So glad you’ve been successful with the dilators you ordered from MiddlesexMD! Vaginal dilators can help to restore capacity and comfort for intercourse. Our website has instructions for how to...
Knowledge
As we get older and our hormone levels drop, we experience changes in our tissues, our sensitivities, and our responsiveness. If we understand these normal changes, we can keep our bodies and minds in shape for continued sexuality, and we can compensate when we need to. At this stage in our lives, we may be "high maintenance," but it's worth the effort! Our recipe for continued sexual health starts with Knowledge and continues with the other tabs, above, across the page.
Start to learn by clicking on any of the statements at right that "sound like you." If you experience — or suspect you may have — any of the conditions listed below, click to understand it more fully and learn what to do about it. There are definitely actions you can take to stay healthy!
First published 02/16/2010 Last updated 06/27/2011
Any of these conditions may affect your sex life now:
Recent blog posts
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Of course, we’d all love to enjoy good health and great sex until the day we die peacefully in our sleep. While we can control many aspects of our health, sometimes we just draw the short straw....
Your description of pain with the vaginal opening makes me think a really careful exam is your next step. It sounds like vulvodynia (also called vestibulodynia) should be considered. This...
More and more research is being done these days about the powerful effects of human touch, with study subjects ranging from newborns to NBA basketball players to sexually dysfunctional couples....
Great question–without a simple, single great answer! Women who have lost their ovaries have lost not only their source of estrogen, but also a significant source of testosterone. I find many, but...
People often make jokes about snoring (the word itself is kind of funny), but if you’re losing sleep because your partner is a loud snorer, you know it’s anything but humorous. Not only are you...
HPV is the most common cause of abnormal pap smears. It is only fairly recently that we get more specific results with pap smears, telling us whether an ‘abnormal’ finding is related to a low-risk...
Good health and good sex? It’s that chicken and egg thing. Being sexually active improves health in some powerful ways, but good health is also an important foundation for good sex. Sex may...
It’s estimated that 60 to 85 percent of all adults have come in contact with HPV and are therefore carriers. Any HPV that you or he introduced to the relationship 20 years ago, you were both...
A few weeks ago I reminded you how beneficial sex can be for your health. Turns out, it might even help you live longer! Perhaps you’ve heard about a new book called, The Longevity Project, by...
As we age, along with everything else we lose (our keys, our glasses, our hearing), it’s common to lose sensation in our genitals. Less sensation makes it harder to achieve arousal, which can lead...
First, know you’re not alone! About 25 percent of us report difficulty achieving an orgasm. The most commonly used approach to treat ‘primary anorgasmia’ (the medical term for a woman who has...
This is the second part of our interview with sex therapist Sarah Young, who works with individuals and couples to help them rediscover–or perhaps discover for the first time–the joys of sex. Q:...
A few months ago we talked about couples therapy, which caused some discussion about a closely related field: sex therapy. The idea of going to a sex therapist may be so scary that you wouldn’t...
Dilators don’t treat vaginal atrophy, but they do help counter a consequence of vaginal atrophy: narrowing or shortening of the vaginal. Used over time in graduated sizes, dilators help to restore...
Who has time for sex any more? That’s a question I hear from women whose plates are full with working, caring for parents, caring for kids, even caring for grandchildren. With all of the demands...
This topic comes up more often with girlfriends than with patients. But it comes up often enough with girlfriends that I know it’s on my patients’ minds, too! The question is whether it’s...
This is a great question. Overall wellness is vital to sexual health; a woman who enjoys good health will usually have more sexual satisfaction, as well. There’s a clear tie, for example, between...
If you read this blog regularly, you know that I usually summarize questions I receive from visitors to the website when I think the answers will be helpful to more people. An e-mail I received...
There are two principle non-surgical options for birth control: hormonal and barrier methods. Sounds like you’ve already decided to steer clear of hormones, at least for a time. The most common...
Hot flashes. They’re the stereotypical symptom of menopause, the subject of T-shirts and mugs: “It’s not a hot flash, it’s a power surge.” But when you say to yourself or your partner, in an...
