Sex, Love and Intimacy Through Midlife Changes (cont.)

karenjoyarney_WebMD: Is it usual or unusual for older men to experience erectile problems? Is this to be expected?

Jacobowitz: Erectile dysfunction (ED) is not inevitable in men. It is often caused by the medications men are taking for high blood pressure, diabetes, anxiety, and depression. Once the physician is made aware of the problem, often a switch to another product or another dose can eliminate the problem. No ED is not inevitable. In the book, I discuss testosterone replacement for both men and women.

maxjack_MSN: I have been taking Premphase for past 6 months - yesterday my dr. changed me to fenhrt. I was a little confused as to why the change since I feel as though I was doing very well on the Premphase. any thoughts?

Jacobowitz: You'd have to ask the doctor. I have no idea why the change. In fact, I'd be interested in knowing why the change.

poppylv_WebMD: Are there any vitamins, supplements or herbs that can increase sex drive?

Jacobowitz: Here again, I've reviewed everything we know in the book, but basically testosterone is the hormone of desire. Estrogen, exercise, and eating properly can also help your sex drive. Estrogen is the feel good hormone and, when you feel better, you are more interested in sex. Exercise causes our happy endorphin hormones to increase and they are very helpful as well. And giving up alcohol in large amounts helps, too.

abigale_WebMD: Does the frequency of sexual activity have an affect on libido or sexual hormones?

Jacobowitz: Frequency is helpful, not in increasing hormone levels but enabling the vagina to remain lubricated and more elastic. That's how the phrase "use it or lose it" became popular.

mold28_WebMD: Are there sexual positions that are better or safer for us old fogies?

Jacobowitz: How old is an old fogy? Sexual positions depend on preference and on medical problems. For example, a woman with osteoporosis may be more comfortable one way than another. You need to experiment to see what works best for you and your partner.

maxjack_MSN: I am a little concerned - I am 49 yrs old and have not had sexual relations with my husband for 3 yrs now. can this possibly lead to increase risk of female problems? I recall hearing that sexually active women have tendency to have less medical problems. any truth to that?

Jacobowitz: Sexually active women have, as I mentioned earlier, have less problem with vaginal atrophy. If you are taking estrogen that helps with lubrication and staving off problems.

smersh_WebMD: What's the difference between sexual desire and libido.

Jacobowitz: Sexual desire is libido. Lack of libido is defined as lack of desire or interest in sex.

poppylv_WebMD: Sex has become pretty mundane with my partner, how can we get out of the routine?

Jacobowitz: You have to be creative to keep sexually alive and challenged, particularly in a long term relationship. Try having sex in the garden at twilight -- if the neighbors can't watch. Try in front of the fireplace or meet in a motel in the middle of the afternoon in your own home town. You know, if he always does this, and you always do that -- it can become ordinary. Create excitement in your relationship. I've covered lots of ways to fire up your lovemaking in my book.

Moderator: Ruth, we have a few members asking where they can purchase your book: 150 Most Asked Questions About Midlife Sex, Love & Intimacy: What Women and Their Partners Really Want To Know...

Jacobowitz: The easiest way is to visit my web site, and order it there, or call 1-800-4414033. Or, of course, you can get it at your book stores.

gillie1_WebMD: What can be done to counteract decreased sex drive as a side effect of birth control pills?

Jacobowitz: That's a good question for you own physician. I am not familiar with birth control pills as a deterrent to sex drive. Perhaps something else is going on. You know there are many factors that go into desire--some physiological and some psychological.

abigale_WebMD: I'm not interested in sex anymore, I'm worried that my husband will look for it elsewhere? what can I do to increase my interest?

Moderator: We are nearing the end of our discussion with Ruth Jacobowitz. Please ask your final questions at this time. Please preface your questions with /ask.

Jacobowitz: I would absolutely discuss your lack of interest with your doctor. Are you taking hormones? Do you need them? Do you need testosterone? Are you angry with your partner? Disappointed? All of these issues need to be confronted. A good sex life can go on as long as we live, if we want it to. You can contact me through my website, next

laurah2_WebMD: Sure there are lots of ideas for creating excitement, but as a pregnant mother of a toddler, how can I get over the huge hump of total exhaustion? I have desire but very little energy.

Jacobowitz: That's very understandable. See if you can schedule some time for yourself to rest and to meet your mate. Sometimes making a date for sex is very exciting and also liberating. It also can permit you to rest, perhaps, that day.

smersh_WebMD: any suggestions for a forty something woman recently divorced with lots of libido and desire...I'm nervous about the dating scene and safe sex

Jacobowitz: You're right to be nervous. It's scary out there. Once you find a date you really want to have sex with, discuss your concerns and make sure he uses a condom.

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