Archive for Sexuality

Yoga Can Improve Your Sex Life

Researchers have found that mindfulness meditation can lead to an increased feelings of relaxation, decreased muscle tension, reduced anxiety and increased self-confidence—all important factors for a healthy sexual response. Research also suggests that practicing yoga asanas stimulates your brain to produce the hormone oxytocin, which is responsible for the formation of emotional bonds and trust.

Mindfulness and the Female Libido

yoga sex lifeSpecifically, the article, “Eastern Approaches for Enhancing Women’s Sexuality: Mindfulness, Acupuncture and Yoga,” by researchers Lori A. Brotto, PhD, Michael Krychman, MD, and Pamela Jacobson, LAc, Dipl OM, cited the benefits of mindfulness meditation, a key component of yoga, to the female libido. They said, “Mindfulness significantly improves several aspects of sexual response and reduces sexual distress in women with sexual desire and arousal disorders.”

Research has shown that mindfulness meditation upon a particular part of the body increases blood flow to that area; and, as we all know, adequate blood flow is key to a healthy sexual response. Scientists have also found that practicing yoga asanas and meditation techniques can increase your abilities to bond emotionally with others.

How Meditation Acts Upon the Brain and Emotions

Furthermore, scientists have found that, when practice is consistent, mindfulness meditation can permanently alter brain function. Mindfulness meditation increases activity in the insula, a region near the front of the brain that plays a role in the physical expression of emotion. The insula is believed to be vital in the processing of empathy, and the perception of the emotional states of others.

Richard Davidson and Antoine Lutz, two researchers at the University of Wisconsin-Madison, believe that repeated stimulation of the insula through mindfulness meditation can lead to a lasting increase in the ability to feel the positive emotions of love and compassion. If increased feelings of love and compassion can improve our daily interactions, then it can also improve our sex lives, as a stronger connection with a sexual partner means a more powerful sexual experience.

Yoga Exercise for Better Sex and Relationships

Research has found that yoga asanas and mindfulness meditation can increase feelings of relaxation, self-confidence and well-being while decreasing muscle tension and anxiety and stimulating the secretion of oxytocin, a hormone that enhances feelings of trust and emotional bonding. According to recent research published in The Journal of Sexual Medicine, mindfulness meditation can enhance blood flow to specific areas of the body and help women to cope with sexual dysfunction. And, of course, yoga will make you more flexible, too.

 

Vagina

The vagina serves as a passage for the exit of menstrual flow, insertion of the penis during sexual intercourse, reception of semen, and is the birth canal.

Anatomy
The vagina is a canal that extends from the external vulva to the cervix. The vaginal walls can be easily distended but are normally 7.5 cm in length anteriorly and 9 cm long posteriorly. The upper portion of the vagina encircles the vaginal part of the uterine cervix. The vagina touches the empty bladder on the ventral and superior surface. Inferiorly the vagina adheres to the posterior wall of the urethra and opens adjacent to the labia minora. The vaginal lining has many transverse ridges, or folds.

Vaginal tissues receive blood supply from uterine arteries and sometimes branches of the internal iliac artery. Blood returns to the venous system through veins that empty into the internal iliac veins. Lymphatic drainage is via the external and internal iliac lymph nodes and superficial inguinal lymph nodes. The muscles of the pelvic floor provide important support to the vagina and uterus.

The vagina is moistened by primarily by mucous secretions from the cervix. Secretions from the vaginal epithelial cells containing glycogen and water also play a role.

Histology
The vaginal wall is made of three layers: a mucosa, muscular layer and an adventia. Vaginal epithelium is stratified squamous epithelium having a thickness of 15-200 microns. Intense keratinization like that seen in the stratified squamous epithelium of the skin is not seen, although some keratin is found in vaginal epithelium. Estrogen causes the epithelium to thicken, differentiate and accumulate glycogen. This glycogen is found within the vagina when the epithelial cells slough off. Vaginal bacteria metabolize the glycogen to lactic acid, causing the typically low pH of the vaginal environment. Loose connective tissue with many elastic fibers is found underneath the vaginal epithelium. A rich vascular supply is the source for vaginal moisture during sexual stimulation. Vaginal muscle is mostly smooth muscle oriented longitudinally. However, there are some circular bundles. The outer layer, the adventia, is made of dense connective tissue with many elastic fibers, extensive nervous supply and venous capillaries.

