THE ANATOMY OF DESIRE
By the time we reach midlife, the challenge for each of us is to be able to access life force or passion in other ways besides looking to another person for fulfillment and gratification. The call goes out for each of us to expand our personal repertoire for accessing Source energy in our lives.
Many women who are in the midst of negotiating this step for themselves find that in order to tap into their Source energy directly, they first have to withdraw from the outer world for a while as they do the inner work of reassessing their goals, boundaries, and relationships. With this more inner focus, the sex drive of many wanes for a period.
Though a menopause-related deficiency of hormones most often gets the blame for a drop in sex drive around this time, the most recent research on sexual function at midlife (which is increasingly being carried out by women) has found that menopausal status, per se, is not related to most aspects of sexual functioning. The truth is that midlife women are having sex more often and enjoying it more than ever before! An ongoing study on midlife presented at the 2007 meeting of the Gerontological Society of America reported that American women age fifty-five and older enjoy sex more and put more thought and effort into their sex lives than women a decade ago who were the same age.1 The good news gets even better: the women in the study who were in their mid-sixties to mid-seventies reported the biggest increase. The researchers noted that women who’ve reached midlife and beyond feel younger, are more open about their sexual needs, and are more interested in health than women at the same age a decade ago. Today’s midlife women, they added, consider a healthy sex life to be part of having a healthy lifestyle.
These results echo those of a study published the same year in the New England Journal of Medicine showing that midlife men and women have sex an average of two to three times a month—the same frequency that younger adults report. Even more encouraging was that more than 25 percent of the oldest group surveyed (seventy-five to eighty-five years old) were still having sex.
Not surprisingly, the survey further showed that those in poor health reported having sex the least, while those who said they were healthy reported having the most sex. The researchers concluded that a strong sex life has less to do with how old you are and more to do with how healthy you are.2
Though some women do indeed report a decrease in desire, less interest in sex, and changes in arousal, research on healthy nonsmoking menopausal women with partners shows that there’s no change in sexual satisfaction, frequency of sexual intercourse, or difficulty reaching orgasm.3
Researchers have also demonstrated that a woman’s perceptions of “being menopausal” may also affect her sexual functioning, especially if she has been led to believe that her sexy years are finished. For ages, women have been brainwashed into thinking that menopause is the end of their sexual attractiveness. When you have been led to believe that you are no longer desirable or attractive, this belief itself certainly can affect sex drive—not to mention one’s body image and self-esteem. Older studies done on women seeking treatment for menopausal symptoms have reinforced this cultural bias. It is well documented, for example, that women who seek treatment for menopause tend to report more life stress, and they suffer from more clinical depression, anxiety, and psychological symptoms than women who don’t seek care. Of course, these factors are all strongly related to sexual functioning.
The Truth About Sexual Functioning and Menopause
Sexual function is a complex, integrated phenomenon that reflects the health and balance not only of the ovaries and hormones but also of the cardiovascular system, the brain, the spinal cord, and the peripheral nerves. In addition, every factor that affects sexual function has underlying psychological, sociocultural, interpersonal, and biological influences of its own. Happily, current research on women and sex is finally taking into account how complex female sexual arousal really is. Consequently, the entire concept of so-called female sexual dysfunction is being updated. New research (much of it done by women) is shedding increasing light on how seamlessly psychological states affect biological responses. Finally research has begun to validate what women already know: a woman’s experience of sexual arousal is more influenced by her thoughts and emotions than by feedback from her genitals. In other words, her emotions and thoughts must be in sync with the goal of sexual satisfaction for her body to perform sexually.4 This is very good news! When you learn how to change your thoughts, you can change your sexual response.
~ The truth is that a woman’s relationship satisfaction, attitudes toward sex and aging, vaginal dryness, and cultural background have a much greater impact on sexual functioning than does menopause, per se.5
~ What is commonly called female sexual “dysfunction” may well be a logical adaptation to such things as past negative experiences, pain with intercourse, fatigue, depression, and medication—or lack of emotional intimacy with a partner.6 A 2008 Harvard study of 32,000 women age eighteen and up found that 43 percent reported having sexual problems, yet only 12 percent said they were upset by them.7 What’s particularly ironic about this study is that it was funded by Boehringer Ingelheim, the company that makes the female sexual dysfunction drug flibanserin. (Interestingly, the FDA recently denied approval of this drug because of lack of evidence that it offered any benefit that was worth the considerable side effects.8 Though drug companies will continue to want to cash in on the discovery of a female Viagra, female sexuality is way too complex for a quick fix like that. Female sexual dysfunction is, at its core, a reaction to our cultural programming about sexuality—and there’s no drug yet that can cure that!)
