The Recipe: Revisited, Reconfirmed

At MiddlesexMD, our approach to sex at midlife didn’t spring to life fully formed. In fact, it’s the result of a lot of thought and discussion about the kind of information women need during and after menopause to stay sexually healthy and functional.

We were concerned that a lot of the chatter surrounding sex during these years is based on hearsay and old wives’ tales, and it’s often cast in terms of dysfunction—of what’s not working right anymore. Also, in case you haven’t noticed, a lot is still unknown about normal female sexuality after menopause. (So let’s not be quite so quick to label it dysfunction.)

From my years in practice, I know that women don’t talk about these issues. They may associate hot flashes and mood swings with menopause, but changes that affect their sexuality aren’t widely known and don’t tend to enter into the doctor-patient conversation. I suspect that many women don’t exactly know what questions to ask.

So we envisioned MiddlesexMD as a forum and a clearinghouse for reliable, current information about changes to your libido and sexual organs during menopause. We also tried to organize this information in a way that is understandable and easy to manage. And that’s how we came up with the “Recipe.”

Our Recipe for Sexual Health coalesced after we reviewed a lot of research and looked at reports from the North American Menopause Society and the International Society for the Study of Women’s Sexual Health. We considered what sex therapists and researchers, counselors and relationship coaches, alternative medicine gurus and mindfulness gurus had to say.

We took all that information, mulled, mixed, and digested it, and voila! the ingredients for our Recipe rose like cream to the surface. Our website and our blog are organized around those five ingredients:

Knowledge. So you can understand what happens physiologically during menopause as well as learning some techniques for staying sexually healthy and functional.

Vaginal comfort. From my clinical experience, vaginal dryness and discomfort are the most common and annoying changes that women mention, and they happen to all of us. A lot of the information on our blog and the website discuss ways to maintain vaginal health.

Genital Sensation. So you can find ways to compensate for diminished blood flow and loss of sensation.

Pelvic tone. So you can understand why a well-toned pelvic floor is important, and how to develop those muscles.

Emotional intimacy. Because your body won’t respond if your heart and mind aren’t engaged. We feel this is, and always has been, the most important ingredient to a great sex life.

Since the launch of MiddlesexMD.com almost two years ago, you—our readers—have reinforced some of our educated guesses. How common and distressing vaginal dryness can be, for example. Also that sex for women is complicated. Unlike men, the path from stimuli to desire to arousal to the big O is far from linear. And the unpredictability of our responses only intensifies during menopause.

As we age, we can develop other heath conditions, like hypertension or diabetes. Then it becomes more difficult to tease out the effect of these conditions from sexual problems. Plus, both the physical condition and the medications used to treat it can affect sexual responses.

We’ve also come to appreciate the difficulty of putting some heat back into a long-term, ho-hum sex life (or maybe completely reinventing it).

You remind us that that sex is a very individual matter—certainly not a one-size-fits-all affair. That’s the beauty—and the challenge—of claiming, or reclaiming, your sexuality.

We’ve been impressed with the fact that, contrary to some stereotypes, we’re still pretty sexy ladies at midlife. We like having sex, and we want to keep on enjoying it. That’s what MiddlesexMD is all about—creating a forum and providing the information that will keep you sexy for a long time.

So, how are we doing? Do you have unanswered questions? Have we missed anything in the recipe? Can you find what you’re looking for?

Let us know, because we like many cooks working on our recipe.