Menopause & perimenopause
Rekindling desire — the soul of your libido
by Marcelle Pick, OB/GYN NP
Many of us who came of age in the 1970’s, burned our bras, and rallied around
Germaine Greer may have felt exultant, confident, and sexually liberated then. But
now as we approach our 50’s, and move through
menopause and beyond, we may find ourselves increasingly plagued by fear:
fear of our maturing bodies; fear of looking like our mothers and grandmothers;
and most of all, fear of becoming marginalized by a society that seems to only value
youth. If any of these fears plague you, they can undermine your sex life in many
ways and lead to a nosedive in self-esteem and desire.
Our culture has painted a barren sexual landscape for most peri- and post-menopausal
women. The message persists that an active, vibrant sex life at midlife is somehow
inappropriate or unattainable, as if gravity exerts its pull not only on skin and
body parts, but sex drive, too, and there’s nothing to do but accept it. But
this is just so untrue!
For some women, a less active sex life may feel fine — they may even be relieved.
But for those women who would like to be thinking about and having more —
and better — sex, I want to share this happy truth: there’s no time
limit to the ability to experience desire, no deadline for your sexuality, and no
expiration date for intimacy. In fact, with a little work and the right support,
many of my patients report having the best sex of their lives after menopause!
Certainly there are quantifiable physical changes in a woman’s health,
as we transition from perimenopause to post menopause, that can make arousal, intercourse
and orgasm different or even difficult to achieve (which we discuss in-depth in
our article on sex after menopause).
But now I’d like to discuss the more intangible part of the sexual equation
— your emotional sexual state — and how to refuel it.
Changing bodies, changing attitudes
When I chat with my patients about their sex lives, there is usually a sharp delineation
between those women in their 20’s and 30’s and those in their 40’s
and 50’s. It’s almost as if the loss of libido mirrors the slow waning
of fertility in perimenopause. Some women admit that not only are they not actively
engaging in sex, but they also aren’t fantasizing about it, thinking about
it, or prioritizing it as much as they used to.
Sadly, too many women find that as the years go by they begin to cease to consider
themselves overtly sexual beings. Why? After all, nature has given both men and
women the ability to enjoy sexual pleasure for the duration of their lives. And
the important physical benefits of regular sex — greater longevity, slower
aging, lower risk of heart disease, improved fitness, and better sleep to name just
a few — have been well studied and documented.
You may be someone who celebrates your release from the tug of fleshly pursuits
— and if you are, I encourage you to honor that. I know many women who find
a great freedom in not being defined by their urges — or the lack of them.
But I also know that many of the women I meet are saddened by their loss of desire
in menopause. More than anything else they (and their partners) wish to get it back.
The building blocks of desire
When it comes to figuring out what is undermining your desire for sex, it’s
best to deal with any physical realities first. You may be surprised to learn that
hormonal shifts related to loss of libido in menopause are relatively easy to diagnose
and treat by a caring health practitioner. Supporting your body during perimenopause
and menopause, with optimal nutrition and customized hormone supplementation, will
help reset your hormone balance at a healthy level. If your hormones are primarily
to blame for the absence of your sex drive, it should return once balance is restored.
But, hormone shifts are only part of the picture. For many of my patients, the unseen
changes at mid-life are less detrimental to their sex drives than external changes.
As many women look at the mirror and take note of unwanted skin and hair changes,
or shifts in musculature and weight, they may begin to get scared. Mentally, we
may feel like a 20-year-old, but on the surface it seems as if our bodies are “falling
apart.” Many of my patients describe a sense of no longer being in control.
Some experience real panic, others become angry or depressed, while others begin
to resign themselves to the wages of time.
Not many of the women I see feel confident in the face of aging — and self-esteem
is critical for fostering desire. Unknowingly, women turn down their own desire
thermometers by internalizing society’s adulation of the young “hot”
body. We also live in a culture that has a very conflicted attitude about sex beyond
its necessity for reproduction: corporations know it sells product, but as a society
(in contrast to many European cultures) we are often a little prudish when it comes
to encouraging sexual activity for pure pleasure. At a certain age, many women begin
to buy into the idea that it is somehow undignified or inappropriate to yearn for
sex and so they unconsciously sabotage their physical urges.
The mind, specifically the limbic system (which has been described as the emotional
seat of the brain), is the single most important organ when it comes to sexual arousal
and desire, which means that desire actually begins long before any body parts touch.
Desire begins with a state of mind.
So, in order to rekindle your desire, you must claim it. Give yourself
permission to be a sexual, lustful creature in pursuit of pleasure. Whether you
are 49 or 90, make it a priority to fall in love with yourself again and remember
how truly desirable you really are.
Body image and desire
A good body image is the best aphrodisiac I know — and the most elusive for
many women. We’re trained from girlhood to think that the grass is greener
body-wise (if we had curly hair, we wanted it to be straight; if we were skinny,
we wanted to be curvier, and so on).
