Menopause - The Pause That Refreshes! Unless you lied through your teeth to get in here, presumably every woman reading this has personally experienced puberty. We can all remember going from having basically no sex hormones to raging hormones. You know that eighth-grade year where you don't remember a single thing about school because your brain was too busy coping with the onslaught of all those nifty, life-changing chemicals in your bloodstream? Remember the training bra thing? And tampons! But what about menopause? Not there yet? Not even thinking about it? It may be years in your future or right around the corner - or parked in your front yard - but it's never too soon to learn a how to help keep your health, libido, and sexual enjoyment intact and functional well through your menopausal years and beyond. An Historical View At the turn of the century, women who experienced menopause knew not only that 'the end' was approaching, it was often literally very near. What your mother, grandmother and great-grandmother's generations likely knew of menopause, drawn from their experiences of previous generations of women, was that post-menopausal life offered most only depression, fatigue, forgetfulness, incontinence, senility and, finally, death. As Western culture has become increasingly youth-centered over the past century, menopause has loomed ever larger. It can often seem that that everything that is exciting and of value is done by or happens to young people, and that includes sex. For a long time, it seemed that there were only two choices for a postmenopausal woman: she could be a quiet little old lady or a crotchety little old lady. Either way she would end up being sexless, unproductive, and dependent. Menopause became associated not only with the fear of death, but the newly manufactured fear of not being young. At the same time all this was going on, the American woman's lifestyle and diet were changing. Automobiles meant less exercise, washers and dryers meant less exercise, vacuum cleaners meant less exercise. Canned and frozen foods meant more convenience but less nutrition. And, acceptance into the workplace meant more economic freedom but also more stress in addition to maintaining a home and child rearing. The result of all this is generally less physically active, more poorly nourished and highly stressed women facing a turning point in their lives that they have been taught is not only difficult but the beginning of the end. But at the same time, due to advances in medicine and changes in lifestyle, women are living an awful lot longer. In 1900, the average life expectancy for an American woman was 48 years. Today, the average life expectancy for an American woman is 84. Most women today experience menopause between ages 45-55. As the century went on, there were an increasing number of women who were living as long following menopause as they did before it, and as a result, the symptoms of menopause became an increasing subject of concern.

Marcia Jones Marcia Jones is the Founder and Director of The Dixie PMS & Menopause Center, an international women's holistic health resource group that has been in operation since 1993, educating and empowering women about their reproductive health.  Marcia is also a  Scorpio (Libra rising, Cancer Moon) for whom sex has been an important part of life ever since she hit puberty lo these many years ago.   Marcia enjoys sharing what she has learned with gusto.   Please feel free to: E-mail the Health Goddess

Menopause, a natural part of a woman's life like puberty and childbearing and rearing, came to be seen and treated with extreme negativity as a disease that needed to be 'cured.' Without getting into gender politics, we can simply say that in the eyes of the Western medical community, which takes (young) bodies of childbearing age as its "norms," menopause has come to be widely viewed and treated as a health problem or a disease stemming from loss of sex hormones.

When Western medicine decided that menopause was simply a hormone deficiency problem, the "logical" response was to find a pill to make it go away. Going through menopause? "Here, honey," says the ever-solicitous medical profession, "Don't you worry about a thing. We can cure that -- have a nice big dose of estrogen! Can I get you a fresh patch?"

Other Cultures, Other Ways of Thinking

In some other cultures, however, menopause is celebrated. It is a joyous event. Just like adolescence is seen as a transition from being a child to becoming an adult, menopause is seen as a transition from the binding responsibilities childbearing and family care to the emergence of a completely evolved individual with a unique treasure of accumulated wisdom. Another way the changes of a woman's life cycle have been explained is that a pre-adolescent girl is a flower, a woman in her childbearing years is the fruit, and a post-menopausal woman is the seed, containing the essence of all her valuable life-experience, which she can plant in upcoming generations.

