This results in what sex therapists call “spectatoring,” which is a mental disconnection during lovemaking, thinking more about work or household chores than about the partner beside you. For the man, this may translate to erectile difficulties; for the woman, difficulty reaching orgasm. The man who looks first to Viagra to “save” him may be discounting the importance of making a deeper connection with himself and his lover. A woman involved with a man who feels he needs Viagra for psychogenic impotence would be wise to ask herself about the quality of their connection. Those things that remain unspoken between them, the issues and feelings that are too uncomfortable to talk about, may be blocking full erection and orgasm, and may also be putting their health at risk in other areas.
GINNY: Victor and Viagra
Ginny and Victor had been married for thirty years and had a pretty happy relationship. Victor had always prided himself on his virility, and he and Ginny had enjoyed a vigorous sex life for years, making love about three times per week. When he turned fifty-five, however, Victor noticed that his erections were not as hard as they used to be, and it sometimes took him longer to achieve them. Occasionally he even found that he was unable to sustain an erection long enough to bring Ginny to orgasm. He and Ginny had gradually slowed down in their lovemaking to about once every two weeks. This didn’t bother Ginny, particularly because she was very busy starting a new catering business—something she’d always dreamed of. Her business was taking off, and now that their youngest child had left home for college, her life was no longer focused solely on the needs of her husband and children. But Victor, who was planning to retire in a year or two, was not nearly as happy with his life. It seemed that just as he was starting to slow down, Ginny was taking off in the outside world.
Victor sought a consultation with his doctor, who prescribed Viagra. Victor was elated with the results. Ginny wasn’t. The Viagra introduced a “mechanical” element to their sex life that had never been present before. She didn’t like having to be sexually available just because Victor had taken his pill, and she began to spend more and more time away from home, partly because she was having so much fun at work, partly because she didn’t want to have sex “on demand.” When asked how she felt about Viagra, Ginny replied, “I think we were better off without it. I love Victor and it really didn’t bother me when it took him a little longer to get hard. I usually knew how to help. Now I feel as though a vital emotional component of our lovemaking has been replaced by a pill.”
Their situation is not unusual. Victor’s change in sexual function is, in part, related to his sense of decreasing power in the outer world, even though it is his own choice to retire from work. Though Viagra is probably a relatively safe solution for him for a time, I would strongly recommend that he also find a new life’s purpose into which to pour his energy. Otherwise he won’t be able to keep up with his wife, in the bedroom or otherwise, without resorting to a drug for support. That doesn’t mean there aren’t valid indications for Viagra. Rather, it is to point out that sexual function is related to much more than the size and duration of an erection. There is also a great deal that men can do to improve their health, circulation, and erectile function. Exercise, an inflammation-reducing diet, and a good supplementation program are the first places to start.
MENOPAUSE IS A TIME TO REDEFINE
AND UPDATE OUR RELATIONSHIPS
Before the first edition of this book, I would have written all of this while thinking it did not apply to me. Similarly, many of you may be thinking, “That’s interesting, but my relationship with my significant other is good,” and you may be right overall. For many of us, the relationships we have maintained over the years have served us well and have been mutually beneficial, even passionate. But it is very often necessary to renegotiate some of the terms of the old relationship as you enter the transformative years of midlife. No matter how good that relationship may have been, what worked for you in your “previous” life will, in all likelihood, need some updating in order to serve the person you are becoming.
One area in which the necessity for change may become apparent is in the waning of a woman’s libido. Just as wild animals refuse to breed in captivity unless everything is in balance in their environment, a woman and her significant other may notice problems in their sexual intimacy if their relationship is in need of rebalancing. Menopause is also a time when what a woman wants from a relationship begins to change. And that change has to start with her relationship with herself.
As we have seen, it has usually been the woman who sacrifices career and personal growth for the sake of maintaining and nurturing the family, even if she works full-time outside the home. Not only the unwritten rules of society but the hormones flowing through her veins encourage her to give high priority to family, nurturing, nesting, and protection of loved ones. At menopause the hormonal changes are only part of a woman’s ongoing transformation, which begins at an energetic level and triggers changes not only in her biology but also in her perception, intuition, neural pathways, emotions, creative drive, and overall focus. While she spends the first half of her life giving birth to others (literally and figuratively), everything about her menopausal transition suggests that the second half of life is when she is meant to give birth to herself.
If, through the lens of your transforming self, you discover that you are not in love with your life, your libido may suffer as a result. The same thing may happen if you’ve given too much of yourself away in your relationship. In fact, a fading sex drive may be one of the first places a red flag will pop up, as a signal of a fading love of life—a waning life force. Only if both you and your significant other are willing to question what is no longer viable in your relationship and work together on the necessary remodeling can you open the door to rejuvenation of your life energy and the rekindling of your passion, sexual and otherwise. Healing will require a bilateral effort—both you and your partner must be willing to ask, and hear the answers to, some difficult questions in order to restore and renew your relationship.
Terminal Busyness Leads to
Exhaustion and Waning Libido
Someone sent me the following anonymous posting from the Internet. This one paragraph summarizes the plight of many midlife women—and the difference between their lives and those of their husbands.
