Where’s my little blue pill?
A woman’s sexuality changes throughout her life and it’s one of the most common questions I get at the end of an appointment…we’ve covered treatment options for incontinence, talked about natural changes in vaginal health over time, and my patients will commonly lament “I understand things change and how I can maintain my pelvic health, but where did my libido go? And how can I get it back?”
In the 1990s, there was a burdgeoning of treatments for male erectile dysfunction (ED) and now you see ads on the 6 o’clock news for an assortment of ED pills, but where’s the woman’s “little blue pill” for her to get her mojo back? There have been several attempts to get FDA approval for drugs treating women’s low sex drive, including using testosterone as hormone replacement and a drug called flibanserin, but neither made the grade for approval. Hormone replacement after menopause can be helpful in restoring sexual vitality, but there are pros and cons based on your risks of other conditions such as bone loss, breast cancer and heart disease.
Women’s sexual desire is an emotional state that is dependent on being in a healthy relationship, so open communication and creating time for intimacy are all key in having a gratifying sexual relationship. Each woman is unique as is her sexuality and her ideas of “great sex”, so I advise women to keep an open mind to what constitutes intimacy and a gratifying sexual experience, and until we have our own version of a little blue pill, it will take creativity, communication and a lot of lube to keep up with the men!
Which lube is right for me?
Did you know that at least once a month women are placing something in their vagina other than a tampon or penis? Just look at all the new products on the shelf at your local drugstore for vaginal moisturizers, sex lubes, sex enhancers and even vibrators! There was recently a study published by the National American Menopause Society looking at which vaginal lubricants posed the lowest risk for vaginal infections, such as yeast or bacterial overgrowth. Surprisingly, some of the safest lubes can be found right in your own kitchen! It is perfectly safe to use coconut oil or olive oil as a vaginal moisturizer – both inside and out. For intercourse, the silicone based lubricants have the lowest risk of vaginal infections. These are more expensive than the EVOO in your cupboard, but will give you long-lasting, low friction lubrication during intimacy.
The water-based lubricants tend to have more preservatives to promote shelf life, but these preservatives may be toxic to the normal healthy vaginal flora. The glycerin or oil-based lubes have a smooth, low-friction texture, but may have components that promote yeast growth. I tell my patients, there’s no such thing as too much lube! And find a product you like and use it liberally!
Share your pelvic health story!
Did you know that half of all women over 50 years old have some bothersome pelvic problem? Pelvic health problems can arise throughout our lives, from potty-training to adolescence, budding sexuality, peri and postpartum, and as we age with changes in hormones and time. Problems like urine leakage, vaginal bulging or painful sex are very common and part of the burdens women may bear in silence and limiting exercise, sex and suffering a slow whittling of self-esteem and body image over time.
If you’ve brought these issues up to your caregiver and gotten help and relief, you can also help the women around you by sharing your experience. We have so few places now where women can share women’s knowledge, so consider sharing your story - amongst your friends, at your yoga class, in your book club or … wherever you feel comfortable helping to empower women with knowledge and hope!