Dr. Cheryl Woodson

Woodsonian Informational Thoughts From Thursday. Staying Frisky after 50 – Pt 2

There are many approaches to improving your sex life, with or without medicine.

Drug-free options

Doctors can prescribe vacuum devices that draw blood into the penis, generating a stronger erection without medicine. Penile rings keep the blood in place, sustaining the erection, but this may compromise inflow of new blood, decrease oxygen delivery, and cause irreversible damage. It is unsafe to use a penile ring for more than 4 hours.

Drug stores carry a variety of water-based lubricants to provide short-term relief of vaginal dryness. Women can produce more long-term results without hormones, by inserting a 400 iu capsule of Vitamin E into the vagina every day.

Hormone replacement
Estrogen (female sex hormone) improves vaginal dryness. In nature, estrogen never works without its companion hormone progesterone. Unless you have had a hysterectomy, be sure you take these hormones in combination, to decrease your risk of cancer of the uterus. If you have a history of breast cancer, you should not use estrogen.

Levels of testosterone (male sex hormone) decrease as men age. This has little effect on erections, but it can affect desire, energy levels, and the over-all sense of well-being. Women produce androgens (testosterone-like hormones) as well as estrogen, and low testosterone levels may also decrease desire in women. Doctors disagree about whether the risks of testosterone therapy outweigh the benefits for both sexes. Most worry that treatment raises cholesterol levels, possibly, increasing the risk of heart disease. There is no evidence that testosterone supplements cause prostate cancer, but most doctors agree that men with this history should not take testosterone.

The amount of testosterone used to improve libido in women is MINSCULE compared to the amount prescribed for men. Women should NEVER use “just a little” of a man’s prescribed dose. Excess hair growth, aggression, and acne can occur, but there are other dangerous physical changes that may not be irreversible.

PDE5 inhibitors (like Cialis, Levitra, and Viagra) are drugs that increase blood flow to the penis. This improves erections, but can cause severe drops in blood pressure, especially if the man also takes nitrates for heart disease. As with vacuum devices, an erection that lasts more than 4 hours is a medical emergency. Urologists (specialists in male sexual function and urinary function for both sexes) offer other medical managements for erectile dysfunction.

Traditional health professional training focuses on anatomy, mechanics, and risks, without addressing ways to support healthy sexual function. The American Board of Sexology lists criteria for becoming a certified sex therapist, but the education and experience required for licensing varies state to state. Some states do not require a license. Be careful and really investigate before choosing a sex therapist.

I believe it is best to start with a thorough physical examination. Then, ask your primary care doctor for a referral to a urologist, or a reproductive gynecologist like my good friend Dr. Barbara Soltes (Rush Medical Center, Advocate Christ Hospital and the Center for Women’s Health in Palos Heights.)

The key to sexual satisfaction in the second half of life is to understand the changes of normal aging and commit to enjoying the journey, at least as much as the end goal. Intimacy is key. Even if men worry about sustaining erections, they must resist the urge to rush through foreplay, taking more time to arouse their partners. Women need to get treatment for vaginal dryness, and both must realize that penetration is not the only way to share satisfying intimacy.

Stop blaming each other; overcome embarrassment, and seek advice a qualified professional who will make a plan that works for you and your partner.

ALL THROUGH NOVEMBER, we will Celebrate National Alzheimer’s Awareness and National Caregivers’ Month on Mondays and Thursdays. I am blessed and privileged to also offer Wisdom on Wednesdays-guest blogs from experts in special topics. Stay tuned.

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