Sex After 50

Nonetheless, studies find that women with abnormally low levels of testosterone benefit sexually with supplemental testosterone. We also know that taking oral estrogen could reduce levels of available testosterone by increasing the amount of sex hormone binding globulin (SHBG). Testosterone links up with SHBG, making it useless to sexuality.

These are all issues to consider when you broach the topic of sexual desire and sex with your health care professional. And I definitely recommend it as a topic worth exploring.

That's because there are medical options to counteract the estrogen drop. For instance, topical estrogen in the form of a cream, ring or pill inserted into the vagina can help restore tissue health, flexibility and lubrication to your vagina with few of the side effects known to affect women who take oral estrogen. In fact, studies on these products find extremely high rates of improvement in dyspareunia, with up to 93 percent of women reporting significant improvement and between 57 and 75 percent saying that their sexual comfort was restored, depending on the approach used.

If you'd rather not go the estrogen route, consider using some of the over-the-counter products designed to increase sexual comfort. Long-lasting vaginal moisturizers provide relief from vaginal dryness for up to four days, possibly making intercourse less painful. They have no effect on the underlying cause of vaginal dryness.

If your sexual problems appear related to low testosterone, your doctor may suggest a trial of a topical testosterone gel or even the insertion of a testosterone pellet. Although not FDA-approved for use in women, it is sometimes used "off-label" for this purpose.

On the other end of the spectrum are sexual issues that arise apropos of nothing hormonal or medical; they are simply the result of time and/or relationship issues. For instance, the whole myth about women losing interest in sex around the time of menopause may result from simple boredom. After all, studies find that while the frequency of sex drops by half in the first year of marriage, it takes another 20 years to see such a large drop again—right around middle age. Could it be that women (and men) simply tire of their partners? That sex has become all-too-routine?

One recent study to evaluate sexuality in women pre- and post-menopause is the Women's International Study on Health Sexuality (WISHeS). Researchers mailed a survey to 25,000 U.S. women between the ages of 20 and 70. More than half (14,605) completed it and mailed it back. The study found that between 24 percent and 36 percent of women, whether postmenopausal, surgically postmenopausal or premenopausal, had low sexual desire. In other words, the lack of sexual interest was not tied to age, but to other problems such as arousal, orgasm or reduced pleasure.

The question about how common sexual function is in women of all ages remains uncertain. The 2008 PRESIDE (Prevalence and Correlates of Female Sexual Disorders and Determinants of Treatment Seeking) trial, a large, national study, reported the overall prevalence of sexual disorders to be 12 percent when including subjects meeting the "distress" criteria for a true diagnosis and over 40 percent for subjects reporting a sexual problem. Other studies of "older" women include reports of "problems" (not necessarily diagnoses) and therefore show rates as high as 43 percent for low desire, 39 percent with poor lubrication and 34 percent with inability to achieve orgasm.