Dissatisfaction with their bodies is so pervasive that a huge segment of women live
in a storm of negative thoughts from adolescence on — a negativity that is
fueled by the media, super-skinny models, and cosmetically altered and retouched
icons of beauty. Women slave at the gym, starve themselves and sap their natural
strength and sensuality to live up to some unattainable, cultural ideal, then internally
berate themselves when they can’t. It’s no wonder that many women continue
to obsess internally over their perceived physical imperfections into adulthood
and middle age.
A potent antidote to this negativity is the ability to attract a lover. In other
words, if someone else finds our body attractive, we conclude that we must be attractive.
But as the years pass, and the veil of sex hormones falls back with its accompanying
physical changes, relying on external validation to feel attractive gets dicey.
Many of my patients tell me, “I used to get upset when a man would stare at
me as I walked down the street. I didn’t realize then how upsetting it would
be to walk down the street and have no one notice. I feel invisible.”
One of the joys of menopause
is the opportunity to really examine your inner beliefs about beauty and personal
power. It’s a time to shrug off the cultural ideal of what’s attractive
and discover what you think is beautiful about yourself. Instead of feeling good
about yourself only because you’re chosen by someone else, menopause is a
time to learn how to do the choosing yourself. After all, whose opinion would you
rather rely on, your own or some stranger’s on the street?
Fueling your personal power
In life, every exchange we have with our internal self or with others is a kind
of transaction that can leave us feeling emotionally enriched, neutral or depleted.
The personal transactions that leave you feeling depleted are those that take away
your power. When you allow others to dictate how attractive you are, you give them
control over something very valuable indeed.
One way to start taking back your power is to learn to love your body in all its
wonderful limitations and possibilities. This means finding tools that help you
tap into your inner wellspring of beauty on a daily basis. One big one is to make
the right supportive choices in nutrition and lifestyle that let you and your body
feel well.
Protecting your power also means getting help in shifting your emotional energy
to a place where you can truly hear and accept compliments and affirmations. This
means learning how to redirect your mind every time the negativity script starts
to play. It’s often not easy, as any woman who has really struggled with her
self-esteem and appearance can tell you. And you may need some professional guidance.
Many patients find
EFT to be helpful for fatigue and stress,
others may need more one-on-one counseling in a program like that offered by the
Hoffman Institute.
If you commit to doing this work, I can promise you a big pay-off. You will find
yourself enjoying your body and easing into a new level of comfort with yourself
that is truly, undeniably sexy.
And once you’ve mastered the storm of negativity, the question becomes how
to turn down the noise in your everyday life so you can feel your desire when it
eventually returns.
De-stress to put sensuality back in your life
Women in perimenopause and menopause face a host of developmental stressors. Many
have teenaged children or newly empty nests. Others may be dealing with a divorce
or troubling relationship. Parents get older and require caretaking. All the while,
many women simultaneously work full-time in professional and volunteer capacities.
Not only does stress impact your hormones, but it leaves little room for the mind
and body to indulge in the thoughts and activities that nurture desire.
Remember being a teenager and mooning over the local heartthrob, or lying on your
bed just listening to music and writing in your diary? This may seem like a waste
of time now but it actually had a purpose. It gave you time to tune into your fantasies,
to learn what you liked. It helped shape your mindset to accept love and passion
when it came along.
The fastest way to bring back sexual excitement is to make time for it. Make it
a priority in your life. And the best way to do this is to reduce the amount of
space that stress takes up in your life. How many people find their sexual desire
increases when they’re on vacation? It’s no mystery; it’s just
about giving your body, mind and spirit the room to relax and have fun.
So set up boundaries to the stress in your life to help you rekindle your sexual
nature. This may mean changing your routine to include some inviolate downtime.
It may mean creating space in your life to pursue the things that literally “turn
you on.” No matter how old you are chronologically, your desire will always
be that teenaged girl daydreaming on the bed, waiting for you to dress her up and
take her out. All she needs to bloom is the right support, enough time, and of course,
the right partner.
Which brings me to communication and its long-term bedfellow: intimacy.
Talking with your partner about your needs
We have a saying at the practice: “If your upper lips don’t talk, the
lower ones will,” which means that if you can’t say it out loud, your
body will do it for you. If you are having difficulty in your relationship on an
emotional level, it will influence your physical relations and eventually your desire
may wane.
Creating and maintaining intimacy in a relationship is a deep subject (one we will
explore in a future newsletter), but as it relates to desire, I will say this: Learning
to love and protect yourself is one step; figuring out what you need in bed is another.
Asking for what you need can be hard for some women and may open up a Pandora’s
box of emotional issues.