Vaginal Cycle
Cytologic examination of the cells exfoliated from the vagina yields information of clinical importance. In experimental animals, such as the rat, the exact stage of the estrous cycle can be determined by microscopic examination of vaginal smears. In humans, the ratio of different cell types and their morphology can be used to determine the hormonal status of the patient and can be useful in the early detection of cervical cancer. Vaginal smears can distinguish between the follicular phase and the luteal phase.

In post menopausal women, the vaginal epithelium becomes very thin, the blood supply to the vagina is reduced, and the cervical glands regress so that the vaginal wall can become weak, dry and itchy. Exogenous estrogen is often prescribed (oral, patch, or cream) to reverse the effects of estrogen withdrawal on the vaginal epithelium. In addition, vaginal moisturizers may be helpful, especially prior to sexual relations to compensate for lack of moisture.

Pathology
The vagina can become host to various infectious organisms including bacteria, fungi, protozoa and viral agents, most of which are sexually transmitted diseases. Treatment depends on the causitive agent.

Sexually Transmitted Diseases (STDs)

Some 56 million Americans have an STD other than AIDS and many more are infected each year. The causative bacterial, viral, or parasitic agents are spread primarily by sexual contact, but may also be spread by the use of infected needles. Some STDs are chronic infections, but many can be cured. Quick diagnosis and treatment are often the keys to cure.

The only 100% prevention is abstinence. Maintaining faithful monogamous relations with one’s spouse is effective, provided both partners are free of STDs. Safe sex (use of a condom) with a monogamous partner is the next best protection against STDs. Always remember that prevention is better than therapy.

Bacterial:

Gonorrhea
Gonorrhea (“clap”), a common disease worldwide, is caused by the bacteria Neisseria gonorrhoeae. There are over 650,000 new cases in the U.S. each year. 82% of cases of gonorrhea occur in teenagers and young adults, and females are twice as likely to become infected after one act of intercourse with an infected male as males are after one act of intercourse with an infected female.

Symptoms occur within a few days of exposure and include urethral or vaginal discharge and frequent and painful urination. Bacterial culture confirms diagnosis. Gonorrhea requires antibiotic to resolve, so see your doctor for appropriate diagnosis and treatment. Penicillin used to be the drug of choice but many strains have become resistant. Sexual partners should be treated and intercourse avoided until the infection is cured. Untreated gonorrhea can damage the heart or cause a form of arthritis.

Chlamydia
Chlamydia is caused by the bacteria Chlamydia trachomatis. Infection with chlamydia is often concurrent with gonorrheal infections. Chlamydia is the most frequently reported and fastest spreading STD in the United States. More than 3 million men and women in the U.S. are diagnosed each year.

Males typically experience painful and frequent urination and a urethral discharge 7-21 days after exposure. Females often do not have any symptoms and the infection is discovered in conjunction with a gonorrheal infection. Chlamydia requires antibiotics to resolve. A physician should be consulted for appropriate diagnosis and treatment. Sexual partners should be treated and intercourse avoided until the infection is cured.

Pelvic inflammatory disease
Pelvic inflammatory disease is a complication of gonorrhea or chlamydia. It is an infection that generally involves the uterus, fallopian tubes, or pelvic area. Symptoms vary but usually include abdominal pain and tenderness, fever and vaginal discharge.

This is a very serious infection and requires antibiotics to treat and may also require hospitalization. A doctor should be consulted for appropriate diagnosis and treatment. If untreated or inadequately treated, it may result in infertility and/or sterility.