None too surprisingly, in many of these cultures, women experience far fewer and less severe symptoms of menopause. Asian women report far fewer hot flashes than Western women do. In some castes in India, depression, dizziness, incontinence and other symptoms are almost unknown. Only 5% of Chinese women report menopausal symptoms. Mayan women in Mexico report no menopausal symptoms except irregular periods.

In Africa, women in Botswana report no menopausal symptoms except increased sex drive - the knowledge that pregnancy is no longer an issue can make women without regular access to contraception feel a whole lot more interested in sex! In Australia, 70% felt good natured and only 4% felt depressed. Clearly, there are some major differences in how people experience menopause when they're in a menopause-positive culture than they do when they're in a culture where menopause is stigmatized. The question, for many Western women, is how to get from the latter to the former.

A Holistic Approach to Menopause

Here in the United States in the 1990's, the average life expectancy of a woman is 84 years. That means she has just about as many years of life ahead of her after menopause as she had before menopause. It also means that today's adult American women have the opportunity to create a new image and experience of menopause, for themselves and for generations yet to come.

American women can culturally transform menopause into the positive transition in life that women experience elsewhere. They can do it by making it a positive transition for themselves, letting their example transform the old stereotypes. Since menopause is a mind-body-spirit transition, its character can be transformed positively by nurturing mind-body-spirit.

Women can nurture their minds by dissolving negative myths with accurate information. For example, many people believe that post-menopausal women are sexless or uninterested in having sex once their hormones change. The facts of the matter are quite different! About 50% of menopausal women experience no change in sexual appetite and pleasure; over 30% experience an increase; and less than 20% experience a decline in sexual appetite and pleasure.

Women can nurture their spirit through new activities. Women can replace the time spent caring for now out-of-the-nest children by pursuing activities they never had time to explore. Other women gain focus and forward momentum by rededicating themselves to their careers or by launching or to new careers - perhaps the kind of job they'd always wanted to create for themselves.

Another great way to nurture that part of yourself is to pursue spiritual activities through the church, the community, or with developmental disciplines like meditation or yoga. As a counterpart to this spirit-enhancing activity, women should avoid spirit-draining experiences like exposing yourself to negative views and opinions of menopause and post-menopausal life.

Women can also nurture their bodies. Part of this is learning ways to prepare for or respond to menopause through lifestyle changes, physical fitness, and good nutrition. Just as a child needs good nutrition and exercise to grow into a healthy adult, a woman transitioning from her reproductive years to her self-productive years needs good nutrition and exercise.

As menopause progresses, women can nurture their bodies by adding natural therapies to the base of nutrition and fitness. Nutritional supplements, herbs, massage and relaxation techniques can do much to prevent or alleviate hot flashes and other menopausal discomforts. In fact, women do not need to suffer most of what our culture fears most about menopause.

Menopause, Sex, and Hormones

But now, let's talk about sex. (The Health Goddess just knew you were waiting for her to get around to this part.) Sexual energy is the driving force of the human race. Mother Nature intended for it to be that way: survival of the species and all that.

Does the sex drive have to dwindle or disappear as we hit forty and beyond? Must pleasure and sexual aliveness become a thing of the past for women and men as they age? Not on your tintype, kid. Healthy libido and an active sex life can be maintained and in some ways even heightened throughout our lifetimes.

The major reason for lowered libido in older folks is a decline in the production of hormones like estrogen, progesterone, HGH, DHEA, and testosterone. All of these and many more hormones are produced by both men and women in the ovaries, prostate/testicles, adrenal glands, pineal and pituitary glands, and by other bodily sites.

With women, usually it is progesterone that declines first. It is the gestational or pregnancy hormone produced in greatest amounts by the corpus luteum or matured egg that is released at ovulation. This generally occurs 14 days after the start of the menstrual cycle and, by nature, this is when a woman's drive and sexual desire is greatest.

While the more well-known hormone estrogen is not responsible for libido, per se, low levels of the three estrogens -- estrone, estradiol and estriol - can cause problems like loss of vaginal lubrication, vaginal wall thinning, and eventually vaginal atrophy. When these things happen, sex becomes painful, even dangerous to the woman's health. If the walls of the vagina tear during sex, bacteria can get into the pelvic cavity and wreak all kinds of havoc. Sex may simply become impossible if vaginal lubrication fails, the vaginal walls thin, and there is atrophy present.

