequent bubble baths if your
vaginal tissues are sensitive, or frequent douching can be the cause of irritation. Be
careful when shaving the pubic hair around the vagina to avoid injury or inflammation of
the hair follicles.
- Pelvic floor strenth and exercises
With age, the muscles of the pelvic floor tend to lose some of their strength.
Pelvic relaxation can affect the ability of the vaginal muscles to function during
intercourse, which can affect the pleasure both you and your partner feel. Vaginal
weights, small tear-shaped weights that are placed into the vagina, can help maintain
pelvic muscle strength. These exercises can also help prevent and even treat urinary
incontinence or loss, which can have a major impact on sexuality.
- Making sex special
How about actual sexual activity itself; what can you do to make it more special,
to help increase arousal and organism?
- Fill up your senses.
Use all of your senses, touch, taste, smell, sight, and hearing during arousal
and sexual activity, as well as with non-sexual contact with your lover. Touching and
kissing is becoming a lost art. You can walk by your partner during the day and just let
your hand rub by them or just gently touch them. You acknowledge that this person exists
by touching them. Get back to the long sensual kiss, impassioned or gentle.
- Smells and Aromas
Using the sense of smell can have to do with the smells or aromas of candles or
perfume during lovemaking but, more so, to do with the natural smells of lovemaking; the
smells of each other's body; the musky odor of the vagina. The aromas of passion; stop and
smell the roses. There is also much more to be said about these and the senses of taste,
sight and hearing, but it would take up all the space here. This is covered in depth in
Chapter 11 in the book.
- Manual Stimulation
Due to the natural decrease in blood flow during the arousal phase, the use of
manual stimulation can become more important and may be necessary for a longer time to
achieve complete arousal and orgasm in both men and women. Be patient with this, and
understand it.
- Communication
The need to communicate about it is key. Communication about What I need is one
of the most natural and important steps to getting it together sexually in the bedroom. I
need for you to do this longer and more gently or more rapidly. Towards this end, the use
of vibrators or other sex toys during foreplay or intercourse can improve or add a new
dimension to your sex life. Some male partners may be threatened by it. I shouldn't need
to have to stimulate you with a vibrator. The solution to this is all in the presentation.
If you say I love when you make me feel this way and this can also help, why don't you try
this, lets do this together, it can become a wonderful addition to lovemaking.
- Romance
Last, but not least, there's romance and passion. Put some romance back into your
life. You may not be able to light the fire again, but you'll be able to gain sparkles
that can rekindle some of this, whether it's a romantic weekend away or just a dinner that
you set up by candlelight. Try sitting in a luxurious bubble bath and read to each other.
 Read
poetry or sensual stories.
There is a book available that's actually waterproof called Aqua Erotica
that you can read to each other in the bath and turn each other on. Make love in different
places and/or different positions, or where you're not supposed to. Put the romance back
into your life. Finally, when it comes to passion, you can't have passion in your
lovemaking if you don't have passion in your life. If you haven't renewed your life,
re-invented yourself, gotten away from the boredom of what you do regularly, whether it be
your job, your relationships with friends, what you do for relaxation or excitement, now's
the perfect time to do so.
FSH,
Menopause & Symptoms
Sue:
We all know about what estrogen and
progesterone does during peri menopause.
But the hormone that is talked about the least but maybe just as important as far as
causing symptoms of perimenopause and menopause is FSH or follicle stimulating hormone.
Can you discuss how elevated FSH levels which accompany menopause and beyond can cause
physical symptoms. For example like hot flashes?
Dr. Altman
FSH, or Follicle
Stimulating Hormone, is produced in the brain. Its function is to stimulate
the ovaries to produce estrogen. As estrogen is produced, the production of FSH by the
brain diminishes. This feedback mechanism means that when estrogen levels are high, FSH
levels are low, and vice-versa. FSH itself does not cause hot flashes or other symptoms of
perimenopause or menopause. It is a reflection of low estrogen levels. It is actually the
withdrawal of estrogen, and the effects on the temperature control area of the brain of
this withdrawal, that causes hot flashes. Some time ago, it was thought that elevated FSH
levels had more to do with the actual symptoms, but this has not been shown to be the
case. FSH, in fact, can cause more problems and confusion when blood levels of this
hormone are drawn during perimenopause. The hallmark of the perimenopausal transition is
the erratic production of estrogen by the ovaries. Sometimes it can be too much, sometimes
it can be too little, sometimes it can be just right. Thus, these estrogen levels are
totally unpredictable. Because of the erratic ovarian production of estrogen, there is
also a fluctuation of FSH. What the FSH level is on Tuesday afternoon has nothing to do
with what the level is on Thursday morning. Hence, there is neither prognostic nor
therapeutic information that can be gained by taking an FSH level during perimenopause and
only minimal information post menopausally.