~ There is nothing about the menopausal transition, per se, that results in decreased libido in healthy, happy midlife women. In fact, the number-one predictor of good libido at menopause is a new sexual partner—even in those women who previously had sexual problems in prior relationships.9
~ Genital sexual responsiveness of premenopausal and postmenopausal women doesn’t differ significantly.10
~ Male sexual function is an issue for many midlife women. More studies need to address the effect of a male partner’s erectile dysfunction on a woman’s sex life. Many midlife men experience this problem and most are not comfortable talking about it or seeking treatment. A fiftysomething woman recently told me that ever since her husband’s treatment for early prostate cancer, he hasn’t touched her sexually. She said, “He won’t even talk about it. I love this man and I’m not going to take this sitting down. There must be something that can be done!” Thankfully, there is. For example, I’ve known men who have regained full sexual functioning even after prostate removal, improved their health, and also learned how to open their hearts. (See www.divine-feminine.com for a list of programs that help address this issue in men; I also highly recommend Invasion of the Prostate Snatchers: No More Unnecessary Biopsies, Radical Treatment or Loss of Sexual Potency [Other Press, 2010] by Ralph H. Blum and Mark Scholz, M.D., as well as The Male Biological Clock: The Startling News About Aging, Sexuality, and Fertility in Men by Harry Fisch [Free Press, 2005].)
HELP YOUR MAN AVOID THE SEXUAL SIDE EFFECTS OF PROSTATE CANCER TREATMENT
I recently met with Aaron Katz, M.D., director of the Center for Holistic Urology at Columbia University Medical Center in New York City. Acknowledging the fact that far too many men are overtreated for slow-growing prostate cancers, Dr. Katz places those who want to avoid the sexual side effects of surgery and/or radiation on a program that includes aerobic exercise, dietary improvement, antioxidant-rich supplements, optimal levels of vitamin D, and active hexose correlated compounds (AHCC)—an immune-enhancing nutritional supplement, derived from several species of mushrooms, that is used in more than seven hundred hospitals in Japan. In fact, AHCC is Japan’s leading alternative cancer therapy. This program has allowed many men to not only avoid the adverse sexual side effects of standard prostate cancer therapies, but also vastly improve their health. Needless to say, I was thrilled to find out abou
t Dr. Katz’s work. He is in the process of setting up a foundation to teach other urologists how to use the holistic approach that he is using so successfully. (For more information on the Center for Holistic Urology, visit www.holisticurology.columbia.edu; for information about using AHCC, read Dr. Katz’s Guide to Prostate Health: From Conventional to Holistic Therapies [Freedom Press, 2006].)
~ A woman’s overall mental and physical health are more important to sexual functioning than menopausal status.
~ Smoking has a much greater impact on a woman’s sexual functioning than her menopausal status. Smokers have decreased blood flow to the genitals and other organs. Toxic substances in cigarettes also poison the ovaries, changing hormone levels.
~ Vaginal dryness is more common at midlife because of the effect of lower estrogen levels on the vagina. As a result, midlife women suffer from painful intercourse more often than younger women unless they are fully aroused or adequately lubricated prior to intercourse.
~ There are significant ethnic and cultural variations among menopausal women. Compared to white women, studies have shown that African American women have a higher frequency of sexual intercourse, Hispanic women report lower physical pleasure and arousal, and Chinese and Japanese women report more pain and less arousal.11
~ Sexual preference may change at midlife. Several of my patients reported to me that after menopause, they became sexually attracted to women, even though they had defined themselves as heterosexual their whole lives. Research now shows us that women’s sexuality is much more fluid than we ever knew before, so this makes sense.12
~ Although orgasm certainly shouldn’t be the “goal” of having sex, it’s still well worth noting that orgasm is incredibly healthy in more ways than you might imagine. The hormone oxytocin (released by the pituitary gland during labor and breast-feeding as well as during skin-to-skin contact with others and during orgasm—in both men and women) encourages bonding and helps prevent blood pressure spikes in response to everyday stress.13 It also reduces cravings for sweets and for drugs and alcohol in those who are addicted. The most recent research, published in 2010, shows that oxytocin can reduce cell death in damaged hearts as well as lower certain inflammatory factors known to slow healing.14 This hormone is probably what’s behind the findings that couples generally live longer than single people, support groups work for those battling addictions and chronic diseases, and pet owners heal more quickly from illnesses than do those who don’t have pets. Healing touch, including touch from massage, also increases oxytocin.
Resolving problems in an existing relationship can have an effect on your sex life that’s comparable to that of a new sex partner—when a woman makes a decision to have more fun and pleasure with the man (or woman) she loves, she experiences a boost in her life energy, which translates to an equivalent boost in sexual energy. Hanging on to old anger and resentment, on the other hand, quells libido rapidly.
THERESA: The Restorative Power of Passion
When Theresa became a widow at the age of fifty-seven, she thought her heart would never be the same again. When her husband of thirty years was diagnosed with cancer, she’d been right by his side every step of the way. But when Stan started what was to become a long, slow decline, Theresa felt as though her whole world was slowly slipping away. He’d been the love of her life, and she couldn’t imagine being without him.
When Stan died, she took it very hard. She kept busy with friends and work, but she still felt the loss deeply. The summer Theresa turned sixty, she decided to follow a dream she’d not yet had a chance to fulfill—she went to Italy for two weeks. And she took her best friend, Margo, along for support.