Mom and Dad were watching TV when Mom said, “I’m tired, and it’s getting late. I think I’ll go to bed.” She went to the kitchen to make sandwiches for the next day’s lunches, rinsed out the popcorn bowls, took meat out of the freezer for supper the following evening, checked the cereal box levels, filled the sugar container, put spoons and bowls on the table, and started the coffeepot for brewing the next morning. She then put some wet clothes into the dryer, put a load of clothes into the wash, ironed a shirt, and secured a loose button. She picked up the newspapers strewn on the floor, picked up the game pieces left on the table, and put the telephone book back into the drawer. She watered the plants, emptied a wastebasket, and hung up a towel to dry. She yawned and stretched and headed for the bedroom. She stopped by the desk and wrote a note to the teacher, counted out some cash for the field trip, and pulled a textbook out from hiding under the chair. She signed a birthday card for a friend, addressed and stamped the envelope, and wrote a quick note for the grocery store. She put both near her purse. Mom then creamed her face, put on moisturizer, brushed and flossed her teeth, and trimmed her nails. Hubby called, “I thought you were going to bed.”
“I’m on my way,” she said. She put some water into the dog’s dish and put the cat outside, then made sure the doors were locked. She looked in on each of the kids and turned out a bedside lamp, hung up a shirt, threw some dirty socks in the hamper, and had a brief conversation with the one still up doing homework. In her own room, she set the alarm, laid out clothing for the next day, and straightened up the shoe rack. She added three things to her list of things to do for tomorrow.
About that time, the hubby turned off the TV an
d announced to no one in particular, “I’m going to bed,” and he did.
MARY: Overcare and Burnout Send Libido Underground
Mary was a registered nurse. As the eldest of five children from an Irish Catholic family, she had always been expected to take care of her parents and younger siblings. When her mother died suddenly, Mary’s alcoholic father, a man in the early stages of dementia, came to live with Mary and her husband, Jeff, a police officer. Despite having four other siblings, Mary had never questioned her role as the designated family caregiver. But the increased need for “alone time” so many women experience at menopause led Mary to feel not only a total loss of sexual desire, but also complete emotional burnout. She had recently been diagnosed with hypothyroidism and was suffering from weight gain, depression, lethargy, fatigue, dry skin, and the desire to sleep all the time. Though her family doctor had prescribed thyroid hormone replacement, Mary saw little improvement in her depression. And despite normal estrogen, progesterone, and testosterone levels, her sexual desire remained nonexistent.
When a woman is experiencing caregiver’s burnout, her body is often, quite literally, running on empty. She may have insufficient levels of many nutrients, such as the B vitamins and magnesium, which contribute to her fatigue. And her adrenal glands may be producing too much adrenaline and either too much cortisol or, after years and years of unabated stress without replenishment, too little cortisol. Either way, the end result is physical exhaustion. Sleep, not sex, is what women like Mary find themselves fantasizing about. Interestingly, sleep is often the best way to restore hormonal balance.
I prescribed a program for Mary that focused on her rejuvenation from the inside out. I told her that she needed to get help at home at least two days per week. She also needed to improve her eating habits, cutting way back on refined carbohydrates such as cakes, candy, and cookies and increasing her intake of protein, essential fatty acids, and fresh fruits and vegetables. I also suggested a high-potency multivitamin and told her she needed to go to bed by ten o’clock every night and get at least eight hours of sleep per night—preferably ten! Mary had known all along that her life needed to change, but, she told me, she was relieved to finally have a medical authority supporting her in the changes she would have to make if she was going to resume optimal functioning—which would include the rekindling of her libido. If she didn’t stem the chronic draining of her life force by getting adequate rest, exercise, and nutrition, then her libido, like every other aspect of her health, would pay the price. It’s too bad that so many women who have taken on the caretaker role need a doctor’s “prescription” to give them permission to live more healthfully.
HORMONE LEVELS ARE ONLY
ONE PART OF LIBIDO
One of my colleagues underwent a hysterectomy (uterus removed, ovaries left intact) at the age of forty-eight, a procedure that is associated with measurable declines in estrogen and testosterone because the surgery compromises the blood supply to the ovaries. This is the reason given for the fact that many women experience some sexual problems following hysterectomy. But my colleague, who had started a new relationship just prior to her surgery, couldn’t wait to get out of the hospital and back into bed with her new love. She told me, “When you have someone waiting for you whom you’re madly in love with, you can bet you’re not likely to have much problem with desire or lubrication, or anything else.” And that is exactly what research shows. On the other hand, if you are in a relationship that has been problematic for years, a relationship in which you have had little or no interest in sex (perhaps because you didn’t know how to get your sexual needs met) but put up with it anyway, you can bet that your body will do anything it can to keep you from having to get back into that position again. It is well documented, for instance, that unassertive women in dysfunctional sexual partnerships experience limited genital arousal and few if any orgasms. Sexually assertive women, on the other hand, report higher levels of sexual desire, orgasmic frequency, and greater satisfaction with both their sexual and marital relationships.20
Sexual impulses and desire are controlled, in part, by the frontal lobes of the brain, and anything that changes frontal lobe activity can affect libido—in either direction. Frontal lobes are areas of the brain involved in choosing and directing conscious thought. Frontal lobes can also inhibit unbridled desire, channeling it into socially appropriate behavior. In the frontal lobe dysfunction known as depression, libido is often decreased. But in the frontal lobe dysfunction known as dementia, sexual impulses can run rampant, sometimes resulting in socially embarrassing behavior. An example of this is a nun I once treated who had developed an uncontrollable urge to masturbate all the time. Although she was not distressed by this, her community was. She eventually ended up under the care of a neurologist, for dementia.