The
gold standard for perimenopausal therapy
Sue:
Today many women are using low dose birth control
pills to help them manage the symptoms of perimenopause. Most of them I hear
from are very happy with this route. Some though have found that the lower dose of a
particular pill is too low while the higher dose is too high. I have heard from some women
in perimenopause alternating every other day with one lowered pill and one higher pill,
they report that they feel great. What do you think about this?
Dr. Altman
The gold standard for perimenopausal therapy, in women who are having problems
severe enough to necessitate treatment, is the low dose birth control pill, specifically
the 20 mcg birth control pill. The reason for this is that the birth control pill
suppresses the ovaries, stopping the erratic production of estrogen and allowing the
stable level of hormone in the pill to take over and alleviate symptoms. Hormone
Replacement Therapy (HRT) is inappropriate during perimenopause simply because HRT is not
strong enough to suppress the ovaries, which will continue to function erratically causing
bleeding from the wandering estrogen levels and bleeding from the HRT as well.
Occasionally, even though symptoms are greatly diminished on a low dose pill, they return
during the pill-free interval due to estrogen withdrawal. This can be fixed by omitting
the pill-free interval by just taking active pills all the time. As to the specific
question of alternating low dose and slightly higher dose to tailor it better to the
individual patient, I have no objection as long as both pills contain the same progestin,
i.e. the same pill with different estrogen levels. I have not had a need to do this with a
patient because of the vast array of birth control pill choices available, but if it was
the only option that kept the patient comfortable, I might try it. I have done this
postmenopausally, alternating two different doses of estrogen and testosterone to achieve
a desired level, so I am familiar with the concept as it facilitates individualization of
therapy.
Interview
with Laurie Ashner & FREE Excerpt on Libido
Interview
with Laurie Ashner
Sue:
Today you can flip on the television set and find shows talking about everything-
from court room battles to confessions about how a husband spent the life's saving on
alcohol. yet, there seems to be no discussion about women's sexuality.
Why do you think this is?
Laurie:
The discussion on TV about women's sexuality always seems to center around major
dysfunction. I guess that's what makes headlines. Or the media prints out its yearly
assessment of how often "normal" couples have sex--so we can all feel terrible,
because we're having too much or not enough! Making
Love the Way We Used To...Or Better is about the more subtle stuff.
- It doesn't necessarily make the morning news if you're so
tired from raising your kids, and dealing with your aging parents, that you fake it when
you make love to get it over with, so you can get back to your list of things to do.
- Or that you and your husband feel more like roommates than
lovers, although you still love each other deeply.
- Or that you adore your partner, but he or she wasn't the
best sexual partner you've ever had, and you miss your wild side and wonder if you can go
the rest of your life without one more time that really shakes up everything in your
world.
These are not exactly headline-breakers, but they can add
up and be as devastating to one' s sex life as a major sexual problem. Dr.
Altman and I tried to look at the little secrets people keep from each other
in the bedroom, that can end up feeling like there's a huge elephant sitting at the end of
the bed, that everyone sees but no one is talking about. When those secrets are aired, sex
can become even more satisfying than it ever was.
Sue:
Women are very proactive about their health. But there seems to be a disconnect
between "regular" health and sexual health. They just don't want to talk about
it. How and why should they become more proactive about their sexual health?
Laurie:
It doesn't always occur to women that their complaints in the bedroom, even
boredom or lack of interest, can have a medical cause. And the last person we think to go
to and discuss sex with is the gynecologist. I think sex matters, and it sex is
unfulfilling, it is often a health problem as well as an emotional one. Sexual fitness
means realizing that you have years and years in which you can experience pleasure. Why
lose it? Why become numb to it? Why be fit everywhere else in your body, but sexually
flabby--and I don't mean the organ, I mean the mindset, and the health set. Exercise,
hormone replacement therapy, techniques that increase the fitness of the vagina--hey, why
should that not be as crucial as fifty sit ups a day? Writing this book with such an
understanding specialist convinced me of one thing--so many of us are feeling these
feelings and not talking about them. You really can age-proof your sex life and have
incredible joy ahead. You just have to learn how.
Meet the author
Susan Rako, MD
author of "The Hormone of
Desire"
 Interview & Book excerpt
hosted by Sue Spataro, RN, BSN
 
Dr. Rako discusses her thoughts on testosterone deficiency in women. The Hormone of Desire
is a very complete and thoughtful book. She separates the long held myths about
testosterone and women from the powerful reality. Women's sexuality is beginning to get
the attention it deserves and Dr. Rako's book is a long awaited and much anticipated
resource.
Spicy Beef
  
Dr. Larrian Gillespie has developed a way for women to eat to stay fit, sharp and lose
weight and keep it off! Dr. Gillespie has been the first to recognize that women have
different nutritional needs - we use foods differently and need to eat differently than
men. Her recipe Spicy Beef comes from her book The Goddess Diet. This stir-fry dish
can easily be made for dinner and enjoyed by the entire family - especially the men! |
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