Syphilis

There are more than 70,000 new cases of syphilis each year in the U.S. caused by the spirochete bacteria Treponema pallidum. The risk of infection with syphilis after a single exposure is ~50%. Syphilis has four clinical stages — primary, secondary, tertiary and congenital (passed from mother to baby). The primary stage occurs between 10 and 90 days after infection and causes an ulcer at the site of infection. The primary stage is highly infectious. Secondary syphilis occurs about 6 weeks after the primary stage and causes a rash all over the body, fever headache, loss of appetite and joint pain. The tertiary form of syphilis has many different forms and may present without any external signs or symptoms. If untreated, the third stage, can affect the heart, brain or other vital organs.

Syphilis is usually diagnosed by a blood test, The disease can cause many problems in all areas of the body including the heart, brain, skin, bone, upper respiratory tract and liver. Syphilis requires antibiotics to resolve. Consult a doctor for appropriate diagnosis and treatment.

Bacterial vaginosis
This is a vaginal bacterial infection caused by several bacteria that are normally harmless. Signs and symptoms include malodorous vaginal discharge, but you may or may not be symptomatic. This infection requires antibiotics to treat. Consult a doctor for appropriate diagnosis and treatment.

Protozoal:

Trichomoniasis
Trichomoniasis is a readily curable infection caused by the protozoa Trichomonas vaginalis. Common signs and symptoms include a mild to severe malodorous vaginal discharge, intense itching and painful urination; males may not have any symptoms.

Trichomoniasis requires antibiotic therapy, so see your doctor for appropriate diagnosis and treatment. The drug of choice is metronidazole (Flagyl®). It is very effective but may produce several side effects. Both partners should be treated.

Viral:

Genital Herpes
Genital Herpes Information

Human Papilloma Virus (HPV)

Some 5.5 million new cases of HPV infection are reported each year in the U.S.. Twenty million Americans, men and women alike, are infected with this virus. HPV is a double stranded DNA virus that is the causative agent of genital warts. There are more than 65 types of the virus. Infection with specific types of HPV can lead to neoplastic changes in genital epithelia. The lesions are usually papules or plaques that may be hard to see. In women, the infection may be intravaginal or cervical. If the cervix becomes affected, cervical cancer can result. Because of the contagious and possibly neoplastic nature of the infection, treatment is necessary.

Destructive treatment includes removal of the warts by the use of lasers, freezing or burning. Some medications may be applied by a physician (podophyllin, trichloracetic acid) or the patient with proper training (podofilox, imiquimod), but there are some side effects. These include pain, burning, inflammation, skin erosion, scarring, erythema and the medications should not be used during pregnancy. There is no cure and the warts may recur at any time. Patients with genital warts are also at risk for other STDs.

Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)
HIV is the virus that causes AIDS. Some 900,000 Americans are estimated to be infected with HIV with 45,000 being added each year. The most common risk factor for this disease is homosexual relations (male-to-male). In addition, the virus can be spread by heterosexual relations or by blood transfusions, although these are less common. Thus HIV infections are preventable.

HIV is a virus that affects the human immune system, specifically T-helper cells that have a CD4+ marker on their surface. These T-helper cells normally function to protect against infection.

When HIV enters one of these cells, it is protected by a capsule. This capsule breaks open and a single strand of RNA is released along with an enzyme called reverse transcriptase. Reverse transcriptase than converts the single strand of RNA into a double strand of DNA. This DNA is then incorporated into the normal cellular DNA. The rest of the immune system does not respond because the virus is inside the cell. The HIV virus has taken over the cellular machinery and forcing the immune system to make millions of copies of the HIV virus. Infected persons frequently succumb to opportunistic infections.

Clinically, HIV presents with flu-like symptoms, and then the symptoms go into dormancy but the virus continues to replicate. As the amount of HIV virus in the body increases, the immune system is further impaired and opportunistic infections become more common. Some of the most common infections include thrush (fungal infection), Kaposi’s Sarcoma (cancer), pneumonia, recurrent herpes infections, and in later stages severe bacterial, protozoal or fungal blood stream infections.