Two days after they arrived, the two women found themselves wandering around an almost-deserted Sorrento. It was a Sunday and everything was closed. A forty-nine-year-old artist named Antonio who happened to be in the same café having coffee struck up a conversation with them. His warm eyes and heartfelt laugh instantly won Theresa and Margo over. Antonio was also a race car driver, and when he talked about racing, the women could tell that this was a man who was genuinely in love with life.
Antonio offered to drive the women around for the day to share the sites with them, and they eagerly agreed. In no time, they were all on their way to an ancient Greek temple, singing Frank Sinatra tunes at the top of their lungs. It was the most fun Theresa had had in a long time.
Antonio joined the women regularly throughout their trip. He innocently flirted with Theresa the whole time, and she allowed herself to flirt back. Margo, in the meantime, aided and abetted the relationship, finding excuses to leave Theresa and Antonio alone together for an hour here and there so they could get to know each other better.
After a few weeks, the women flew home to New York, and Theresa and Antonio continued to talk on the phone and text each other. Theresa went back to Sorrento to see Antonio the following fall and spent a month with him. He in turn flew to New York to visit her several times and even came to spend Christmas with her.
But here is the best part: when Theresa and Antonio are together, they often make love four times a day—and Theresa has even had orgasms when Antonio has merely touched her nipples! She’s truly come alive again in a way she could never have imagined. In fact, she’s more passionate and sensual now than she was at twenty. And she didn’t need hormones to do it—she’s never been on any hormone therapy of any kind. What brought her back to life was not only being in a new relationship, but also allowing herself to be a new woman.
An active and joyful sex life can have amazingly restorative effects on life force. In Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life (Health Reflections Press, 2010), my colleague, OB-GYN Diana Hoppe, M.D., details studies showing that a healthy libido has significant health benefits, such as boosting your immune system, promoting cardiovascular health, alleviating stress, and increasing longevity.
NITRIC OXIDE: THE MOLECULE OF
LIFE FORCE AND PLEASURE
Back in 2005, when I was doing the last revision of this book, I found a book on my shelf called ESO: Extended Sexual Orgasm, published in 1983. I went to Amazon to see if an updated version was available. It wasn’t, but what was available was The Illustrated Guide to Extended Massive Orgasm (Hunter House, 2002), by Steve Bodansky, Ph.D., and Vera Bodansky, Ph.D. I figured that massive and extended was better than just plain old extended anyway. Amazon said that those people who’d ordered the Bodanskys’ book had also ordered Mama Gena’s Owner’s and Operator’s Guide to Men (Simon & Schuster, 2003) by Regena Thomashauer (a.k.a. Mama Gena). I couldn’t figure out how they were related, but I bought both. The Bodanskys’ book was an extraordinarily helpful tool for teaching individuals and couples to feel more pleasure, and it is beautifully illustrated. Much to my surprise, I found that Mama Gena’s Owner’s and Operator’s Guide to Men was based on the same principles in the Bodanskys’ book. I later found out that Regena and the Bodanskys are friends and colleagues and have been collaborators for years. I was so impressed with their work that I soon thereafter began teaching at Mama Gena’s School of Womanly Arts in New York City. (See Resources for information about the School for Womanly Arts, including the new interactive global online community Mama Gena has created at www.sistergoddess.com.)
After attending a couple of sessions and doing some lectures, I observed that many of the women finishing Mama Gena’s program seemed to be far happier than when they’d started. And I had a hunch that they were also getting healthier. I asked women who had experienced physical healings or improvements in health conditions to stand up and form a line. The line stretched to the back of the room as one after another, women told me how they had healed from chronic pelvic pain, abnormal pap smears, ovarian cysts, and even the symptoms of lupus. Thus I began to study pleasure as a health strategy.
About that time, I was introduced to the work of Ferid Murad, M.D., Ph.D., who won the Nobel Prize in Physiology or Medicine in 1998 for his work with nitric oxide
. He and his colleague Edward Taub, M.D., had, in fact, written an entire book about the role of nitric oxide called The Wellness Solution. This raised the possibility of a link with pleasure, because the mechanism through which erection-enhancing drugs such as Viagra work is by increasing nitric oxide in the blood vessels of the penis, which increases blood flow.
From my observations at Mama Gena’s and my own research, it soon became clear to me that the path of pleasure involved raising nitric oxide levels in both men and women. This fact was brought home to me very clearly during one of Regena’s Men’s Nights—an event in which men are invited to learn all about women in a very fun and festive setting. The husband of one of the participants, a man in his seventies, had had to use Viagra to get erections before his wife took Mama Gena’s mastery course. But he no longer needed the drug because his wife had become so turned on by pleasure and by life that she was now turning him on without his having to take the drug.
Nitric oxide is a gas produced by the endothelial lining of every blood vessel in the body as a result of healthful pleasures such as exercise, taking antioxidant vitamins, laughing, and having sex. In fact, orgasm can be thought of as a big burst of nitric oxide. Drs. Murad and Taub dubbed nitric oxide the molecule of the fountain of youth. Nitric oxide not only increases blood circulation, it’s also an überneurotransmitter that balances the levels of all other neurotransmitters, including serotonin, dopamine, and endorphin. Plus it also helps quell cellular inflammation, which is the root cause of most chronic degenerative diseases.
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