Women still want sex. Here’s how they can have it.

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First of all, not all older women lose interest. And for the ones who do, it is almost always a function of decreased hormones. Decreased hormones lead to a condition that goes by the absolutely delightful name of “vaginal atrophy.” Yay. How did this happen in an era in which we were not supposed to age? Wasn’t science supposed to take care of aging by now?

Actually, it did. When I was 49 and perimenopausal, my doctor put me on hormones, including over the counter DHEA and Pregnenolone. These are naturally produced in our bodies when we are younger and have the ability to form whichever hormones we are most lacking. She added small dose bio-identical estrogen and a larger dose of progesterone. She also offered me testosterone. But since my libido was just fine, I was still fertile and my 36 year old boyfriend was just keeping up, I turned her down. No need to poke the bear.

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Because of the original flawed study, many women of my generation stopped or never started HRT. We lost all the benefits HRT promised: younger skin, protection against osteoporosis and heart disease, AND an ongoing healthy sex life.

While sex may not be the most important of the losses, it does affect women and their partners to an alarming degree. Like most women at the time, I stopped HRT within a few years, and went through menopause at age 54. I had maintained a fairly active sex life, and did not anticipate that ending. But nearly end it did, when I went to visit my next boyfriend in Philadelphia where he had an art show. It had been a few months since we had see one another. The chemistry was amazing as usual. After the art show we went back to the hotel. At the moment of penetration I screamed, and then I bled. He was traumatized and horrified. I had NO IDEA what was wrong, other than it felt like razor blades slicing the inside of my vagina. Definitely the opposite of aphrodisiac. We limped through the weekend with patience and understanding on his part, and plenty of lubrication from the drugstore. I went straight back to my doctor upon return and demanded, “Hormones. Now.”

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Some estrogen and progesterone later (synthetic this time, but bio-identical are equally effective), the issue was resolved. In addition, progesterone acts as a relaxant, so my sleep improved. And I lubricate like I’m in my 20s.

There has been one issue, but it was of my own making. I ran out of progesterone and took estrogen by itself. According to doctors, this is permissible if you have no uterus. If you do, and I do, it’s a bad idea. No details, but, believe me, you don’t want to do that. Progesterone alone works perfectly well for me. I’ve added DHEA and Pregnenolone back in, so if I need estrogen or testosterone, these hormones can create them. Estrogen can also be added by using a vaginal cream. Small amounts of testosterone in a cream form can increase libido, but I have found that HRT without testosterone does that for me, without the possible side effects of hair growth and a lowered voice. It can help retain muscle mass. If you are in Europe, you can get tibilone, an anabolic steroid which causes a mild increase in estrogen, progesterone and androgen by activating the receptors.

Now, of course, the clitoris is the main orgasmic organ. So if you are a woman who doesn’t need or desire penetration, so-called vagina atrophy is not an issue. Although without HRT, you will still need store bought lubricant to apply to the clitoris during stimulation. But there is more to HRT than vaginal lubrication.

Added benefits to HRT is less pain from joint and inflammation issues, stronger bones, less anxiety, better sleep, protection against heart disease, and the simple joys of feeling womanly. Also more energy, and I could argue, more creativity.

We live so much longer now than we did historically. Perhaps when people died in their 40s or 50s there was a survival benefit to older women, who could no longer reproduce, losing “interest” in sex, so they could solely contribute to raising the next generation. Now, with longer life spans, extended families living far apart, women’s opportunities in general being expanded and science finding ways to extend our youthfulness, we can take advantage of maintaining our fully functioning sexuality for as long as we want.

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If you are a perimenopausal or menopausal woman, or the partner of one, please do your own research. Dr. Christiane Northrup “Women’s Bodies, Women’s Wisdom” is a great place to start. Then talk with your doctor, and start with low dose HRT and gauge the benefits for yourself.

Psychotherapist, Hypnotherapist. Leans Left. Mindfulness practioner before it was cool. M.Ed., LPC. Carolsantafe93@gmail.com. Www.Newsbreak.com/@c/561037

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