Up to three-quarters of postmenopausal women say their sex drive has reduced since going through the change. That's not surprising when 70 percent report suffering from vaginal dryness that significantly impacts their ability to be sexually active.
Spontaneity and enjoyment go out the window as a result. Many women regard their loss of libido as part of their fading youth. Our libido levels are most often a well-kept secret, and not something we consider an acceptable part of social chit-chat over cocktails, even with our best friends.
There are no hard and fast rules about what is a normal level of libido, and there is no such thing as a 'normal' sex drive. What is normal to one couple may be abnormal to another. You can only judge your libido by your own standards, and if you feel that your sexual desire has diminished, the good news is that you can take action to restore it.
Tiredness, lack of energy and mood swings can put a damper on the most solid relationship. At the same time, falling levels of estrogen can result in the lining of your vagina becoming dry and uncomfortable. When the vaginal tissues dry out, penetration can become painful, and in extreme cases, they may tear and bleed. If you are also suffering from night sweats, it's not surprising that you don't feel very sexy.
Many women suffer in silence, thinking this is an inevitable part of growing older. But the good news is it doesn't have to be this way. There are plenty of things you can do naturally to repair the vaginal lining, encourage the cells to produce mucus again and rekindle your libido. Here are the top supplements and topical solutions I recommend, as well as some promising new treatments.
Easing vaginal dryness
Sea buckthorn oil
Sea buckthorn oil, from a berry bush native to Asia and Europe, can help treat vaginal dryness. It's a rich source of omega-7 fatty acids, which have been shown to help maintain the health and integrity of the mucous membranes in the vagina. It also contains vitamin C, which helps to maintain collagen, the protein that gives skin its elasticity. This may not only help with vaginal dryness, but also with incontinence, by helping to retain elasticity in the urinary tract.
In a high-quality study carried out in Finland, nearly 100 postmenopausal women with vaginal dryness, itching or burning consumed 3 g of sea buckthorn oil or a placebo oil daily. After three months, those taking the sea buckthorn oil had a better rate of improvement in the health of their vaginal tissues. The researchers concluded that sea buckthorn oil had beneficial effects on vaginal atrophy—the thinning, drying and inflammation of the vaginal walls—among these postmenopausal women.1
Suggested daily dosage: two capsules of PharmaNord's 'Omega-7' sea buckthorn oil capsules in the morning and two in the evening
Used for many years in Thailand for medicinal purposes, this herb has been shown to help with the changes that occur in the vaginal tissues at the time of menopause. In a study of 82 post-menopausal women suffering with vaginal atrophy, Pueraria mirifica vaginal gel was found to significantly reduce symptoms after three months.2 Another study showed it to be effective in reducing symptoms over six months.3
Aloe vera gel
This is a great natural remedy for feminine dryness. It can be directly applied to the area to hydrate it, or taken internally to help from the inside out. Combining aloe vera gel, saffron and Ashwagandha with milk is an Ayurvedic remedy that is often used to treat problems with dryness. It can help to provide lubrication to the vagina and can keep the reproductive organs moist and youthful as well.
Vitamin E oil
Applying vitamin E oil to the vagina on a regular basis can relieve some of the dryness that you are experiencing. You can buy vitamin E capsules and break them open with a needle to obtain the oil. Mixing the oil with black cohosh cream can also help. A recipe I recommend is six capsules of vitamin E oil mixed with about five teaspoons of black cohosh cream. Apply to the inside and outside of the vagina a couple times a day.
YES natural lubricants and gels
YES makes a range of aloe vera- and flax-based vaginal lubricants and gels that are free of synthetic ingredients and hormones and are certified organic. They offer a choice of either oil- or water-based vaginal gels. My patients report that they like using the water-based version and have their partner use the oil-based version as lubrication.
YES has also introduced a vaginal moisturizing gel designed to match the typical vaginal environment, with none of the skin-damaging or concerning chemicals typically found in vaginal moisturizers. Many women have reported that it relieves vaginal atrophy and dryness; rapidly alleviates irritation, itching and burning; and moisturizes and soothes dry, sensitive vaginal tissues. Unlike phytoestrogen gels, which sometimes have a recommended use of twice a week for long-term use, YES can be used as often as needed (see www.yesyesyes.org).
A hormone-free cream developed by Remifemin called FeuchtCreme, containing Hamamelis virginiana distillate—more commonly known as American witch hazel—plus well-established vaginal cream ingredients, seems to be effective for vaginal dryness.
When 20 postmenopausal women treated their vaginal dryness using this cream once a day for a week, around 80 percent of them reported no dryness after the study ended.4 The research is very new, and the cream is not widely available in the US, but you can find it online from Austria and Germany, where it was developed.
A new type of laser therapy known as vaginal erbium is showing promise for helping to restore women's vaginal tissues. When a group of 45 women had three treatments over three months, they reported a significant decrease in both vaginal dryness and discomfort when making love, as well as experiencing an improvement in stress incontinence. The effects were rapid and long-lasting, although one in five women reported minor itching or burning after the treatment that resolved within two days.
Although larger studies are still needed to prove its long-term safety and efficacy, vaginal erbium laser might ultimately be preferable to estrogen creams, the standard treatment
currently recommended by most doctors.5 [WDDTY says: procedures like this should be considered a last resort, after other natural methods have been exhausted.]
The main herbal remedy I recommend for general menopausal symptoms is organic Peruvian maca root. In particular, I recommend a supplement called Femmenessence, which has been shown in studies to be a safe
natural alternative to hormone replacement therapy.
