Fifty Shades of Grey

Fifty Shades of GreyIt’s either a guilty pleasure or an example of subservient sexploitation. Or both. One thing is certain – Fifty Shades of Grey, E.L. James’ bestseller has people thinking about sex, maybe in a new way. If you’re able to consider it objectively, the book and all the talk about it can have a significant benefit, especially to many of my patients. Let me tell you why it makes sense to suspend judgment on the politics of the sexual relationship at the core of the story, to consider its value.

It’s no secret that many post-menopausal women struggle with a lack of sexual desire and the physical changes that may make intimacy difficult. Hormone production changes mean a decreased libido; and that’s the plain and simple science of it. But thankfully, that’s not the only factor in sexual appetite. For many people, the suggestion of new positions, scenarios and roles can stimulate an interest in sexual activity. In the case of Fifty Shades, the themes of domination and submission are explored, which isn’t really a new concept. It is a bit groundbreaking, however, for that kind of sexual role-playing and its impact on a relationship to be featured in something it seems that everyone is reading.

The allure of sexual fantasy has long played a part in ramped-up excitement levels, even if never overtly expressed. Therapists and other professionals have promoted role-playing for years. The difference now is that Fifty Shades of Grey has got us demanding it from our libraries and openly discussing with our book clubs.

It’s enough to make any reader (or eavesdropper of readers) curious, and that is such a positive result, especially for anyone struggling with the loss of interest in sexual activity. Think about it. And then think about it some more. Thankfully, we’re complicated creatures when it comes to intimacy. Some people may have trouble getting beyond the taboo nature of the domination/submission scenario, and that’s a shame. For my patients, especially those who have struggled in a post-menopausal sexual interest-free zone, this book may be just what they need.


Interested in women’s sexual health? Contact us for an appointment.

Menopause PhysiciansThese days, it seems like hormone “treatment centers” are popping up all over the place, and online “pharmacies” are constantly pushing the latest and greatest hormones for menopausal and postmenopausal women. But what about the woman who is looking for individualized evidence-based counsel and care to help guide her through the menopause transition? Why is it so hard to find a physician who specializes in menopausal medicine?

Part of the reason dates back to the Women’s Health Initiative, a first-of-its-kind, 15-year study that included a trial on the effects of combined (estrogen-progestogen) hormone replacement therapy. Before the trial’s abrupt end in 2002, menopause care was a developing area of medicine, with a growing number of continuing education classes being offered to healthcare professionals, and the use of hormone therapy among postmenopausal women on the rise. But then the combined hormone therapy arm of the study was cut short—four years ahead of schedule—and news quickly spread of its controversial results.

Results showed that women taking the estrogen-progestogen combination had a greater incidence of breast cancer, heart disease, stroke and blood clots—risks that far outweighed the benefits of hormone therapy. With this news, everything stopped. Patients were advised to discontinue treatment. Physicians were afraid to prescribe anything.

Unfortunately, the publicity surrounding the combined therapy results overshadowed the positive results of the estrogen-only therapy, which did not show an increased risk of heart disease or breast cancer. But the damage was done. The topic didn’t get much attention after that. And the impact on physician education was significant.

Ten years later, views on hormone therapy continue to evolve. For instance, recently released guidelines from the North American Menopause Society (NAMS) indicate that many women can safely take hormone therapy. (To view the latest NAMS recommendations, click here. But I suppose some physicians are still a bit gun-shy about what remains a controversial topic in the media and even the medical community—despite the rapidly growing number of women seeking menopause care.

The fact remains, however, that the alternative treatment options—the online pharmacies and “hormone houses”—are no substitute for evidence-based medical care by a certified menopause practitioner. Menopause treatment is highly individualized and requires a patient-focused approach to care.

So do yourself a favor, and seek out a healthcare professional specially trained in the care of women during menopause. If you live in or around DC, I’d love the opportunity to partner with you in your care. And if you’re not local to DC, simply visit the NAMS website to find a certified menopause practitioner near you.


Interested in women’s sexual health? Contact us for an appointment.

Sexual HealthDid you know that the female sexual response changes throughout a woman’s lifetime? It’s true. When a woman is young and in love, her sexual response is drive in great degree by desire, meaning she is much more likely to seek out and be receptive to sexual activity.

So what causes this change in sexual response? It’s mostly due to hormonal and physiological changes that take place as a woman ages. And while a change in sexual response isn’t a problem in and of itself, it can often lead to worry for the partner. Men may think that their partner’s feelings for them have diminished. That’s why it’s so important to keep the lines of communication open and educate your mate about the changes you’re experiencing.

There are times, though, when lack of desire, arousal or orgasm is a serious issue that needs to be addressed by your physician. In fact, this is probably more common than you think, as an estimated 44 percent of women experience sexual dysfunction at some point in their lives. The good news is that there are low-risk, non-complicated hormonal and non-hormonal options for women that can bring back that loving feeling. Watch for an upcoming blog, which will discuss these options in greater detail.


Interested in women’s sexual health? Contact us for an appointment.

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