Both Replens and Yes, the vaginal moisturizers we offer at MiddlesexMD, are perfectly safe for oral sex. In fact, all of the products we offer are chosen with safety in mind. Your partner may have...
You say you don’t have issues with vaginal dryness, but you did feel discomfort–difficult to sit comfortably, spasms of pain–for at least a week after intercourse. It does sound as though you...
“I just want to want sex again.” I can’t tell you how many of my patients have expressed — in one way or another — this simple desire for the desire they experienced in their 20s and 30s, when...
Absolutely not! As we grow older, it takes more stimulation for us to arouse and lubricate, and that stimulation can come in many forms–physical or mental. If watching an erotic video provided...
When a patient tells me that she no longer enjoys sex, one of first things I ask her is to tell me about something that she does enjoy. If she isn’t able to come up with a fairly quick answer, in...
“There are many paths to heaven, and sex is one of them.” –Abraham Maslow Maslow, the humanist psychologist who invented the term “peak experience,” would know exactly what participants in the “...
I’m still thinking about the research that says lots of post-menopause women have sex even though it hurts. The study I read said many of them think there’s nothing that can be done—that painful...
I’ve talked about a couple of general topics prompted by reading the REVEAL research results: that lots of women aren’t aware of the effects of menopause on sexuality and that many of us aren’t...
A woman born in 1850 could expect to live just past her 40th birthday. A woman born in 1900 was likely to make it to 50—assuming she survived the flu epidemic of 1918 and other hazards. I looked...
Just be yourself, our mothers told us when we worried about what to wear and say and do on our first date with that special someone. Such hard advice to follow when we wanted to be cool and sexy...
I was struck by this sentence in a report on research with women aged 45 to 65 experiencing menopause: “As a generation, they have yet to develop a voice for this situation, and many remain silent...
When the results of a new AP-LifeGoesStrong.com poll of the boomer generation about sex and relationships were released last month, the news media highlighted two seemingly contradictory findings...
Vagifem will have some influence on tissues within four to six weeks; I hope it won’t be long before you note some benefit. Beyond tissue health and lubrication, having comfortable sex depends on...
I’m sure I’m not the only one who gets sentimental during the holidays. As my family gathers in a home that looks better than usual, preparing gifts and eating more-than-usually festive food, I...
HPV (Human Papilloma Virus) is so common that the lifetime cumulative risk of being an HPV carrier is 80 percent. In other words, we’re nearly all carriers of HPV. Fortunately, most people do not...
You may have heard about the Centers for Disease Control and Prevention’s prediction that by 2050, one in three Americans could have diabetes. One in ten already do, although many of them haven’t...
We’ve talked before about the fact that sex is different for women. Rosemary Basson, MB, FRCP, of the University of British Columbia, describes a couple of ways that women experience arousal...
We love hearing from our readers and our customers. We’re thrilled when we hear from someone who’s gotten unstuck in her sex life because of information or products we’ve been able to supply. Two...
When they listed “communication” as an essential component of “optimal sexuality,” participants in the groundbreaking study published last year in The Canadian Journal of Human Sexuality were...
Vaginal moisturizers can typically be applied in two ways: either with your fingertip in the vagina and externally as needed, or with an applicator in the vagina. Applicators often come pre-filled...
A magazine in my waiting room cites a study that suggests 40 ounces of caffeinated coffee a day to prevent memory loss. The downside, of course, is that you may not sleep at night—which would...
Most of a woman’s genital lubrication comes during arousal, not with orgasm (unless you’re wondering about female ejaculation; there isn’t agreement about whether this occurs for women, and if it...
An article in The New York Times last week reports that, come January, Playboy TV will begin “shifting from traditional pornography toward a higher-quality, female-friendly slate of of reality...
Critics of the quest for “pink viagra” — the elusive drug to increase female sex drive — often argue that depressed libido isn’t medical condition (like erectile dysfunction) that can be “fixed”...
Many of the women I see in my office would like a black and white answer: Where, exactly, are they on the path to menopause? Unfortunately, I can’t really give them a solid answer, and here’s why...
When we were assembling our product collection, the MiddlesexMD team spent a fair amount of time researching personal lubricants. Some of this research was straightforward: We knew safety came...