Femmenessence is the first herbal product made from organic maca root, grown for over 2000 years in Peru. It has been shown in trials to raise estrogen and progesterone levels—the two key hormones that fall at the time of perimenopause.6
Clinical trials show it can bring about a marked reduction in menopausal symptoms. Women report fewer hot flashes and night sweats, and improved sleep, energy levels, mood and libido.7
Femmenessence works by stimulating the hormone-secreting glands in the body, such as the pituitary and adrenal glands. In the process, it also has a positive impact on bone health and cholesterol levels. There are two versions of Femmenessence: the peri-menopausal product is called MacaLife, and MacaPause is for women who haven't had a period for at least a year.
Suggested daily dosage: three tablets in the morning and three at night
Lady Prelox, a dietary supplement containing Pycnogenol® pine bark extract, the amino acids L-arginine and L-citrulline, and Rosvita® rose hip extract, may help women feel sexy again at midlife. A study of pre-menopausal women suggests that Lady Prelox significantly improves sexual function and enjoyment,8 and there have been encouraging results (improved desire, arousal, lubrication, orgasm, satisfaction and less pain) in post-menopausal women too.9
None of the ingredients in Lady Prelox has hormone-like effects, and the individual components have been on the market for years.
Suggested daily dosage: two tablets, preferably with a meal
St John's wort
Also known as Hypericum, this herb is an effective alternative treatment for depression, with fewer side-effects than conventional antidepressants. It also seems to be good for boosting libido.
A German study of over 100 women experiencing libido problems around menopause found that 60 percent of those using St John's wort significantly regained their libido.10
Suggested daily dosage: 900 mg per day
Horny goat weed
This herbal aphrodisiac has been used in Chinese medicine for centuries to increase sexual interest in both men and women.
Suggested daily dosage: 600 mg per day
Transcutaneous temperature controlled radiofrequency (TTCRF) is a non-surgical, non-hormonal treatment developed for women who have difficulty achieving orgasm or complain of stress incontinence—common menopausal symptoms.
A small study showed that after TTCRF, over 90 percent of the women took half the time to orgasm, and others reported an improvement in their stress incontinence and deteriorating vaginal tissues. The researchers recommended an annual 'top up' to maintain the gains, and also noticed that women were able to stop using vaginal estrogens.11
- If you suffer from vaginal dryness, make sure you drink enough water (about eight to 10 glasses a day). If you are very dehydrated, lubrication is going to become a problem for your body. And consider avoiding alcoholic and caffeinated drinks, as these may lead to further dehydration.
- Regular sex can help vaginal lubrication, as can spending plenty of time on foreplay, since it can take longer to become aroused after menopause.
- Pelvic floor exercises help keep your vagina healthy and strengthen pelvic muscles, and they may also boost your enjoyment of sex. Here's how to do them:
1. Find your vaginal muscles, if necessary, by stopping a flow of urine mid-stream.
2. With your legs slightly apart, draw your buttocks in.
3. At the same time, draw your vagina inward and upward. Squeeze and hold for a few seconds. Repeat 10-15 times a day.
- Avoid the use of fragranced soaps, powders, bubble bath and other beauty products around your intimate area, as they could cause irritation and contribute to dryness. Stay away from petroleum-based lubricants, which will not only add to your vaginal dryness but can also cause yeast infections.
What causes vaginal dryness?
The presence of estrogen in our fertile years ensures that there are plenty of new cells producing lubrication and maintaining the elasticity of the tissues lining the vagina. However, when our estrogen levels fall at midlife, the production line at the cell factory diminishes, and as a result our tissues dry out. The dryness can cause pain, as the thinning brittle tissues can tear easily; some women even experience burning sensations and bleeding.
Nonetheless, there are a number of other factors that can contribute to vaginal dryness:
Antidepressants. Many antidepressants produce drying effects on the vagina. If you are taking an antidepressant, check with your doctor about an alternate antidepressant or investigate natural alternatives.
Condoms, tampons, and douches. Using the wrong product can sometimes cause dryness. Try to stay away from anything with fragrance or added powders.
Prescription and over-the-counter drugs. Certain antibiotics, antihistamines and decongestants, if used often or at high doses, can produce vaginal dryness.
Chemotherapy and radiation. If you're undergoing these treatments, natural supplements and topical treatments can help.
What causes loss of libido?
After childbirth, many women lose interest in sex because of their rapidly changing hormone levels, their disturbed nights and the fact that Mother Nature makes a woman prioritize her baby rather than her husband's needs.
Excessive weight gain, weight loss, irregular periods, hair loss or excessive hair growth may all signify hormonal problems, which can also result in a low sex drive.
Other hormone disturbances like thyroid problems, or galactorrhea, a white milky discharge from the nipples, can cause low libido.
Pain. Sometimes people are put off sex as intercourse becomes painful. The pain can be due to infection, vaginismus—when the vaginal muscles go into spasm, an enlarged or displaced womb or other hormonal abnormality.
Hormonal changes at the time of menopause, causing night sweats and insomnia, often result in a reduced libido.
Long-term illness and lack of energy.
Psychological distress from traumatic experiences can play a role.
Stress, worry and depression often take their toll on sex drive. When you are mentally preoccupied with pressing problems, the body diverts its energy to helping you through the troubled times, and sexual desire may take a back seat.
Adapted from Beat Menopause the Natural Way by Maryon Stewart, available from www.cruisingthroughmenopause.com