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by Dr. Barb DePree MD

A big bouquet of roses waited for me at the front desk of my clinic.

It wasn’t my anniversary or my birthday. And doctors just don’t get a lot of flowers. When I saw who sent them, I smiled that special “good sex” smile, even though the sex I was smiling about wasn’t my own.

I've been a women's health doctor for more than 20 years, focused on midlife women for the past four. These flowers were not from a new mom or a patient with a difficult disease. These came from a patient who got her sex life back.

That may not seem like a big win in the scheme of things, but it was a wake-up call for me. My patient, now in menopause, was distraught that her sex life seemed to be over so soontoo soon. Sex was effortless for most of her life. It had been very satisfying. And suddenly, it wasn't any more.

We talked about sexual response with her hormonal changes, all of the many factors that could be influencing her experience. Then we talked about her options for managing these changes. She tried different routes, but when I introduced her to a deviceshe had not used them beforethat made the difference for her. With the help of a simple tool, she was able to adapt to her new reality, and enjoy sex again.

It was a fairly straightforward doctor-patient exchange, but not a common one. Women rarely talk to their doctors about sex. As a menopause practitioner, though, I know that changes in sexual response are a key source of distress for a lot of women and their partners at this age.

Heart made of flowersIs it a doctor's job to help their patients have good sex? I think it is, absolutely. A healthy sex life sustains our overall health and well-being. Sex is good for us, and helps us to remain vibrant and strong. Menopause isn't a disease. It's a natural process. The more we understand this process, and discuss it openly, the easier it will be for us to make adjustments to accommodate our bodies' changes.

The roses were evidence that my patient's sex life had been restored. How many women like her have never raised the question with their doctors. Their gynecologists? Or sisters? Or friends?

Natural changes during meopause can make it feel like the door is closing on your sex life. For some of us, that’s not a huge loss. For others, it’s seriously distressing.

But these changes don't have to stop your sex life. They will certainly change things a bit. They may require learning some new things, trying some new techniques, experimenting with a few products.

I'm working with my friends to launch MiddlesexMD. We will reach out to women like my patient, women at midlife who aren’t ready to close the door on sex, and who aren’t sure how or when to talk with their doctors about their experiences. My partners and I want to build a trustworthy (and bouquet-worthy!) sexual health resource for midlife women, combining helpful advice, clinical expertise and a carefully selected set of products with a record of helping women continue to enjoy a satisfying sexual life as they age.

By launching our blog first, we're starting the conversation. We'd love to hear what you think, need, want. What do you think about a website devoted to midlife sex? Can you relate to the changes in your sex life? Please leave a comment to join the discussion, and/or sign up to receive the posts by email.


  • Hi Reesa, thanks for visiting!

    Yes, anxiety can be a component of midlife. Women are ten times more likely to experience mood difficulties (anxiety, depression, irritability) in the perimenopause to menopause transition time.

    And you’re right that emotional health certainly influences sexual health (not to mention overall wellness).

    There are a variety of ways to address this, through lifestyle modifications, counseling or therapy, or even medications. Your own doctor can provide more specific advice on this, but rest assured you’re not alone in confronting this symptom.

    Dr. Barb

    barbdepree on

  • Reka,

    It is true that women have an increased risk of heart disease after menopause, and decreased estrogen levels can bring on changes in your cholesterol profile. Often harder to keep the HDLs up and the LDLs down. Premenopausal women have a lower risk of heart disease. Having been pregnant or not does not influence the risk of developing heart disease.

    Women need to address lifestyle more intentionally in midlife and beyond, exercise becomes increasingly important for influencing that good and bad cholesterol favorably, and don’t forget about diet.

    There’s a very good resource that NIH has put together called the Red Dress campaign, to help women understand heart disease better. Check it out here:

    Dr. Barb

    barbdepree on

  • I’m in the perimenopause to menopause transition time and can attest to a significant spike in my level of irritability and anxiety.

    Like Reesa, I worry about my heart health. When I turned 40, my cholesterol levels shot up and the LDLs went down. I have brought this up to my doctor and she seems clueless about the relationship between women’s heart health and menopause, but I’m sure I have read that there is a correlation, especially if the woman has not had children.

    Is there any truth to this?

    Reka on

  • It occurs to me that a healthy sex life, particularly in mid-life starts with a healthy body, mind and spirit. Is ANXIETY recognized as a symptom of Menopause? There are days I feel as though I might burst with anxiety, this leads me to worry that my heart, too, will explode (at least this is what it feels like). The point being, I worry my heart health suffers and brain health (stroke) as well. Please share any thoughts. Thank you.

    Reesa on

  • Yay! I love this new blog! It’s wonderful that as our generation gets to this middle age we can do it intelligently, openly, and without shame. A celebration of age in fact! It’s about time.

    Personally, I’m hanging on every word . . . my experience is that my sexual feelings shut off like a light-switch at age forty. Now I’m in the position of thinking about sex in the abstract: I want to want to have sex . . . or not . . . whatever.

    Carrie Andrews on

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