Progesterone is also extremely important for bone health and reducing the risk of osteoporosis. In healthy bone, old bone cells are always going out and new bone is always going in. Progesterone stimulates the osteoblast, or bone building, function. Estrogen supplementation just restrains the osteoclast function - it prevents old bone from going out.

A lot of doctors have wrongly assumed that this meant it was preventing osteoporosis. Wrong. It just keeps old brittle bone in. Once women have been off of their estrogen supplements (like estrogen patches) for five years, their bones are worse than if they had never taken it because the old bone hasn't been renewed, just retained.

The reason that progesterone decline is more significant than estrogen decline is that it is produced by only two sites in the body: the gonads (ovaries) and the adrenal glands, which produce it in tiny quantities as a precursor for the creation of over 100 identified types of other hormones. By contrast, estrogen is produced by the pineal gland, hair follicles, breasts, liver, adrenal glands, ovaries, and body fat. This is why it is wrong to assume, as many doctors will, that menopause is an estrogen deficiency disease. It's not a disease at all - and it's not just about estrogen!

Very few women are truly estrogen deficient, although they may not have the kind of estrogen they need exactly where it is needed. The list below shows the different types of estrogen and what they do, which helps explain why "estrogen" per se is not really much of an answer to menopausal symptoms.
1. Estrogen (systemic) --depresses the libido and orgasmic ability.
2. Estrogen (local) -- very helpful to vaginal health and lubrication.
3. Estrone (E1) and Estradiol (E2) -- the most carcinogenic forms of the hormone.
4. Estriol (E3) -- the healthiest and most reactive form when used topically. (10mg. Estriol = approx 1 mg. Estrone or Estradiol.)

Estrogen supplementation has the best effect when it's done locally in the places where there are problems, like lack of lubrication, thinning of the vaginal skin, and atrophy. This does not mean a woman needs systemic estrogen (pills, patch, depo-shot, etc.). A little estrogen cream, DHEA cream, testosterone cream, applied topically to the vulva, or vaginally, will often do the trick.

Many women benefit from the use of estrogen creams in which the estrogens are plant-derived. These come in three varieties: plant extractions that are in their natural form, plant extractions that have been enzymatically converted, and chemical estrogens that have some long forgotten base in plant extractions or have just enough plant extraction re-added to meet the popular demand for 'natural' without being in any way 'natural.' Read labels carefully, and consult a holistic health practitioner for advice if you want or need it.

Another option for local delivery of estrogen is an estrogen-laced silicon ring that is placed up near the cervix for 3-6 weeks in more severe cases. Generally speaking, there are enough hormone receptors in the pelvic region that the hormones do not uptake beyond this area. Such localized treatment, generally speaking, is healthier than and preferable to something which increases the free level of estrogen throughout the body like pills or patches.

Menopause also involves testosterone, the hormone of energy and desire and probably the most misunderstood of the major sex hormones. True, it is the predominant sex hormone for men, but testosterone is not only for men.

Women actually produce more testosterone than men do, but estrogen and progesterone moderate it. This is how women have the energy to take care of the house, go to work, raise the children, tend to the husband and sometimes find enough energy left over to enjoy life and pamper themselves a bit. The telltale symptoms of low testosterone in women are poor muscle tone and lowered libido. When she is overwhelmed by the care of the house, the family, the partner or spouse, the job, and herself, Mother Nature does not want her to bring another child into the equation, so as stress increases, libido drops.

In mid-life and older women, the loss of libido is in some ways simply a matter of natural age progression. Mother Nature does not think it wise to begin raising a child late in life, so libido likewise tends to fall off.

At the top of the whole hormonal chain, and of potentially great interest for people who are going through menopause, is HGH or Human Growth Hormone. Initially HGH stimulates the growth of the body and all the organs, setting puberty into motion.

