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How I Came to Care about Menopausal Sex

How I Came to Care about Menopausal Sex

by Dr. Barb DePree MD

...and why you should care too!

It began when I partnered with the local hospital in my hometown to evaluate local women's health services, looking for any gaps where additional services were needed. In the process, it became clear that our community needed and could support a healthcare practice devoted to the special needs and care of women who were past their child-bearing yearsthese special needs were largely ignored by existing providers.

Portrait of Dr. BarbI decided to transform my practice. That was 4 years ago. I studied and became
certified by the North American Menopause Society as a menopause care provider, and while welcoming patients into my practice, used their questionaire—a thorough document that makes it easy for new patients to give me a comprehensive view of their symptoms and health histories. On that eight-page-long form there are just a few questions for women to answer about their current and past sexual experiences:

  • Do you have concerns about your sex life?
  • Do you have a loss of interest in sexual activities (libido, desire)?
  • Do you have a loss of arousal (tingling in the genitals or breasts; vaginal moisture, warmth)?
  • Do you have a loss of response (weaker or absent orgasm)?
  • Do you have any pain with intercourse (vaginal penetration)? If yes, how long ago did the pain start? Please describe the pain: Pain with penetration? Pain inside? Feels dry?

Well, I was amazed by the responses from my new patients. 60 percent of my patients have experienced a loss of interest in sexual activities, 45 percent have a loss of arousal, and 45 percent a loss of sexual response. And when I talked to them, they were:

  • Perplexed—because they don’t understand what’s changed.
  • Disappointed—because they expected there to be more .
  • Frustrated—because they don’t know what to do about it.

And when you carry those numbers from my practice to the rest of the countrywell, more than 44 million women are aged 40 to 65 in the US alone. Some 6,000 of us reach menopause every day. And at least half of us experience sexual problems with menopause. Probably more.

That’s a lot of disappointed women. And a lot of disappointed men too… I believe there can be more, and women don’t have to just accept the changes if they don’t want to. I see MiddlesexMD as a real caregiving opportunity: Make it easy for women over 40 to gather the information and products they need to sustain their sexuality after menopause.

And that could make everyone happier!


  • Dr. Depree, in my personal situation, and I’m sure I’m not alone among men, your work is about as important as it gets. This is THE major quality of life issue in my marriage, which is otherwise a long and happy one. Wife is in her early 60’s, and I’m in my late 60’s.

    I’m thankful to be in excellent health, with boundless energy and optimism in my late 60’s, and a sex drive and function that is not much different from what it ever was. But it’s also kind of a curse because my wife gradually started losing interest about 20 years ago, and it never came back in spite of all kinds of efforts, including sex therapy.

    I’ve spent many hours reading the huge number of articles you have here. Your work is really great. Wish more women and men read it!

    Gary on

  • I look forward to your blog and the email notices that updates are available. You describe me – disappointed, perplexed and frustrated. I looked forward to not having to worry about pregnancy and read much about how my libido need not stop in menopause. Well, whoever wrote those books was misleading at best. While intimacy has not ceased, it is, at the very least different. I look forward to this blog and the information I hope it offers. I do wish that I could find a physician near me who specialized in menopause and life after childbearing.

    mjt on

  • Hi MSN quilter,

    Thanks for your kind comments.

    Your book club sounds a lot like mine! What I have come to more fully understand is that for relationships to thrive (vs. just survive), we need to share intimacy. For many it seems that once intercourse gets more difficult, the relationship wanes or fades, and few of us know what to do next.

    I tell my midlife patients, “We are now high-maintenance.” And it’s up to us to do the work of maintaining our bodies. We have so many resources to understand every other aspect of body maintenance, but so little information about maintaining our sexuality. I hope MiddlsexMD can be that resource.

    And I hope we can stimulate more great conversations for more bookclubs!

    barbdepree on

  • I belong to a book club of ten wonderful, funny, intelligent women and from time-to-time (or more often) our conversation strays to topics around our sexuality. The one theme that comes up again and again is the loss of libido. We have laughingly shared that whoever can “fix” that for all of womankind will be our hero — and it can’t be soon enough! Dr. Barb, you may be that person! While we laugh about this topic, there is an undercurrent of frustration as well. I have shared your blog with my book club and encourage others to spread the word as well. We need to take charge of our sexuality to assure many more satisfying years ahead and knowledge is the first step. I look forward to more information and am excited to see what products you will offer in a tasteful, educational format. This blog, and the encouragement it offers to mid-life women, brings to mind Kathy Bates’ immortal shout in Fried Green Tomatoes …“Tawanda!”

    MSN quilter on

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