There are many medications available to help slow the progression of HIV, however no cure is currently known. If you have questions and also for appropriate diagnosis and treatment, talk to a doctor.

Safe Sex

Sex can be part of any stage of a woman’s life. Many women may not have a partner, some may be in same-sex relationships or may have a  partner with ill health.

The key to enjoying a fulfilling sexual relationship as is understanding ourselves and our partners, and growing with and accepting each other.

As we age we’re constantly developing and changing, but there are some things we can expect to enjoy as much as always and, thankfully, taking pleasure in a loving and caring relationship is one of them. And yes, that can include sex. But as we grow older our attitudes towards, and desire for, sex can change.

It’s important to remember, regardless of your stage of life, enjoying a sexual relationship is not purely about sexual intercourse. It’s about thinking and feeling sexy, touching, kissing, caressing, cuddling, and talking about sex. While many older couples might report their sex drive has diminished, they’re usually referring to their desire for intercourse. They  still love, touch, hug and caress, and perhaps even masturbate.

It’s normal for desire to fluctuate, and while there may be many reasons for this, as we grow older the hormone changes associated with menopause may influence desire and arousal for many women. Remember too that a man’s libido may be influenced by age, illness, stress or  medication.

Oestrogen loss at midlife causes much of the discomfort (eg vaginal dryness, loss of vaginal elasticity or contact bleeding) that can occur during intercourse. This can create a negative association with sex. Water-based lubricants or oestrogen cream applied locally may help to relieve these symptoms. Lower oestrogen can also influence our perception of touch, and may decrease muscle tone and elasticity of the pelvic floor. Hot flushes and night sweats can impact on sleep, which may make women tired and  lethargic and uninterested in sex.

For those who weren’t brought up with safe sex warnings, there’s one simple rule to remember – no condom, no sex!

The good news is that simple lifestyle changes can ease symptoms. Changing what you eat, being more physically active, trying a lubricant and seeking advice from a health practitioner may offer some relief. Talking to your partner about the changes you’re experiencing can also help, as it not only lifts some of your anxiety, but may help your sex life. Studies of women who have used oestrogen and progestogen therapy have found vaginal dryness improves and overall the vagina, vaginal walls and  cervix improve in  elasticity and thickness. Another factor, increasingly relevant to some women as they age, is changing sexual partners. With the high divorce rate and women outliving men, some women find themselves facing new relationships at an older age. Until menopause is reached women are not totally protected from pregnancy, despite the decline in fertility during perimenopause. The safe sex message is just as important at  this time.

The risk of Sexually Transmitted Infections (STIs), including HIV, remains a lifelong concern and knowledge of safe sex practices, including the use  of condoms and other preventative measures, is  important.

Being born before the age of HIV and other sexually transmitted diseases, such as herpes and the rapidly spreading Chlamydia, many older women commencing new relationships for the first time in 25 years forget about applying safe sex rules. For those who weren’t brought up with safe sex warnings, there’s one simple rule to remember – no  condom, no sex!

Once you understand the changes your body experiences as you age, which can influence your sexual drive, and are comfortable in knowing how to  deal with those changes, there is no physical reason why you can’t enjoy a safe, happy  and satisfying sex life. And the good news is that many women actually find that with age their sex lives improve as they become more comfortable with their bodies and who they are.

It is important that society frees older women from sexual taboos, stereotypes and misconceptions as a way of trying to control their sexuality and sexual behaviour. With information and support, women can challenge negative social attitudes and continue to  enjoy and express their sexuality in their own way.

Ten Safe Sex Rules

It’s not who you are, but what you do that puts you at risk of an STI.