As we age, our skin and hair change. We notice a decrease in energy, immune function, sexual energy, cardiac output, vision, muscle mass, sleep quality, memory--in short, just about everything that makes life in the body pleasant. But human growth hormone has been proven to reverse all of these changes. According to Dr. Ronald Klatz, who has written extensively about HGH as anti-aging therapy, HGH helps to bring organ and tissue function back up to more youthful levels, helps to improve the metabolism, and additionally can help to alleviate age-related insomnia and libido loss.

HGH is produced by the pituitary gland, and normally is somewhat similar to insulin in that it is not secreted continuously, but in short bursts following vigorous exercise, like sex, and during the first few hours of sleep. Since HGH is a hormone common to both women and men, it seems that it works equally well on people of both sexes.

However, synthetic growth hormone injections are outlandishly expensive, costing between $800 and $2,500/month. A cheaper and safer route for those wishing to try HGH is to use professionally formulated growth hormone releasing products. These non-prescription products are made entirely from natural sources, and provide maximum safety without side effects. They contain secretagogues, or substances that stimulate the pituitary to release HGH.

One such product, KH3\GHQ10 by Dixie Health -a natural Growth Hormone Precursor Cream, is highly comparable in effectiveness to more traditional forms of HGH treatment. However, I should note that results can be so remarkable in some people that it is recommended that both members of a couple start and continue the therapy together. Otherwise there can be trouble in the relationship due to major disparities in libido level.

The smaller dosage provided through transdermal precursor creams alleviates the known side effects of HGH injections and also assures the user that their pituitary will not become "lazy" and stop producing its own growth hormone. Hormone supplementation may not be necessary at all, but for those who need it, it can be very helpful.

Menopause and Sex FAQ

In summation, let me offer some choice bits of advice for those who are facing menopause or who are now in menopause - answers to some frequently asked questions about menopause and sex.

Q: What are the best ways to keep my sexual function high during and after menopause?
A: Regular exercise, good nutrition, and keep having sex! If sex is the most strenuous thing you do, it's going to feel like work. Plus, exercise is a great way to stimulate HGH production, keep your bones healthy, and keep the pelvic girdle muscles toned and happy. Eating well will make sure that your body has the vitamins and minerals and calories it needs to produce hormones and keep your libido as high as it can be. Getting a good multivitamin supplement is not a bad idea, either. And keeping on having sex - to say nothing of the restorative effects of having a dirty mind and a good fantasy life - is a great way to keep things rolling along, whether you're having sex with a partner, masturbating, or whatever.

Q: If I have occasional vaginal dryness problems, what's the best thing for me to do about it?
A: If it only happens occasionally, just use a good water-based lubricant. Glycerin lubes (Astroglide, ID, Probe, and others) can sometimes exacerbate or lead to yeast infections in women who are prone to them, but silicone-based lubes (Eros lube, Liquid Silk, and others) do not have that tendency, so you may decide to use silicone-based ones if that's a concern. Topical applications of estrogen creams or estrogen precursor creams may also be helpful, but remember that these aren't necessarily intended to be used as sexual lubricants. Many of them are oil-based, too, and oil and condoms don't mix!

Q: Speaking of condoms, when do I get to stop worrying about birth control?
A: As a rule of thumb, wait a year to two years after you've had your last menstrual period before you consider yourself home free in the BC department. An occasional stealthy egg can pop out after menstruation has ceased, and every so often women do get surprised by finding out that they were fertile when they thought they weren't so unless you want to be putting your kid through college when you're 75, better to play safe than be sorry!

Q: What about the vaginal muscle atrophy or incontinence problems that seem sometimes to accompany menopause?
A: Kegel exercises are in your future, girlfriend! Women of any age can do them. Just squeeze your pelvic muscles as if you were squeezing off the flow of urine while peeing, hold it for a second, and then relax. That's a Kegel exercise! Do them as many times a day as you like (they're a great way to pass the time when you're waiting in line at the bank). They help to tone and strengthen all the pelvic and vaginal muscles. If exercise is good for the rest of you, why shouldn't it be good for your pussy too!?!

© copyright Marcia Jones, 1999 - 2006.

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