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Q Please advise me, doc. I am a woman who used to have a great sex life. But since I reached the age of 40, everything has 'gone downhill'.First of all, my husband left me for a much younger woman, stating that his main reason was that he thought I had 'lost interest in sex with him'. There was some truth in that, though, in fact, a lot of my problem was due to the fact that he only wanted to make love to me when he had been out drinking. And I did not like that.
So, I was on my own for a little while. I felt real frustrated at that time, and I kept thinking that I would find another guy and have great sex with him, and maybe marry him.
Well, earlier this year, I did find another man, and fell in love with him. He says he loves me too, and he has talked about marriage. He is around five years younger than me.
I have had sex with him two to three times, and he told me he was 'delighted' with me. He said I was 'the best woman' he had ever been with.
But, unfortunately, my own sexual feelings were not so good. I did discharge, but not as often as I used to. On one occasion I got a severe pain in the belly when I discharged.
Also, I felt quite sore and dry inside me. I did not seem to be producing enough lubrication. My man noticed this.
Furthermore, I am fretting about the fact that I do not seem to have as much desire as I used to. When I was young, I would happily have had intercourse every single day. But, at present, I do not seem to have the 'thirst' for it that I did once.
An additional problem is that I keep getting 'sweating attacks' at night, which makes it kind of awkward for the two of us to be in bed together. Also, there are times when my whole face seems hot, hot, hot - and then I cannot concentrate on sex or anything else.
My friends say that I am going through the menopause, and I guess maybe that is true. So, could I get treated with that Hormone Replacement Therapy? And would it restore my sex life? Also, I have heard where they have now found that it is dangerous. So, would it harm me, doc?
A. Thank you for your question. I recently promised that I would return to the subject of Hormone Replacement Therapy (HRT) in this column, and I am glad to do so today - because I feel that this treatment would help you.
I am sure that your friends are right, and that you are going through the menopause. I say this because you have the following symptoms of it:
Sweating attacks Hot flushes - what Americans call 'hot flashes' Vaginal drynessYou also mention that on one occasion you experienced pain in the belly when you discharged. That, too, can sometimes be a symptom of the menopause.
You have not told me what your menses are doing, but it would not be surprising if you were having a few problems with them.
Now, what could HRT do for you? Well, it would almost certainly get rid of your distressing sweating attacks - thus making it easier for you to be in bed with your man. It would also take away those 'hot face' attacks.
It might also prevent you from getting belly pain at the moment of climax - though I cannot guarantee that.
Furthermore, the hormones would get rid of your vaginal dryness, and help you to lubricate much more freely during sex. I am certain that both of you would appreciate that.
However, in order to cure the vaginal problem, you might have to take a hormone in the form of a vaginal cream or pessary (that is, a vaginal tablet). There is also a vaginal hormone ring.
What other ways of taking Hormone Replacement Therapy are there? Well, most women take the HRT by mouth, in the form of tablets. Others take it in the form of medicated skin-patches.
Now, what are the drawbacks with HRT? As you suggest in your letter, it has been discovered that there are some risks. In recent years, research has shown that HRT tablets or patches can increase your chances of getting:
Breast cancer Womb cancer Ovary cancer Heart attack Stroke Thrombosis in the leg veinsI know that list sounds bad! However, most experts now think that it is OK to take HRT for a reasonably SHORT time - like a year or so - until there is no further risk of menopausal symptoms.
You should definitely NOT stay on HRT for 10 years or so, unless your own doctor says that it is essential that you do so.
Good luck with your new relationship. Your next move should be to go to a doc and get yourself some treatment.
Q I am a somewhat-stressed businessman, and prone to worry! At the age of 32, I have noticed that I am producing less sex fluid than I used to. Does this mean that I will lose my nature soon?A. Certainly not! Nearly all men produce slightly less ejaculate as the years go by. There is absolutely no reason to think you will become impotent, so quit fretting.
Q I have had four children and, as a result, my vagina has become rather loose. A nurse friend says that I could take an operation to cure this. Is she right?A. Yes. A gynaecologist could do what is called a 'repair operation' for you. However, your nursing friend - or any midwife - could teach you some special exercises which would improve matters. They are called 'pelvic floor exercises'.
Q Doc, I am a guy who has formed a relationship with a lovely older woman of 43. The only thing that worries me is this. Although she is fair, there are parts of her genitals - notably, her clitoris - which are quite dark. Does this indicate any disease?A. No, it doesn't. Incidentally, the clitoris is usually pink, so I suspect you are looking at some other structure nearby. In any case, people vary a lot in the distribution of their skin pigment. So this is not something which you need to fret about.
Q I am now 33, and have been on the Pill for 10 years. Do you think that it is now time I stopped taking it, doctor?A. The risks of the Pill are not very great, but they do increase with age. Personally, I tend to advise women to start thinking about other methods when they reach 35.
However, a lot depends on whether you have any 'risk factors' which would make the Pill more dangerous. These include:
Smoking Diabetes ('sugar') A bad family history of strokes, or of thrombosis in the veins.Your own doc can advise you on whether you should continue beyond about 35.
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