Sexual Health: Use It Or Lose It!

Sexuality is like a muscle: exercise it or it's gone. Sounds simple-- but it isn't for the 40 million American women who have a sexual function complaint, at some point.

The most common difficulties are low level of desire, lack of orgasm, and vaginismus (a painful involuntary spasm of muscles surrounding the vaginal entrance, interfering with sexual intercourse), according to a national survey of people aged 18 to 59, by the American Medical Association.

Solving The Problem

The AMA has good news for 43% of women: most sexual difficulties are treatable. A solution may begin at your medicine chest --many drugs can affect sexual responsiveness. If you take anything from a birth control pill to anti-ulcer medication, check with your doctor about a possible alternative prescription, or a way to counteract the sexual side effects. (see checklist)

To move towards sexual health, acknowledge that something's wrong and seek professional help. "Low libido includes arousal problems, hormonal problems, and an emotional component," reports Jennifer Berman, MD, Clinical Instructor of Urology, UCLA Medical Center -- so who do you call? Start with your gynecologist, and assess the response. Surprisingly, "urologists are the thought leaders in female sexual health. Male sexual dysfunction has been researched ad nauseum, so this was an easy shift," explains Dr. Berman.

Treatments are varied. For arousal problems, Dr. Berman may prescribe Viagra. (Yes, it also helps women, who are subject to the same side effects as men, such as headaches.) For vaginal dryness, hormones are one option. "Topical prescription estrogen (like Vagifem) can improve lubrication and vaginal health," she notes. Over-the-counter preparations (e.g. KY Jelly, Replens) may bring temporary relief. Just drinking eight glasses of noncaffeinated, nonalcoholic beverages each day could increase vaginal lubrication.

"Women do have strong sexual desires, and testosterone is essential for us, too," says Dr. Berman, who sometimes prescribes compounded testosterone cream. For greater satsisfaction, she advises learning to locate your G spot, on the interior vaginal wall. "Books go into great, graphic detail on how to find it," she adds. (See Resources.)

Maintaining Circulation

Keep blood flowing to your genital area to help maintain its vascular health. Dr. Berman recommends frequent sexual intercourse. The only FDA-approved treatment for female sexual dysfunction is the EROS-CT, a suction cup that increases vaginal blood flow, improving responsiveness.

"It's safe and effective, with no known side effects or risks," reports Barbara Bartlik, MD, Assistant Clinical Professor of Psychiatry, Weill Cornell Medical College, who prescribes it to patients, with good results.

However, the $350 device, available by presciption only, is "not for everyone!" Dr. Bartlik cautions. "It takes a certain dedication. The idea is to open the blood vessels by applying gentle suction. To achieve optimal benefits, it should be applied several times a week, for gradually increasing amounts of time."

Enjoy Yourself

After menopause, "use it or lose it" is truer than ever. Dr. Berman does a hormonal profile of each patient, and may recommend some type of hormone replacement therapy. Dr. Bartlik stresses the importance of maintaining some level of sexual function in order to remain sexually alive.

What if you don't have a regular sexual partner? "I encourage women to learn to enjoy their own bodies," declares Dr. Bartlik. "Rather than wait for another relationship, self-stimulate. Then you'll have less sexual difficulty when you are in a new relationship."

Mind Over Matters

Psychological factors have strong impact. "Sex is one of the first things to go when you have a depression or an anxiety disorder," notes Dr. Bartlik. Inhibitions about sexual desire or your ability to perform can develop. Those from a restrictive background, such as a very religious home, may be uncomfortable about sexuality. "Therapists give a couple permission to try certain things they might have been too inhibited to explore," she says

Sidebar: Do You Take Any Of These?
Prescription medications for these conditions can reduce
sexual responsiveness:
* birth control
* cancer
* depression
* hypertension
* seizures
* ulcers
Sedatives and anti-psychotics also affect sexuality.

As they get older, some women expect to become more like their mothers. "Not thinking of their parents as sexual, they unconsciously turn off." Dr. Bartlik has a pleasant 'prescription' to counter that effect: "Put yourself in a situation that makes you feel like you're younger. Even if you're a long-married couple, go out on a date!"

Why will that help? Because of this final secret: for women, "the brain is our main sexual organ," contends Laura Berman, Ph. D., Co-Director, Female Sexual Medicine Center at UCLA.

Don't hesitate to visit a sexual therapy center or talk to a professional if something is wrong. And be sure to keep sex firmly in mind--that way, you'll remember to "use it, not lose it."

Sexual Resources
"For Women Only: A Revolutionary Guide To Overcoming Sexual

Dysvunction and Reclaiming Your Sex Life" by Jennifer Berman, MD and Laura Berman, PhD. (Henry Holt, 2001)

"The G Spot and Other Recent Discoveries About Human Sexualty" by Alice Kahn Lades, John Perry, and Beverly Whipple, PhD. (Holt Rinehart Winston, 1982) (an educational resource packed with articles and useful information) (Network For Excellence In Women's Sexual Health): useful information from Dr. and Dr. Berman (Female Sexual Function Forum): another source of useful information the American Urological Association web site includes a Find section to locate a nearby specialist. (Be sure to ask if the doctor has experience with female sexual

For our readers only: "Sex at Midlife" -- a special issue of the American Menopause Foundation newsletter. To receive a copy, e-mail

Many of these articles appear on the publication's website, which are often password-protected or members-only. For your convenience, I've gathered them on my own website.