Keeping the Drive Alive: maintaining a healthy sex life at any age
By Nicola McFadzean, N.D.
Human sexuality is a topic that gets ignored, misrepresented and generally swept under the rug. Our sexuality is a big part of who we are, but as men and women age, physiological changes occur that can alter the way we feel about and respond to sex, both physically and emotionally.
Men and women relate to sex differently, and what we need from sex changes at different times of our lives. Stereotypically, women seek emotional satisfaction from sex along with the physical, while men are more driven by their physical desires. Many men report that they could have sex with their partners even while they are angry at them, separating the physical aspect from their emotional state of mind. Fewer women would be able to do the same.
There are also major lifestyle factors that regulate sexual compatibility between men and women. A classic example is the couple who have just had a baby. Mom is at home all day caring for the child, and often up at night feeding as well. Dad may be working during the day, and less able to tend to the baby’s needs during the night especially if the infant is being breastfed. Mom gets exhausted, possibly depressed, and Dad doesn’t really know how to communicate with her and help her. He makes advances at her to try to show his affection and seek intimacy, but sex is the last thing on her mind – she’s just trying to get through the day and sneak as much sleep as she can at night. This can lead to severe disconnect between the couple at a time when they should be at their closest – tending to their new baby.
But there are physical aspects to this scenario too – a woman’s hormones can get way out of balance after the birth of the baby, and this is something that I feel is ignored. Post-partum depression has been correlated with low levels of two hormones – progesterone and thyroid. Pregnancy puts high demands on both these hormones, and if both plummet once the baby is born, the mom can be thrown into a biochemical quagmire. Some mom’s report that they should feel over the moon because of their new child, and yet all they want to do is cry. Clearly, this is not conducive to recreating a satisfying sex life between the parents, so hormone testing and balancing become crucial.
Just as post-partum hormonal changes can affect a woman’s sexuality, so can the changes during menopause. Suzanne Somers (The Sexy Years, Ageless) described the “seven dwarfs of menopause” as Itchy, Bitchy, Sweaty, Sleepy, Bloated, Forgetful, and All-Dried-Up. It doesn’t exactly paint a picture of a woman who is feeling good about herself and her body, does it? I have had many patients simply look at me and laugh when I ask them about their libido. “What libido?” they say.
Lack of physical desire is certainly a huge deterrent for women in maintaining a healthy sex life throughout their 40s, 50s and beyond. Emotional aspects come in here also, so the importance of keeping the romantic spark alive in non-physical ways should not be underestimated. Couples who have open communication, trust and share a sense of humor have been found to have more satisfying sex lives. On a physiological level, low levels of estrogen and testosterone can dampen both desire and response to sexual stimulation. After having your hormone levels tested, testosterone cream, either applied vaginally for a more local effect or systemically for a broader effect, can kick start libido once again. There are many happy women (and men!) out there using testosterone in safe physiological doses to help with this.
The second major preventive for women is vaginal dryness, which can make sex very uncomfortable. Of course using a lubricating gel such as K-Y can be a short term solution, but again, hormone balancing can give a woman more of her own lubrication. I find estrogen to be the most important hormone here. It can be applied vaginally also, resulting in less systemic absorption while still giving an effective local effect. Vitamin A, Vitamin E and Calendula suppositories can also be soothing to the vaginal tissues and assist with lubrication.
Bio-identical hormone replacement can also reduce the mood swings and depression that can go with menopause, again, making a woman more likely to feel content and more sexual.
Of course, those hormonal shifts that occur in middle age can be just as significant for men as women. Men in their middle years experience a drop in their testosterone levels, and this can directly impact their sexual desire and function. They also are more likely to convert more of their testosterone to estrogen, and produce more sex hormone binding globulin, a protein that takes active forms of hormones and binds them so that they are in ‘short term storage’. So that’s a triple-whammy for men – lower testosterone to start with, more conversion of testosterone to estrogen, and more testosterone being put in storage. The low testosterone level can also lead to a loss of physical strength and endurance, as well as depression and a loss of enthusiasm for life.
The other consideration for erectile dysfunction is more of a circulatory cause than a hormonal one. Nitric oxide is a naturally produced chemical that causes vasodilation in the penis, allowing for increased blood flow and erection. A lack of nitric oxide inhibits this process. L-arginine, an amino acid, has been found to increase levels of nitric oxide. It is used extensively for cardiovascular issues, but has also had success in erectile dysfunction via the nitric oxide and circulatory response.
Men can get significant benefit from hormone replacement therapy. Bio-identical testosterone can bring their levels back up, making them feel more youthful, physically stronger, emotionally healthier, and more sexual. Nutrients such as chrysin and zinc help prevent the conversion of testosterone to estrogen, while herbs such as Tribulus enhance overall wellbeing.
It is not inevitable that your sex life has to dwindle through different stages of your life. One of the keys to keeping healthy desire alive is making sure your hormones are balanced, using bio-identical hormones in a safe, sensible way to assist this process. In addition, consistently working on the emotional connection between you and your partner will go a long way also in creating the intimacy that underlies desire.