What’s the difference between “connection” (number two of the “eight components of optimal sexuality”) and “deep sexual and erotic intimacy” (number three)? That stumped me for a bit while I was...
A vaginectomy–surgical removal of part or all of the vagina–is most often done as part of cancer treatment. It’s rarely a doctor’s first choice, and some reconstruction is usually involved. Your...
Many of the women I see in my practice have been with the same partner for years. These couples have made homes together, raised children together, weathered hard times and enjoyed happy moments...
We had a flurry of questions about foreplay — or dealing with the lack of it — awhile back, which led to a number of conversations within the MiddlesexMD team, but also between team members and...
It’s interesting to me how many patients who come to me with concerns about diminishing libido are there because of their husbands or long-time partners. These lucky women have a great...
Vaginal dilators really do work to increase vaginal caliber–the size of the opening. If you’re having your first sexual encounters, have an exam by your healthcare provider to rule out other...
We’re learning. I was happy to see that confirmed by Indiana University’s Center for Sexual Health Promotion’s findings in the latest National Survey of Sexual Health and Behavior. I was glad to...
We’ve talked about how crucial mindfulness–being mentally and emotionally present in the moment–is to enjoying great sex, sex that is “better than good,” as reported in a study recently published...
Oooh! “Less painful” is a difficult goal; I’d like penetration to be pleasurable for you! I’d like you to start with a thorough exam by a gynecologist or someone who specializes in women’s health...
I saw a headline that irked me in Salon.com’s Broadsheet a week or two ago. I couldn’t quite put my finger on why it bothered me until I wrote a post about the cancelation of the flibanserin...
I’m a recreational runner, and before a run, I always spend a few minutes warming up. I’ll run in place and do some stretches, especially of my calves and ankles. Experts no longer say this is a...
It’s official. Boehringer Engelheim, the German pharmaceutical company, has shelved its plans to develop flibanserin. They’ve decided to focus on other drugs that “have better potential to make it...
In an earlier blog post we reported on a study published last year in The Canadian Journal of Human Sexuality called “The Components of Optimal Sexuality: A Portrait of ‘Great Sex.’” Analyzing...
Now that our new site has been up for a while, we’ve met and made friends with others in online communities serving midlife women and sharing information about sexual health. We’d love for you to...
There are many “natural” reasons women our age begin to lose interest in sex. Hormonal changes, diminished energy, lowered self-esteem as we mourn the loss of our youthful bodies — a complicated...
There is no doubt that the ability to achieve an orgasm becomes more difficult as we age, and the orgasm itself is often briefer and less intense. As we age, we need more time for every step of...
No, I’m afraid a moisturizer won’t help with bladder function. Moisturizers really only improve the tissue condition in the vagina where they’re applied. The vagina and the base of the bladder and...
Recently I treated a patient who’d had elective breast reduction surgery. Nerve damage during the procedure had caused her to lose all sensation in her nipples. She found herself unable to have an...
A declining interest in sex as we age is typical for women, but many face a couple of additional factors that are really big: 1) It is painful; and 2) the event itself may not be particularly...
I had a call the other day from a friend who’s been a widow for several years. “I’ve found someone!” she told me, with just the slightest quiver in her voice. “I’m so excited I can hardly...
Estrogen-containing vaginal preparations are prescription only. If you haven’t tried lubricants and moisturizers, which are available over the counter, you might try those first. Lubricants are...
Maybe I was naïve. We ran into some issues with the launch of MiddlesexMD.com earlier this year: We couldn’t advertise on a popular social networking site. An article we submitted was rejected...
I saw a patient this week who is in her early 60s, in great shape, and happily married to an attractive and generally healthy man also in his 60s. Recently retired from executive positions, they...
Are the medications you’re on behind your loss of interest in sex? Are they making it more difficult for you to reach orgasm? These are tough questions. On one hand, the answer is almost always “...
Isn’t it amazing how quickly things can change? You say you were tested as being mid-menopause. Blood work is accurate at assessing ovarian function on the day you’re tested, but it is miserable...