Again, it makes sense to start with the purely physical. Getting older means a change
in physical sensations. Some women experience
vaginal dryness or
vaginal atrophy with a decrease in estrogen that can make intercourse
painful. Others may have more difficulty sensing clitoral stimulation.
Hot flashes, night sweats, and insomnia take their toll on energy levels. Male partners may experience erectile
dysfunction and/or other physical symptoms. (Men are not impervious to time, either).
The good news is that all of these physical problems can be resolved once they are
acknowledged.
If you are involved in a long-term relationship, you may want to keep in mind that
your partner is changing emotionally too as he or she grows older. Moreover, you
both may be habituated to a kind of timing or foreplay — or lack thereof —
that is no longer stimulating, and you may have to do some real talking to find
out what needs to change. This is an area in which it often pays to consult a certified sex therapist
or another counselor.
If you are going back out on the dating scene, you may feel particularly vulnerable
as you sort out this different stage of your sexual self. This is where holding
on to your power is essential. If you can fully embrace and accept that you are
uniquely lovely and trust yourself to be patient, chances are you will find a safe,
loving partner willing to explore alongside you — not exploit you.
Giving yourself permission to be a sexual, powerful, centered, communicative human
being in the prime of life is wildly alluring and fulfilling — but it may
not come to you overnight. It will take some self-care and some work, but it is
just as important when it comes to desire as resolving your physical symptoms.
Reclaiming your sexuality — the Woman to Woman approach
- First things first — read our article on loss of sexual libido and talk to your practitioner. She may
suggest some blood work to measure your hormone levels; at the clinic, we suggest
a full hormone profile, including free testosterone. I also recommend an adrenal
profile to test for adrenal fatigue,
which can impact sexual desire. If you are experiencing other distracting or uncomfortable
symptoms of hormonal imbalance, focus on treating those outer manifestations with
optimal nutrition, daily exercise, and personalized low-dose hormone supplementation
like that we recommend in the Personal Program.
- Stop thinking about your age and focus more on being comfortable in your own skin.
Actively tune out images, media and negative thoughts that sap your self-esteem.
When you look in the mirror, allow yourself only positive thoughts. Make a list
of the things you love about your body and your personality. Repeat them whenever
your negativity script starts to play. If this seems like an insurmountable challenge,
check into EFT or the Hoffman Institute or ask your practitioner about talk therapy.
- Engage in activities that make you feel strong, happy, and well cared for. Estrogen
has been called the “caretaker” hormone. As it wanes during menopause,
use this time to reevaluate the amount of time spent taking care of others. Schedule
some of this time for yourself and devote a portion of it to cultivating your desire.
If you are overwhelmed by stress, consider talking to a life coach, trusted friend,
or counselor to help find some better coping strategies.
- Each day, do a little something that makes you feel sexy. It might be wearing a
certain lotion, perfume or underwear. Maybe it’s getting your hair professionally
washed and blown dry, reading erotica, or sleeping naked. The point is, you decide,
not someone else. For ideas you may want to investigate GoodVibes.com.
- Keep in mind that age and skill can make the sexual act a richer, more satisfying
experience, but it may take more time! Go easy on yourself and your partner and
focus on building intimacy first, then desire. Have a date, play a sport together,
or simply do the crossword puzzle on the couch together. Even better, learn a new
skill together. Sometimes seeing a partner in a new setting can do wonders for your
libido.
- Try to communicate your needs and fears to your partner and encourage him or her
to do the same. (Menopause does free you to enjoy sex without fear of unwanted pregnancy!)
If this seems too challenging, think about talking with a certified sex therapist.
- For other ideas, you may want to check out a few good books on the subject. Here
are some favorites:
Redefining sexual roles yet again
In the 1970’s, baby-boomer women helped to break open the traditional notions
of femininity and womanhood, leading to the sexual revolution. Today, we can carry
that same leadership forward by helping to free us all from
cultural stereotypes about sexuality and older women. A quick look around
shows us that today’s menopause is not our mothers’ menopause and that
many women are engaged in robust, passionate sexual relationships — sometimes
with men much younger than themselves — throughout their lives.
Learning to want and love sex again is about learning to take better care of your
body by tuning into its request for support. It’s also about letting go of
your perceived limitations and welcoming a whole new range of possibilities. The
world beyond menopause can be as lush
and loving as you want it to be — but you have to be willing to let go of
old emotional baggage and vicious stereotypes. So don’t buy into the negativity.
Learn what you need and how to get it, then get ready to embrace what could be the
most powerfully sexual years of your life!
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements, our exclusive endocrine support formula, dietary and lifestyle guidance, and optional phone consultations with our Nurse–Educators. It is a convenient, at-home version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at 1-800-798-7902. We're here to listen and help.
We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.
Original Publication Date: 05/04/2007
Last Modified:
08/17/2009
Principal Author: Marcelle Pick, OB/GYN NP