MALE AND FEMALE SEXUALITY CHANGES DURING MIDLIFE: TRADITIONAL & ALTERNATIVE APPROACHES Beverly Whipple, PhD, RN, FAAN Professor Emerita, Rutgers University Past-Vice President and Secretary General, World Association for Sexual Health Past-Director, International Society for the Study of Women’s Sexual Health Past-President, Society for the Scientific Study of Sexuality Past-President, American Association of Sexuality Educators, Counselors and Therapists 87 Matlack Drive, Voorhees, NJ 08043 phone and fax 856-309-1510 e-mail bwhipple@pics.com Outline: His and Hers Midlife Changes
Age of onset Major symptoms Treatments Male symptoms
Erectile dysfunction Vascular problems Nerve damage Prescription drugs Testosterone levels Treatments Medications Vacuum devices Surgical implants Penile injections Supplements and herbal medications Female sexual changes Types of menopause
Premature Artificial Suggestions for sexual changes Hormone therapy
Estrogen Progesterone Other therapies and herbs Testosterone Effects of medications
FDA-approved hormones for menopausal symptoms Type/Source Brand Name(s) Preparations Bioidentical? Estrogens
Synthetic conjugated estrogens/plants Cenestin, Enjuvia
Progestins, micronized progesterone Combined hormones
acetate 17 beta-estradiol and norethindrone
*Particlees are made smaller for better absorption. **Biioidentical estradiol until ingested and converted in the liver to estrone. +For vaginal symptoms only. ++The estradiol is bioidentical but not the progestin.
Harvard Women's Health Watch August 2006
Books and Websites on Menopause
Barbach, Lonnie (1993, 2000). The Pause: Positive Approaches to Menopause. Dutton
Easy to read. Good coverage. Incorporates many therapies. Not much depth on hormone therapy.
Cutler, Winnifred B. and Garcia, Celso-Ramon (1992). Menopause: A guide for Women and the Men Who Love Them. W. W. Norton & Co. (Revised from 1983)
Heavy emphasis on biology and research. Strongly for hormone therapy. Most topics covered in depth.
Gates, R., & Whipple, B. (2000). Smart Women, Strong Bones. Oswego, OR: Lifestyles 4Heart Press. Gates, R., & Whipple, B. (2003). Outwitting Osteoporosis: Oregon: Beyond Words Publisher. Greer, Germaine (1992). The Change: Women, Aging and the Menopause. Alfred A. Knopf
Makes readers think. Thoroughly reviews medical literature and has a good grasp of science, but makes some errors in
interpreting results. Jacobowitz, Ruth (1993). 150 Most-Asked Question about menopause. Hearst Books
Very cautious about HRT. No literature review on sexuality.
Kiss, KL., & Whipple, B. (1998). Ease into Menopause naturally. Nutrition Science News, 3(8), 406-412. Lee, J.R. (1996). What your doctor may not tell you about menopause. Herst Books
Murray, M.T. (1994). Menopause: How you can benefit from diet, vitamins, minerals, herbs, exercise and other natural methods. Rocklin CA: Prima Publishing
Natural solutions presented with some research
Northrup, Christine (2001, 2003). The Wisdom of Menopause. Bantam Nachtigall, Lila (1991). The Complete Guide to Reversing the Effects of Menopause Using Hormone Replacement Therapy. Harper Collins
Comprehensive guide by a respected doctor in the menopause field.
Perry, Susan and O'Hanlon, Katherine (1992). Natural Menopause. Addison-Wesley
A general book that emphasizes non-hormonal approaches to treating menopause.
Sachs, Judith (1991). What Women Should Know About Menopause. Dell.
Simple book, but covers major issues. Gives good resource directory for obtaining help.
Sheehy, Gail (1992). Menopause, The Silent Passage. Random House
A quick reading book, (was on best-seller list) could have referred to more of the research conducted
Utian, Wulf and Jacobowitz, Ruth (1990). Managing Your Menopause. Simon and Shuster
Well balanced, up-to-date and correct by a respected doctor in the menopause field.
Weed, Susun. (1992). Menopausal Years: The Wise Woman Way. Ash Tree Pub.
Alternative approaches, especially herbs. Against hormone therapy.
Wright, J.V., & Moren, T. (1997). Natural hormone replacement for women over 45. Petulma CA: Smart Publications.
Against HRT and supports NHR Only presents one side
http://www.nlm.nih.gov/medlineplus/menopause.html http://www.menopause.org http://www.mayoclinic.com/health/menopause Compiled by: Beverly Whipple, PhD, RN, FAAN, 87 Matlack Drive, Voorhees, NJ 08043, phone and fax 856-309-1510, email -
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FDA-approved hormones for menopausal symptoms