On call: Wife’s disinterest in sex

On call

Wife’s disinterest in sex

Q.My wife and I, who both read your column, have
always enjoyed our intimate relations. Since she went through the change last
year, however, she’s lost interest in sex. She’s only 53, and although I’m 8
years older, I’m as amorous as ever. Do you have any suggestions for us?

A.We’re glad to have you both as readers; in many
households, after all, it’s women who watch over men’s health.

Doctors have learned a lot about the male sexual response in the Viagra era,
but there is less information about female sexuality. Menopause signals an
abrupt drop in female hormones such as estrogen and progesterone, but that
shouldn’t affect the female sex drive. In fact, libido depends on
testosterone, the male hormone, in both men and women.
Testosterone levels are very much lower in women than men, but they drop even
lower as menopause approaches, then remain stable during and after menopause as
the adrenal glands continue to produce small amounts of male hormones. Still,
some women are testosterone deficient and might benefit from testosterone
therapy. Unfortunately, however, data are scant, and much more research is
needed to learn if testosterone is safe and effective — and if it is, which
women should receive it and what dose and preparations are best. At present,
those answers are a long way off; in fact, the same questions about testosterone
replacement remain to be answered for men.

Another area for research is the use of Viagra for women. An early trial
found the drug safe but not beneficial for healthy postmenopausal women. More
research is under way, and other drugs are being developed for sexual
dysfunction in both genders. The FDA has already approved a hand-held
battery-powered clitoral stimulator for women with sexual dysfunction. Your
wife’s problem, though, may be a good deal simpler. Postmenopausal women who do
not take hormone therapy (and with research showing more harm than good, most
should not) develop vaginal dryness, which can make intercourse unpleasant or
even painful. So a simple place to start would be a nonprescription vaginal
lubricant such as Replens. If that doesn’t help, your wife should ask herself if
she might be feeling subtle stress or unhappiness or if she may be reacting to
personal, marital, or family conflicts. Her doctor may be able to help her sort
out possible physiological and psychological issues.

Discuss the problem with your wife frankly, but be patient and supportive,
always looking for mutually satisfactory ways to achieve intimacy and express
love and affection.