I know that changing sexual desire is a big struggle for women as they age. It’s one of the most common complaints I hear from patients at the clinic. Sexual desire is considered to be a life force in many cultures and feeling sexy and desired is a powerful part of being a woman. So when fluctuating hormones during perimenopause and declining estrogen after menopause kick in, it leave women wondering why they feel less interested in sex than they used to be.
Many women come to us with physical symptoms that impact their interest in intimacy or diminish their pleasure, while others are experiencing emotional shifts or unresolved relationship issues that may make sex less appealing with their partners.
We often see that women who have not dealt with emotions from their past, be it from childhood or within their relationships, will find that these unresolved issues emerge and express, sometimes in new or surprising ways. Whether they are totally clear to you or completely catch you off guard, one thing is for sure: these emotions will not be denied and they will call to you for deeper exploration. Left unresolved, research shows that they will very likely impact your health as well as your sexuality.
Women, many of whom have enjoyed a healthy sex life until this point, often come to the clinic distraught and desperate to get their “mojo” back. They may even lament the fact that there is not a female Viagra (actually, there is, sort of. But it’s not your best option. See below), thinking perhaps that popping a pill would make their symptoms go away and make everything ok. (But ask any man on Viagra who experiences its high cost and declining efficacy over time and he will tell you it’s not his preferred solution.)
While we’d all like a magic bullet, we know from working with our patients at the Women to Women clinic that there are no quick fixes. Desire can be restored and the most helpful way to start is through diet and lifestyle changes, nutritional supplementation, and exploration of the relationship and emotional connection of the patient to her partner.
When you develop a symptom such as painful sex, diminished desire, or even surprising feelings and emotional reactions toward your partner, it is your body’s way of getting your attention and showing you what is really going on. There are times that testosterone levels are low and adding testosterone can make a big difference for some women, but that won’t get to the root of the problem. And taking a pill to ignore the message may be convenient, but long-term, it’s much more effective to figure out the cause and treat it. In fact, that’s the only way to ensure your optimal health — and that of your relationship.
The New Female Viagra — How Flibanserin Works
As a health care practitioner who has been helping women to experience the best sex of their lives after menopause for over three decades now, I was intrigued when in 2015, the FDA approved a new drug, quickly dubbed the “female Viagra” in headlines, that pharmaceutical companies claim may potentially improve a woman’s libido. The approval didn’t come easily — the drug had been through two failed attempts prior to gaining the green-light from the FDA.
Flibanserin, which was originally created as an anti-depressant, works on the largest female sexual organ: the brain. Researchers claim it increases dopamine and norepinephrine, the “excitatory factors for sex” and decreases serotonin, which can diminish libido.
Despite FDA approval, I’m not convinced it’s a good solution. Side effects including nausea, dizziness, fatigue, insomnia and dry mouth are most common, but more concerning is the association with hypotension (severely low blood pressure) and loss of consciousness, especially when taken with alcohol. It was these side effects that made the FDA reject the drug the first two tries, and I think they are alarming enough to think carefully before giving it a try.
Still, some women are so desperate to save their relationships they will go to any lengths to regain what they once had. But I just don’t see taking a drug with mixed results and such potentially serious consequences as the answer.
There are so many ways to be loving and intimate in a relationship. Does desire need to be amped up in order to have a sexual relationship? Is there is an emotional connection that might be missing on some level? Have women explored and treated the cause of physical symptoms first, or are they reaching for a quick fix? It makes me wonder. Many physical issues, including adrenal dysfunction, may be at the root of the problem. I believe all these possibilities should be explored before turning to a pill.
The Great Flibanserin Debate – Why It’s About More Than Sex
The debate about approval of flibanserin became quite divisive, and turned into a much broader discussion around gender, sex and society; it’s one that we at marcellepick.com want to weigh in on.
The National Organization for Women, or NOW, felt that approval was delayed because of a sexual bias against providing something to women to enhance sexual pleasure. They went on the record as saying that as a culture, men’s sexual health is extremely important but that women’s is not. There may be some truth to this as there may well be a sexual double standard in today’s society, but we think the reason approval was such a challenge is so much more complex than that. And I am all for women having a libido, and enhancing their sexual enjoyment.
Other women’s groups argued that the primary considerations of drug approval should be safety and efficacy. The National Women’s Health Network, for example, said that the drug doesn’t work well, has some noted safety concerns, and has not been fully studied. They feel it’s about waiting to get a drug that really works — and is safe.
While we are not sure any drug can accomplish that when it comes to sexual desire, because it’s not something that can be fixed with a pill, we definitely agree that if a drug is approved, it should be thoroughly studied first and should be proven to be effective — and safe – both over the long-term and in conjunction with other medications. Though it gained its approval, we simply don’t think that flibanserin meets those criteria.
Before approval was granted, others argued that the campaign for the drug oversimplified female sexuality and we couldn’t agree more: There is so much more to sexuality than the stress hormones dopamine and norepinephrine!
Some women (and men) who experience a waning libido at midlife don’t see it as a problem — at least not one worth taking a drug for. At marcellepick.com, we don’t think you should accept low sex drive as a new norm; we know it can be restored and that with some time and effort, you can experience the best intimacy of your life after menopause. So why settle? But we do agree a drug is not the answer.
We are also concerned that the pharmaceutical industry has a desire to take every circumstance and transition in life and turn it into a disease that needs a pill to fix it. This not only prevents looking at the true source of the problem, it creates a mentality that normal life transitions, such as menopause, are diseases.
The pharmaceutical industry then focuses on the convenience of popping a pill to problem solve instead of practicing what is now being called precision medicine: getting really precise about the root case and its effect and then treating the whole problem. Menopause is NOT a disease and a pill is NOT the answer: adjusting stress hormone levels artificially with a drug is NOT the answer to hormonal shifts that may just need some transitional support.
So while the debate ended in FDA approval of the drug, we still feel strongly that no woman should undertake drug risks without first trying to understand what is going on within her body to cause the undesired reaction in the first place.
How to Get Your Mojo Back
After more than three decades supporting women’s health and healing, we know that there are answers. When your body is out of alignment, it needs extra support. A high quality multivitamin along with an omega 3 supplement supports hormonal balance and symptom relief among our patients; even those who eat healthy diets of fresh local food find they need additional support during the menopause transition.
Diet and lifestyle changes such as stress relief, a good night’s sleep, exercise and movement, and a healthy balance of fresh fruits and vegetables along with high quality proteins and fats can further support this rebalance and accelerate relief, especially when combined with high quality nutritional supplementation.
We also recommend a probiotic supplement to restore the balance of healthy bacteria in your digestive system; it may not seem obvious that your digestion is connected to your hormones, but your ‘second brain’ plays a role in supporting all healthy body functions.
We also believe that it’s important to explore the emotions you are experiencing and use the transition time of perimenopause to examine your feelings, process them and to “speak your truth. “ Menopause is a time of release and clearing: it’s time to let go. Studies have shown that holding onto unresolved and unexpressed emotions will lead to the presence of physical concerns down the road and for many women, this catches up to them at menopause.
With a little time, attention and support, including some hormonal support if needed, you can experience a significant improvement in your health and wellness, restore that hormonal balance, and finally feel like yourself again… All without an untested drug that has numerous side effects.
At our clinic we have helped thousands of women alleviate their physical and emotional symptoms, restore a healthy sex drive and create the best intimacy of their lives. We can help you too.
To learn more about changes in sexuality around menopause, read our article here.
To purchase our menopause support products, including multivitamin and omega 3 support, click here.