  • A sexually transmitted disease (STI) can be spread from one person to another during unprotected sex – including the first time you have sex or the 100th.
  • Condoms are an effective barrier against most STIs. This includes HIV as well. Some STIs, such as herpes, genital warts and pubic lice, may still be spread even if a condom is used. Remember, condoms are useful for preventing pregnancy as well!
  • An STI (which includes HIV, genital herpes & warts, chlamydia, gonorrhea, trichomonas, pubic lice, syphilis and hepatitis B) is an illness or infection that can be spread from one person to another during sex. HIV is a virus that can be transmitted through unprotected sex with someone who has it.
  • Safe sex is sex where semen, vaginal secretions or blood are not exchanged between partners. The exchange of these body fluids can occur with the following sexual activities: vaginal sex, anal sex, oral sex, oral anal contact, fingers or objects in vagina or anus if they have these fluids on them.
  • Unprotected sex with your regular partner will only be safe as long as both partners are only having sex with each other.
  • Withdrawal (pulling out before ejaculation) is not safe because sexual fluids can be released before ejaculation (known as pre-ejaculatory fluid).
  • There are some STIs that are able to be transmitted through unprotected oral sex, including herpes and gonorrheae.
  • If either you or your partner have an STI, you need to practise safe sex to minimise the risk of becoming infected. See your health practitioner for further advice.
  • Lesbians are at risk of STIs. Anyone can catch an STI, whatever their sexual orientation. Practise safe sex by avoiding contact with your partner’s body fluids to reduce your risk of sexually transmitted infection. Use dental dams if you are having oral sex. Dental dams are small sheets of latex rubber that act as a shield between the vagina and the mouth.
  • You cannot tell if a sexual partner has an STI. A strong and healthy person may still be infected. Some people may not even know they are infected. You risk getting an STI from any partner who has had, or is having, unsafe sex with another person.

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Libido

Your libido is your sexual interest and desire. Loss of libido may be experienced by women before or after menopause and may result in reduced desire and sexual experiences that are no longer satisfying or pleasurable. Loss of libido is a very sensitive issue and often occurs because of stress, tiredness, relationship difficulties, or mood problems. It can also be caused by a variety of medications used to treat unrelated conditions.

Rest, relaxation, recreation and exercise can all have positive effects on libido, as well as health, bones, moods, and general wellbeing. With greater awareness, knowledge and discussion about sexual health issues, more women are seeking advice for low libido from health practitioners.

The factors that do influence libido are discussed by psychologist, Dr Mandy Deeks PhD, in her “10 tips for understanding and improving your libido“.

10 tips for understanding and improving your libido

1.  What influences your libido? Hormones, illness, medication and the state of your relationships can all influence your libido. Your personality and history of sexual realtionships, as well as society’s expectations and attitudes to sex, can also play a part. Is there one thing that has influenced your libido or many things?
2. Assess your own libido Some people want to participate in sexual activities all the time, while others never think about it and wouldn’t care if they never had sex again. Low libido is only a problem if you perceive it to be so. If your libido level worries you or is very different to your partner’s and causes you distress, you may want to seek some advice as to what you can do about it. Ask yourself what level of libido would you be happy with?
3. Why do you have sex? Lust or desire is only one reason why we have sex. Sometimes we do it to create intimacy, or because it’s fun and pleasurable. Sometimes it’s because we it makes us feel special, or to reproduce, and sometimes even to avoid conflict. Think about the reasons you have sex.
4. As time goes on  When we first get together with our partner there is often lots of sex and intimacy, but it’s natural for desire levels to fall away after the ‘honeymoon’ period. It’s very important to understand this and know that there is nothing wrong with you if the desire levels fall over time. Has your desire for sex fallen with time? How do you feel about this?
5. Understand the physical We often have sexual relationships without really knowing what happens to our bodies when we become intimate. When we experience a problem with sex it can be helpful to understand what happens physically during sexual activity, where things can go wrong and what we can do to improve our sex life.
6.  Is there a difference between men and women Many women (not all) prefer talking, emotional intimacy and being romanced to sex. Many men (not all) tend to be less affected by a bad day or fatigue, and respond to spontaneity, visual stimulation, or just having a willing partner. It can be helpful to understand these generalisations and discuss any differences in libido with your partner.
7. Stop comparing Don’t worry about when or how often others have sex. What’s important is whether you and partner are happy with your level of sexual activity. Do you compare?
8. Watch out for depression and anxiety One in five Australian adults experience anxiety or a depressive disorder, which can impact negatively on libido. If you’re suffering from a mood disorder it’s important that you seek help. Is your mood impacting on your sex life?
9. It’s okay not to always feel desire when you have sex: put time aside for sex  It’s ok to have sex even if you don’t feel lust or desire. It can be important to put time aside for a date night and sex for example. Remember there are many reasons to have sex: because it creates intimacy, it is pleasurable etc. The important things are that there is no coercion, abuse or pain and you find sexual activity enjoyable.
10. Seek help if you need to If you’re worried about your libido or it’s causing you problems, seek professional help, either alone or, if appropriate, with your partner, from a health practitioner or specialist psychologist.

