We're Not Where We Need to Be

I'm happy to have friends and colleagues who keep up on the news on my behalf. I can't count the number of them who texted or emailed me a link to the story that unfolded at the Consumer Electronics Show (CES), which is truly not something I normally pay attention to.

If you missed the story, I'll try for a short objective summary: A tech company was notified they'd won an innovation award, and then, before the show opened, the company was informed that the award was being rescinded and they were blocked from exhibiting at the show.

Crazy, huh? It's one kind of crazy all by itself; it's another kind of crazy when you consider that the product was, essentially, a vibrator with some cool new technology. (Here's the open letter the company's CEO published after the award was rescinded; here's a different kind of explanation from Wired magazine.)

I wish I could ignore this controversy. But the reality is that I run into cultural barriers nearly every day in my practice, preconceived notions and prejudices that make women reluctant or entirely resistant to taking simple steps that could improve their sexual health. My correspondence with women across the country through this website tells me that cultural barriers get in the way of frank discussions between patients and their doctors about sexual health and sexual satisfaction.

I watch Grace & Frankie and imagine that we're turning a corner in willingness to talk about women over 50 as full humans. Then I read about the CES controversy, and I feel a need to restate the obvious, from my medical perspective:

• A hundred years ago, a woman was fortunate to live long enough to reach menopause. Our generation will live a third of our lives past menopause. If trends continue, our granddaughters will live half their lives past menopause.
• Sex can be a healthy part of a healthy life. That doesn't change after menopause. For women, sex supports circulation that keeps urogenital tissues healthy, it counters depression and isolation, it helps with muscle tone that keeps our organs in place.
• Women's orgasm is pleasurable. It's also the part of sex that does the most for pelvic muscle tone and that blood circulation that feeds our tissues. The fact that what's good for us also feels good has always struck me as a pretty brilliant part of our design.

I'd really prefer to be practicing medicine, rather than musing about cultural dynamics. But I can't help but think that for most Viagra users, the drug is really about pleasure, not about procreation—and yet there has seemed to be ready adoption of the concept. We don't call Viagra a "recreational drug," and many insurance companies don't balk at covering the cost.

Women can be helped by a simple device, one not requiring a prescription and with no adverse side effects. Approaching and beyond menopause, we lose some sensation, which can make an orgasm more elusive. All it takes is some additional stimulation—which a vibrator provides without taxing our (or our partners') dexterity or endurance. For us, a vibrator isn't a "sex toy," however playful we might be with it. It's like a hearing aid ("audio toy"), a cane ("mobility toy"), or reading glasses ("vision toy")—devices that help us mitigate the effects of growing older.

We're not where we need to be. And we won't make progress—in making options available to women and assuring they're comfortable pursuing them—if we don't acknowledge that's true.

Did you read the Wired article? I was struck by the reminder that the full shape of the clitoris wasn't mapped until 1998. We can't take for granted that women matter, that women's sexual health matters and that women's pleasure matters, too.

Join me. Speak up. We can make this part of life different for ourselves, our sisters and especially our daughters.

Barb DePree, MD, has been a gynecologist for 30 years, specializing in menopause care for the past 10. Dr. DePree was named the Certified Menopause Practitioner of the Year in 2013 by the North American Menopause Society. The award particularly recognized the outreach, communication and education she does through MiddlesexMD, a website she founded and where this blog first appeared. She also is director of the Women's Midlife Services at Holland Hospital, Holland, Michigan.