For the first 10 or 15 years that we knew her, we were not to call Elaine “Grandma.” At least and especially not in public. She was too busy attending to her coiffure and hosting wild parties for...
It’s a personal question, I know, but one I’m trying to be sure to ask my midlife and older patients who are newly single and sexually active. Among women our age, sexually transmitted infections...
This is an important issue. At 49 you are ‘subfertile,’ but not infertile. You also can’t rely on rhythm, as there is no rhythm! Barrier methods–condoms or a diaphragm–can work well, although they...
We’ve written before about our efforts to find erotica to recommend to our growing MiddlesexMD community (Hi there, community!). Our efforts are are purely pragmatic, you understand. By subjecting...
She’s 54 years old. She’s spent most of her adult life in a long-term monogamous relationship. She’s just been diagnosed with genital herpes. This happens more often than you might think. Even I...
Thyroid disorders are not typically a significant factor for libido or orgasm. A bigger issue is expectations: The majority (probably at least 80 percent) of women cannot have and never have had...
When you’re in perimenopause, we say that your hormone levels are, in general, declining. While they are declining “in general,” it’s likely that your levels of estrogen and progesterone are...
In menopause, in the absence of estrogen, the vagina narrows and becomes more thin and fragile. Even when you are lubricated enough, the tissues have likely lost elasticity and can’t comfortably...
The first thing I try to do with women who have both of these issues is to make sex comfortable. It is pretty hard to be interested in intercourse when you know it is going to lead to pain. You...
Fortunately, the vagina is self-cleansing; it requires very little attention. The cells on the surface of the vagina naturally regenerate or ‘turn over’ on an ongoing basis. After intercourse,...
I’m busy exploring the boundaries of a new phase of my life, brought on by an illness I’m managing. As illnesses will, it’s grabbed me by the collar, given me a big shake, and forced me to order...
Oh, where do I begin? Perimenopause can be a pretty tough transition for many women. It is not only possible but probable that those symptoms are related. Patients with these complaints get a one-...
My libido woke up. This week we shoveled out a room to make room for a new hobby. In the unearthing, my husband found my long-lost, autographed picture of Dean Martin: Oh, be still, foolish heart...
Last year researchers published their study defining "The Components of Optimal Sexuality: A Portrait of 'Great Sex.'"
Not long before launch time, we wrote about our movie night with girlfriends, exploring erotica, and talking about what sort of flicks worked to turn us on… The premise being that as we grow older...
If you have pain during intercourse, you need a good, thorough physical exam to start, to make sure there is no obvious cause for the pain with penetration (for example, vulvodynia/vestibulodynia...
The most important thing is usually to re-estrogenize the vagina—with localized, not systemic estrogen. I haven’t seen a single oncologist not agree to allow breast cancer patients to use this....
No! It’s great that you recognize the value of remaining sexually active, despite your decreasing libido. As we get older, we have to learn some new techniques to continue to enjoy sex. You can...
If you’ve missed periods, you are perimenopausal. It’s likely that you are experiencing symptoms of less circulating estrogen. Hot flashes are the most common symptom from that, but the way we...
Urinary incontinence for women is usually classified as “stress incontinence” or “urge incontinence.” Losing bladder control during sexual stimulation is most likely urge incontinence: The...
Weights in hand, what I need is time and focus and coaching. And ladies, there is an App for that. That is, if you use an iPhone or iTouch, you can download Kegel coaching applications for...
I surely don't miss the troublesome little egg sacs. The havoc they played with my system when they were there made my life miserable, to say the least. The new freedoms I have without them are...
While we are on the subject of finding medications and supplements that can help us… a quick note about using herbal remedies to help alleviate the symptoms of menopause and/or to boost your...
Vagifem is a low-dose ‘localized’ estrogen. It is delivering estrogen to the vagina and adjacent tissues, but not to areas outside of this area (that’s why it’s called ‘localized’ vs. ‘systemic...
The real difference between a lubricant and a moisturizer is duration. Lubricants coat the vagina to ease penetration, which adds comfort during intercourse. They provide a benefit at the time of...