Dr Mandy Deeks PhD, The Jean Hailes Foundation for Women’s Health

Because libido is dependent on so many things it is worth paying attention to them. These include what we think about our partner (if we have one), our own body image, what’s going on in our lives and our past experiences with sex.

Testosterone is one of the factors that affect libido. Sometimes added testosterone in the form of a cream or implant is suggested, although this has yet to be approved formally for use in women and further research is needed. There are many good books available and a consultation with your GP or a psychologist may help.

The important thing to remember is that just because one person has a lower level of libido than their partner doesn’t necessarily mean that something is wrong with them – it is only when it’s viewed as a problem that further help can be sought.

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Lesbian Health

Many of the health issues experienced by lesbians at midlife are the same health issues experienced by heterosexual women, however, as we live in a homophobic world where lesbians are largely invisible, other issues may impact negatively on general health and wellbeing. Midlife presents challenges and changes that for many of us bring welcome relief, whilst for others it may be a difficult time. In order to remain healthy at midlife, we need to take care of our whole selves, not just our physical needs. This includes nurturing our physical, emotional, spiritual and psychological selves.

Because of past negative experiences with the health system, some of us may be reluctant to seek out information and assistance from health professionals at midlife. Although this is understandable, by not accessing health services we may be putting our health at unnecessary risk.

It is often difficult to find a practitioner who is sensitive to our needs as lesbians or one who even acknowledges our existence. If you feel uncomfortable with your health practitioner, remember it is your right to find one with whom you feel safe and respected. This may be difficult if you are living in a rural or remote location where the choices available to women in the city are simply not present. In an attempt to find a sensitive practitioner, it might be useful to contact a women’s health service. Many women’s health services in all states and territories have toll free phone numbers and usually have links with lesbian sensitive services/practitioners and agencies. These services also have libraries and have a selection of lesbian books and articles, which may be of interest.

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Contraception

Until menopause is reached women are not totally protected from pregnancy despite the decline in fertility during perimenopause.

Effective, safe and appropriate contraception is available if a woman does not want a pregnancy.

Hormonal methods such as The Pill (new low dose preparations are very appropriate), Implanon (a progesterone rod inserted under the skin which lasts for three years) and Emergency Contraception, sterilisation and barrier methods such as condoms or the diaphragm are some of the options available.

The risk of STIs (Sexually Transmissible Infections), including HIV, remains a lifelong concern and knowledge of safe sex practices, including the use of condoms and dental dams, is important.

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Sexuality

Sexuality is a broad concept and is much more than ‘having sex’. It is a potent force in the development of each of us and can contribute significantly to our quality of life, our personal fulfilment, and our emotional and physical health.

Sexuality continues to play an important role in the health and wellbeing of women across their entire life span.

Although we do experience physical changes in our bodies as we get older, there is no reason why enjoyable and fulfilling sexual relationships cannot continue.