Changes in libido can, of course, be triggered by declining hormone levels, especially in women who have undergone medical or surgical menopause.21 In my professional experience, however, fading life force is equally likely, if not more so, to be at the root of declining sexual desire. Two influences are universally underestimated in terms of their potential impact on libido: the state of a woman’s relationship with her sexual partner, and her overall emotional and spiritual love for life. And, interestingly, both of these factors may well have the potential to change hormone levels in and of themselves.22
A woman with a strong current of life force, who is in love with her life, who feels sexy, and who knows how to turn herself on, can continue to have a strong libido regardless of what her hormones are doing. This fact is supported by research that shows that the hormonal changes of menopause, per se, are not the cause of decreased libido. In fact, the relationship between hormones and libido may be a chicken-and-egg question, as it seems equally plausible for a faltering life force to be the result, rather than the cause, of a dying sex life.
Researcher and sex therapist Gina Ogden, Ph.D., has shown in her landmark sex survey (Integrating Sexuality and Spirituality, or ISIS) that not only is sex not just physical, it’s not even mostly physical. When women in the ISIS survey described sexual pleasure and ecstasy, Dr. Ogden reports, they used some 5,000 words from the emotional and spiritual realm (such as love or connection), while they mentioned their genitals only twenty-three times. “Another finding that tells me sex researchers have been asking the wrong questions,” she notes. In her book The Heart and Soul of Sex: Making the ISIS Connection (Trumpeter, 2006), Dr. Ogden reports that 47 percent of women say they’ve experienced God during sexual ecstasy, and 67 percent say sex needs to be spiritual to be satisfying. This is not surprising, given that one of the many regions of women’s brains that show activity during orgasm is the region connected with religious ecstasy and spiritual experiences.
Therefore I want to encourage every woman to consider the health and vitality of her connection with life—her connection to Source energy—along with the more conventionally accepted hormonal issues as she evaluates her sex life and the possibility that it may need help at this stage of her life. I also encourage every woman to update her thoughts about her sexual desirability. It’s important to think of yourself as sexy and desirable, even though you may not even be in a relationship right now. Remember, the vibrational quality of our thoughts creates a magnetic field around us that attracts our circumstances to us. A woman who is tapped into Source energy has the power to transform her body-mind-spirit and sexual experience starting with how she feels about herself.
SECONDARY LIBIDINAL SUPPORT:
ESTROGEN AND PROGESTERONE
With all that said, it is possible for a woman to experience a fading libido during and after menopause even if she is involved in a true partnership, one that supports her life force rather than drains it. If a woman is in love with her life, if her life force—a repository for sexual energy—is free-flowing and vigorous, then a weakening libido may be due to secondary, hormonal, or nutritional factors. Factors such as hysterectomy, ovarian removal (or decreased ovaria
n function), and premature menopause (before age forty) may also have an adverse effect on hormone balance.23
As we learn more about the roles of estrogen and progesterone in the maintenance of bodywide functions such as circulation, nerve transmission, and cell division, it becomes clear how declining levels of these hormones may contribute to changes in sexual response in some women.24
~ The entire nervous system is surrounded with estrogen-sensitive cells.25 It stands to reason, then, that a decrease in estradiol levels can have a dampening effect on nerve transmission during sex for some women. Research has shown that estrogen deprivation can lead to actual peripheral neuropathy—a form of nerve dysfunction that makes a woman less sensitive to touch and vibration. Estradiol replacement can restore this sensitivity to levels that approach those seen in women who are still menstruating.
~ Declining levels of estradiol and progesterone can have an effect on a woman’s potential for sexual arousal, sensitivity, sensation, and orgasm, because at optimal levels these hormones increase the flow of blood to the sexually sensitive areas. In other words, a woman’s physical response to sexual stimulation may be slower and less likely to build to orgasm because of decreased speed and volume of blood supply to the sexually sensitive areas, which may in any case be less sensitive than before because of the nerve dysfunction sometimes caused by estrogen deprivation.26 It is also completely possible to learn how to maximize sensation in these areas by consciously spending time learning how to pleasure oneself through genital stimulation.
~ Estrogen levels that are too low can lead to cell atrophy in the genital region, which can cause thinning of the vaginal and urethral tissue, with the result that intercourse becomes painful. Women with estrogen depletion may also experience urinary problems such as recurrent urinary tract infections or even stress urinary incontinence.
The Wisdom of Menopause Page 41