I have had women in my office, losing sleep, depressed, miserable, because the lack of intimacy where it is wanted can have a domino effect, destroying communication, trust, a couple, a family....
Studies consistently show that estrogen use is not associated with weight gain. The estrogen ring (you are probably referring to Estring, although there are other estrogen ring products) should...
Zoloft is an SSRI (selective serotonin reuptake inhibitor), which increases serotonin. That improves mood, but more serotonin is not good for women sexually. Sometimes changing meds within that...
Part 3 of 3 Shopping for vibrators can be fun, and really very interesting. These devices come in many configurations and with many options, because, well, we’re all different. What one woman or...
Part 2 of 3 Of course, I can explain why we need more vulvo-vaginal stimulation at our age to nearly any woman in my office, and she may understand and fully accept what I’m telling her. But her...
Part 1 of 3 “A Vibrator? Me? At my age?!” That’s a pretty common response when I recommend — actually prescribe — using a vibrator to the patients I see in my menopause practice. I live in a small...
It’s been great to hear from a number of you after the opening of our shop. You’ve validated my suspicion that, for lots of women, there just weren’t good sources for information and products they...
We are learning more and more about what motivates women to have sex — enough to know that we still don’t know that much. We do know that our motivations change with our situations. What motivates...
So you arrive home from a hectic day at the office, and there’s the box you’ve been waiting for, with your new lube, a vaginal moisturizer, and those dilators that have promised to return your sex...
Turning 50 is like walking through a doorway into another world. Suddenly we notice our bodies, primarily because they are not functioning as effortlessly as they used to. Welcome to the...
I hate to be the first to break it to you, but your Mom had sex. She did. And it’s possible she even enjoyed it.
It took a very long time for the medical community to to take the physical and psychological changes that come with the menopause seriously at all. And it took still longer before we began...
A story is necessary to bring about the appropriate emotion… When I was in my early 40s, I decided I needed to run a big race. Not so much a long race, but a big one, with crowds and a chip on my...
As a general rule, women over 40 need more stimulation to become aroused enough for good sex. When we were young, just thinking about making love with our partners may have been enough to arouse...
A lot of the patients in my menopause practice are single women. My patients who have no sexual partners can be quick to dismiss my questions about sexual symptoms, figuring that without a partner...
None of us get through our adult lives without some questions about sexual functioning. And we go lots of places for answers, consulting family, friends, texts, the Internet, piecing together a...
I live and practice in the Midwest, where open discussion about sex is just not part of the culture. Even among close-knit groups of girlfriends, it’s a rare discussion, at least not past a...
The post title is just tongue-in-cheek, folks. A little health writing humor, poking a stick at the whole idea of health “secrets.”
We don’t believe in keeping information about attaining...
MiddlesexMD began with a business plan I wrote for my Masters in Medical Management program at Carnegie Mellon University. Its essential proposition — offering women over 40 the information,...
Since launching MiddlesexMD, I have to say, my dinners have gotten a lot more spicy.
You know how it is when dining with buddies. It’s polite — required — for them to ask what you’ve been up...
Writing for my gynecologist friend has included a lot of Aha! moments. I admit some of this learning makes me blush. It’s not just because I blush when talking about sex — though, I do. It’s...
…and why you should care too!
It began when I partnered with the local hospital in my hometown to evaluate local women’s health services, looking for any gaps where additional services were...
Menopause brings a drop in circulating estrogen. And a drop in circulating estrogen often (but not always!) brings a drop in sexual response. So at midlife, for many of us, sexual satisfaction...
Hi everybody. My name is Julie. I’m a writer here at MiddlesexMD. My credentials for writing about sex at midlife are… Well… I have reached midlife. And I enjoy sex.
Still.
Despite...
The science of human sexuality is young. For most of the last century, we assumed that men and women approach sex in roughly the same way.
I know: Crazy. But as I said, the science is young...
A big bouquet of roses waited for me at the front desk of my clinic. It wasn’t my anniversary or my birthday. And doctors just don’t get a lot of flowers. When I saw who sent them, I smiled that...
Learn how your body's changes affect your sexuality.
Understanding what's changing can help you keep sex enjoyable.