Remember that your sexuality belongs to you and it is for your pleasure. Whether you are alone or with a partner, you will still have sexual needs and desires. No one can define your sexuality for you. It is up to you to express this part of your life in a way that is right for you.

Safe Sex

Fundamentally, age is no deterrent to good sex. More…

Libido

Libido is about your sexual interest and desire. More…

Relationships

For some women midlife is a time to spend together and relax in the comfort of the relationship. More…

Contraception

Until menopause is reached women are not totally protected from pregnancy. More…

Lesbian Health

Many of the health issues experienced by lesbians at midlife are the same health issues experienced by heterosexual women. Others are not. More…

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Relationships

Many women express mixed feelings about the relationship they have with their partner.

For some women midlife is a time to spend together and relax in the comfort of the relationship. Others may be in a relationship with little communication and support because the partners may have grown apart over the years.

Changes associated with menopause can and do affect sexual relationships. Changes to the vagina (vaginal dryness and thinning of the vaginal wall) as a result of menopause can mean women are less likely to want penetrative sex because of associated pain and low libido.

It is important that women talk about these experiences and seek help when necessary. A woman needs to talk to her partner about these changes so the danger of miscommunication is avoided.

Sometimes male partners fear hurting their partner. Rather than ignoring the problem, it is better for the relationship and future sexual experiences to discuss the physiological and emotional changes that may result from menopause.

Improving the Relationship with a Partner

One of the most important things is to discuss your problems openly. Treat each other as friends and plan things to do together. Vary the routines of what you do together.

There are many ways two people can be sexual with each other that do not involve penetrative sex (use your imagination). Both partners could read relevant books and other resources.

Talk about the changes and issues with other women friends. Seek out a psychologist who specialises in working with couples.

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Testosterone

Testosterone and other related hormones in the body (also known as androgens) play important physiological roles in women.

It is generally known that androgens are important for muscle and bone strength and for growth of normal body hair. But androgens may also have important positive effects on mood, wellbeing, energy and vitality in women.

The most well-known and potent of the androgens is testosterone. This hormone is produced by the ovaries and the adrenal glands, and in other parts of the body from hormones made by the adrenal glands and the ovaries, particularly from a hormone called DHEA which also circulates in the blood as DHEA-sulphate.

There is a major fall in oestrogen and progesterone over 3-4 years at menopause; however, testosterone levels start to drop in women in their younger reproductive years. This means that a woman in her forties has on average only half of the testosterone circulating in her blood stream as does a woman in her twenties, however this can vary between individual women. There is almost no change in testosterone levels at the time of natural menopause. There is only a very gradual decline in testosterone after a woman has reached her sixties. If a woman has her ovaries removed by surgery, however testosterone levels can fall afterwards by up to 50 per cent. Blood levels of the hormone DHEA-sulphate also fall during a young women’s reproductive years and continue to fall across a woman’s life span.

Testosterone and libido

Libido and sexual function are complex and relate primarily to lifestyle and relationship issues; however some studies have shown that for women at menopause who are experiencing a loss of sexual interest, various aspects of sexuality may be improved with testosterone therapy, with or without oestrogen. One small study also indicates that testosterone therapy will improve sexual interest and wellbeing in premenopausal women presenting with low libido, but further research is needed.

A study of Australian women recruited from the community, and without any complaint about their sexual function, has now shown that low sexual desire, arousal, responsiveness and other aspects of female sexuality recorded in the questionnaire are not significantly related to low testosterone levels. However women who are distressed by their low sexual function may be found to have low testosterone levels for their age.

Summary

There are further research questions to be answered on the use of testosterone therapy in women. In the meantime, any woman considering testosterone therapy should have her blood hormones checked to ensure that her testosterone level is not above a level that would increase the risks of treatment side effects and needs talk to their health practitioner to gain a clear understanding of what is, and is not, currently known about this therapy.

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